Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China.
IHU FOReSIGHT, Paris and Versailles Saint-Quentin-en-Yvelines University, Versailles, France.
Ophthalmic Res. 2020;63(5):443-451. doi: 10.1159/000505630. Epub 2019 Dec 30.
To compare the efficacy of autologous serum (AS) eye drops and artificial tears (AT) in dry eye disease (DED).
Five databases (PubMed, Science Direct, the Cochrane Library, the Chinese National Knowledge Infrastructure, and the Wanfang Database) were searched for randomized controlled trials (RCTs). Efficacy was evaluated in terms of the Ocular Surface Disease Index (OSDI), Schirmer I test, tear break-up time (TBUT), and fluorescein and rose bengal staining of ocular surface. The estimated effects of AS or AT were expressed as a proportion with the 95% confidence interval and plotted on a forest plot.
Seven RCTs with 267 subjects were included in the meta-analysis. For most of the studies, subjects' age was around 50 years old, and the mostly treatment duration was within 8 weeks. The follow-up results showed that the OSDI after AS treatment was lower than that after the AT treatment: the mean difference (MD) was -10.75 (95% CI, -18.12; -3.39) points. There was no difference on the Schirmer I test after treatment between the two groups: the MD was 1.68 (95% CI, -0.65; 4.00) mm. The TBUT of the AS group was longer than that of the AT group, with an MD of 4.53 (95% CI, 2.02; 7.05) s. There was no statistically significant difference on fluorescein staining score of the ocular surface between the AS group and the AT group, the MD was -2.53 (95% CI, -6.08; 1.03) points. The rose bengal staining score of the AS group was slightly lower than that of the AT group after treatment: the MD was -0.78 (95% CI, -1.34; -0.22) points.
AS could be an effective treatment for DED, improving OSDI, TBUT, and rose bengal staining score. Further RCTs with large samples and long-term follow-up are still needed to determine the exact role of AS in the management of DED.
比较自体血清（AS）滴眼液和人工泪液（AT）在干眼症（DED）中的疗效。
检索了五个数据库（PubMed、Science Direct、Cochrane Library、中国知网和万方数据库）中的随机对照试验（RCT）。采用眼表疾病指数（OSDI）、泪液分泌试验（Schirmer I 试验）、泪膜破裂时间（TBUT）和荧光素及孟加拉红染色评估疗效。AS 或 AT 的估计效应用 95%置信区间的比例表示，并绘制在森林图上。
纳入的 7 项 RCT 共 267 例患者。大多数研究中，患者年龄在 50 岁左右，治疗时间多在 8 周以内。随访结果显示，AS 治疗后 OSDI 低于 AT 治疗后：平均差值（MD）为-10.75（95%可信区间，-18.12；-3.39）分。两组治疗后 Schirmer I 试验无差异：MD 为 1.68（95%可信区间，-0.65；4.00）mm。AS 组的 TBUT 长于 AT 组，MD 为 4.53（95%可信区间，2.02；7.05）s。两组治疗后眼表荧光素染色评分无统计学差异，MD 为-2.53（95%可信区间，-6.08；1.03）分。AS 组治疗后孟加拉红染色评分略低于 AT 组：MD 为-0.78（95%可信区间，-1.34；-0.22）分。
AS 可能是治疗 DED 的有效方法，可改善 OSDI、TBUT 和孟加拉红染色评分。仍需要更多大样本量、长期随访的 RCT 来确定 AS 在 DED 管理中的确切作用。
