Sanchez-Avila Ronald Mauricio, Merayo-Lloves Jesus, Riestra Ana Cristina, Fernandez-Vega Cueto Luis, Anitua Eduardo, Begoña Leire, Muruzabal Francisco, Orive Gorka
Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, Spain.
Moorfields Eye Hospital, London, UK.
Int Ophthalmol. 2018 Jun;38(3):1193-1204. doi: 10.1007/s10792-017-0582-7. Epub 2017 Jun 15.
To provide preliminary data about efficacy and safety of plasma rich in growth factors (PRGF) eye-drops in neurotrophic keratitis (NK) and to analyze the possible influence of certain variables on treatment outcomes.
This retrospective study included patients with stages 2-3 of NK treated with PRGF eye-drops. Primary endpoint was the resolution time of corneal ulcer defect. Outcome measures including percentage of ulcer closure at 4 weeks, Ocular Surface Disease Index (OSDI), Best-Corrected Visual Acuity (BCVA) and Visual Analogue Scale (VAS) were also evaluated before and after treatment with PRGF. The influence of some patients' clinical variables on results was assessed. Safety assessment was also performed reporting all adverse events.
Thirty-eight treated eyes in a total of thirty-one patients were evaluated, of which five cases had no prior response to autologous serum treatment. Most cases (97.4%) achieved the complete resolution of corneal defect/ulcer. Mean resolution time was 11.4 weeks (SD = 13.7). A statistical significant (p < 0.05) reduction in OSDI (60.9%), VAS frequency (59.9%), VAS severity (57.0%) and improvement in BCVA (52.8%) was observed. The results were stratified according to the pathology stage and to the identified potential effect modifiers variables. Only one adverse event was reported in one patient (2.6%).
PRGF eye-drops could be a safe and effective therapeutic option for patients with stages 2-3 of NK, showing high rates of corneal defect/ulcer resolution in short times, either in reducing signs and symptoms of NK, and therefore preventing the progression of NK to greater ocular complications.
提供富含生长因子血浆(PRGF)滴眼液治疗神经营养性角膜炎(NK)的疗效和安全性的初步数据,并分析某些变量对治疗结果的可能影响。
这项回顾性研究纳入了接受PRGF滴眼液治疗的2-3期NK患者。主要终点是角膜溃疡缺损的愈合时间。还在PRGF治疗前后评估了包括4周时溃疡闭合百分比、眼表疾病指数(OSDI)、最佳矫正视力(BCVA)和视觉模拟量表(VAS)在内的结果指标。评估了一些患者临床变量对结果的影响。还进行了安全性评估,报告了所有不良事件。
共评估了31例患者的38只治疗眼,其中5例先前对自体血清治疗无反应。大多数病例(97.4%)实现了角膜缺损/溃疡的完全愈合。平均愈合时间为11.4周(标准差=13.7)。观察到OSDI(60.9%)、VAS频率(59.9%)、VAS严重程度(57.0%)有统计学显著降低(p<0.05),BCVA有改善(52.8%)。结果根据病理阶段和确定的潜在效应修饰变量进行分层。仅1例患者报告了1例不良事件(2.6%)。
PRGF滴眼液可能是2-3期NK患者安全有效的治疗选择,在短时间内角膜缺损/溃疡愈合率高,既能减轻NK的体征和症状,又能预防NK进展为更严重的眼部并发症。