自体血清滴眼液治疗青光眼手术后伴角结膜干细胞缺乏症

Autologous Serum Eye Drops in the Management of Limbal Stem Cell Deficiency Associated With Glaucoma Surgery.

机构信息

Stein Eye Institute (D.N., C.B., B.L., S.X.D.), David Geffen School of Medicine at UCLA, Los Angeles, CA; Department of Ophthalmology (D.N.), Banphaeo General Hospital, Samut Sakhon, Thailand; Cornea Department (C.B.), Cochin Hospital, AP-HP, Paris University, Paris, France; Department of Tropical Hygiene (L.T.), Faculty of Tropical Medicine, Mahidol University, Thailand; Drexel University College of Medicine (B.L.)Molecular Biology Institute (S.X.D.), University of California, Los Angeles.

出版信息

Eye Contact Lens. 2023 Jan 1;49(1):19-24. doi: 10.1097/ICL.0000000000000951. Epub 2022 Nov 2.

DOI:10.1097/ICL.0000000000000951

PMID:36322388

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9789170/

Abstract

PURPOSE

To evaluate safety and efficacy of autologous serum eye drops (AS) in the treatment of limbal stem cell deficiency (LSCD) associated with glaucoma surgery.

METHODS

Retrospective case series of eyes with glaucoma surgery-induced LSCD treated with AS. Diagnosis of LSCD was confirmed by anterior segment optical coherence tomography, in vivo confocal microscopy, and/or impression cytology. Limbal stem cell deficiency severity was staged using a clinical scoring system (2-10 points). Outcome measures were changes (≥2 points) of the LSCD score and best-corrected visual acuity (BCVA) from the baseline to the last follow-up.

RESULTS

Thirteen eyes of 12 consecutive patients treated with 50% AS for at least 3 months were included. The mean age was 78.9±7.5 years and the mean duration of AS use was 20.9±16.8 months. Indications of AS included LSCD progression in eight eyes (61.5%) and visual axis threatening in five eyes (38.5%). The mean LSCD score at baseline (6.7±1.6) was similar to that at last follow-up (6.5±2.2, P =0.625). Two eyes (15.4%) showed improvement, nine eyes (69.2%) were stable, and two eyes (15.4%) worsened. The mean baseline BCVA (0.89±0.64 logMAR) was similar to the mean final BCVA (1.05±0.63 logMAR, P =0.173). There were no serious adverse complications related to AS.

CONCLUSION

AS appears to be well tolerated and may stabilize the progression of LSCD with limited effects. A larger study is necessary to confirm the findings.

摘要

目的

评估自体血清滴眼液（AS）治疗青光眼手术后角膜缘干细胞缺乏症（LSCD）的安全性和疗效。

方法

回顾性病例系列研究，纳入接受 AS 治疗的青光眼手术后 LSCD 患者。LSCD 的诊断通过眼前节光学相干断层扫描、活体共聚焦显微镜和/或印迹细胞学证实。使用临床评分系统（2-10 分）对 LSCD 严重程度进行分期。主要观察指标为 LSCD 评分和最佳矫正视力（BCVA）从基线到最后一次随访的变化（≥2 分）。

结果

纳入 12 例患者的 13 只眼，均接受至少 3 个月的 50%AS 治疗。平均年龄为 78.9±7.5 岁，AS 使用时间平均为 20.9±16.8 个月。AS 的适应证包括 8 只眼（61.5%）的 LSCD 进展和 5 只眼（38.5%）的视轴威胁。基线时 LSCD 评分（6.7±1.6）与最后一次随访时（6.5±2.2，P=0.625）相似。2 只眼（15.4%）好转，9 只眼（69.2%）稳定，2 只眼（15.4%）恶化。基线时平均 BCVA（0.89±0.64 logMAR）与最终平均 BCVA（1.05±0.63 logMAR，P=0.173）相似。AS 无严重不良反应。