Ophtalmology Department, CHU Timone, AP-HM, Marseille, France.
Ophtalmology Department, CHU Timone, AP-HM, Marseille, France; Equipe DiMABio, Université d'Aix-Marseille, Institut Fresnel, Faculté des Sciences de Saint-Jérôme, Avenue Escadrille Normandie-Niemen, 13397, Marseille, Cedex, France.
Ocul Surf. 2019 Oct;17(4):787-792. doi: 10.1016/j.jtos.2019.05.003. Epub 2019 May 16.
Autologous serum eye drops (ASEDs) are used worldwide to treat dry eye disease (DED). However, the biological composition of ASEDs has not been well investigated, and effectiveness predictive factors remain to be identified. The main objective of this study was to compare the response of patients treated with ASEDs biologically characterized and used for DED routine care.
This retrospective observational study was conducted in a single university hospital, and included 50 patients (87 eyes) with DED refractory to conventional treatment and resulting from various etiologies with Ocular Surface Disease Index (OSDI) ≥ 20. Each patient used eight drops a day per treated eye with 20% diluted ASEDs. Undiluted serum extensive biological characterizations were performed, and symptoms were recorded before the initiation of ASEDs and closer to the sixth month of treatment. Responders were defined as presenting an improvement from baseline ≥14 points in OSDI and/or ≥1 grade in corneal fluorescence staining for all eyes treated.
The OSDI and the Oxford scale were significantly reduced from 68.7 ± 23.2 to 54.8 ± 25.7 and 3.2 ± 1.5 to 2.1 ± 1.3 (p ≤ 0.0001), respectively. A total of 68% of the patients were responders. Nonresponding patients had significantly higher epidermal growth factor concentrations in the serum compared to responders (p = 0.017).
ASED administration resulted in significant clinical improvement in the management of DED. Biological differences observed between responders and nonresponders suggested that a better understanding of the biological activity of ASEDs is still required.
自体血清滴眼液(ASED)已在全球范围内用于治疗干眼症(DED)。然而,ASED 的生物学成分尚未得到充分研究,其有效性预测因素仍有待确定。本研究的主要目的是比较使用生物学特征进行分类并用于 DED 常规护理的 ASED 治疗的患者的反应。
这是一项在单所大学附属医院进行的回顾性观察性研究,共纳入 50 名(87 只眼)DED 患者,这些患者对常规治疗有反应,且病因各异,眼表面疾病指数(OSDI)≥20。每位患者每天使用每只治疗眼 8 滴 20%稀释的 ASED。对未稀释的血清进行了广泛的生物学特征分析,并在开始使用 ASED 前以及治疗接近 6 个月时记录症状。所有治疗眼的 OSDI 改善≥14 分和/或角膜荧光染色改善≥1 级的患者定义为有反应者。
OSDI 和牛津量表分别从 68.7±23.2 显著降低至 54.8±25.7 和 3.2±1.5 至 2.1±1.3(p≤0.0001)。共有 68%的患者为有反应者。无反应者的血清中表皮生长因子浓度明显高于有反应者(p=0.017)。
ASED 的使用可显著改善 DED 的治疗效果。在有反应者和无反应者之间观察到的生物学差异表明,仍需要更好地了解 ASED 的生物学活性。