Than J, Balal S, Wawrzynski J, Nesaratnam N, Saleh G M, Moore J, Patel A, Shah S, Sharma B, Kumar B, Smith J, Sharma A
Moorfields Eye Centre at Bedford Hospital, Bedford, UK.
The Royal Victoria Hospital, Belfast, UK.
Eye (Lond). 2017 Dec;31(12):1655-1663. doi: 10.1038/eye.2017.118. Epub 2017 Jun 16.
PurposeDry eye syndrome (DES) causes significant morbidity. Trials of blood-derived products in treatment of the condition show promising results. However, their production is expensive and time-consuming. We investigate fingerprick autologous blood (FAB) as an alternative low-cost, readily accessible treatment for DES.Patients and methodsProspective, non-comparative, interventional case series. In total, 29 eyes of 16 DES patients (2 males and 14 females) from two NHS sites in the United Kingdom. Patients instructed to clean a finger, prick with a blood lancet, and apply a drop of blood to the lower fornix of the affected eye(s), 4 times daily for 8 weeks then stop and review 4 weeks later. Follow-up visits occurred ~3 days, 2, 4, 8 weeks into therapy, and 4 weeks post-cessation. At each visit, visual acuity, corneal staining, Schirmer's test, tear break-up time (TBUT), and ocular comfort index (OCI) were measured, and photographs taken. Results were analysed using Student's paired t-test.ResultsAt 8 weeks, there was improvement in mean Oxford corneal staining grade (3.31 to 2.07 (P<0.0001)), TBUT (5.00 to 7.80 s (P<0.05)), visual acuity (0.08 to 0.01 LogMAR equivalent (P<0.05)), and OCI score (56.03 to 39.72 (P<0.0001)). There was no statistically significant change in Schirmer's test results. Four weeks post-cessation versus immediately after completion of FAB therapy, mean staining grade worsened from 2.07 to 2.86 (P<0.0001). OCI score worsened from 39.72 to 44.67 (P<0.05).ConclusionsIn our limited case series FAB appears to be a safe and effective treatment for DES.
目的
干眼症(DES)会导致严重的发病率。血液衍生产品治疗该病症的试验显示出有前景的结果。然而,它们的生产昂贵且耗时。我们研究手指采血自体血(FAB)作为一种替代的低成本、易于获取的DES治疗方法。
患者与方法
前瞻性、非对照、干预性病例系列。来自英国两个国民保健服务(NHS)机构的16名DES患者(2名男性和14名女性)的29只眼睛。患者被指示清洁手指,用采血针采血,并将一滴血滴入患眼的下穹窿,每天4次,持续8周,然后停止并在4周后复查。随访在治疗开始后约3天、2周、4周、8周以及停止治疗后4周进行。每次随访时,测量视力、角膜染色、泪液分泌试验、泪膜破裂时间(TBUT)和眼部舒适度指数(OCI),并拍照。结果采用配对t检验进行分析。
结果
在8周时,牛津角膜染色平均等级有所改善(从3.31降至2.07(P<0.0001)),TBUT(从5.00秒增至7.80秒(P<0.05)),视力(从0.08降至等效的0.01 LogMAR(P<0.05)),以及OCI评分(从56.03降至39.72(P<0.000))。泪液分泌试验结果无统计学显著变化。与FAB治疗刚结束时相比,停止治疗4周后,平均染色等级从2.07恶化至2.86(P<0.0001)。OCI评分从39.72恶化至44.67(P<0.05)。
结论
在我们有限的病例系列中,FAB似乎是一种安全有效的DES治疗方法。