Gemae Mohamed R, Patil Nikhil S, Yu Caberry W, Agarwal Manokamna, Slomovic Allan R, Chan Clara C
School of Medicine, Queen's University, Kingston, ON.
Department of Ophthalmology and Vision Sciences, University of Alberta, Edmonton, AB, Canada.
Cornea. 2024 Oct 1;44(10):1229-1239. doi: 10.1097/ICO.0000000000003711.
Ocular surface disorders (OSDs) can severely affect vision and quality of life. Autologous blood products, such as plasma rich in growth factors (PRGF), are recently available to treat OSDs refractory to traditional therapies. This review aims to summarize the efficacy and safety of PRGF in OSDs.
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The protocol was established a priori and published on PROSPERO (CRD42024522119). MEDLINE, Embase, and Cochrane Library were searched for primary articles until February 6, 2024. Primary outcomes included slit-lamp examination findings and patient-reported outcomes. Secondary outcomes included visual outcomes and adverse events. Risk of bias was assessed using the Cochrane Risk of Bias and ROBINS-I tools.
Twenty-two studies involving 1158 eyes were included. PRGF showed notable improvement in objective and subjective outcomes in OSDs. Comparative studies did not show PRGF to be superior to a standard steroid taper for dry eye disease. However, the use of PRGF was also reported in persistent epithelial defects and corneal ulcerations. In these conditions, there were high rates of complete healing and reduced corneal staining. PRGF has also been reported to improve ocular surface healing and stability when used as an adjunct to refractive and pterygium surgeries. No serious adverse events were reported.
PRGF has potential as an effective treatment of OSDs resistant to traditional therapies with minimal safety concerns. Large randomized controlled trials are needed to better evaluate the role of PRGF within the treatment armamentarium for corneal pathologies.
眼表疾病（OSD）会严重影响视力和生活质量。自体血液制品，如富含生长因子的血浆（PRGF），近来可用于治疗对传统疗法难治的OSD。本综述旨在总结PRGF治疗OSD的疗效和安全性。
本综述遵循系统评价和Meta分析的首选报告项目指南。方案预先制定并发表于国际前瞻性系统评价注册库（CRD42024522119）。检索MEDLINE、Embase和Cochrane图书馆，查找截至2024年2月6日的原始文章。主要结局包括裂隙灯检查结果和患者报告的结局。次要结局包括视力结局和不良事件。使用Cochrane偏倚风险工具和ROBINS-I工具评估偏倚风险。
纳入22项研究，共1158只眼。PRGF在OSD的客观和主观结局方面显示出显著改善。比较研究未显示PRGF在治疗干眼病方面优于标准的类固醇减量疗法。然而，也有关于PRGF用于持续性上皮缺损和角膜溃疡的报道。在这些情况下，完全愈合率高且角膜染色减少。也有报道称，PRGF作为屈光手术和翼状胬肉手术的辅助手段，可改善眼表愈合和稳定性。未报告严重不良事件。
PRGF有潜力成为治疗对传统疗法耐药的OSD的有效方法，且安全性担忧极小。需要进行大型随机对照试验，以更好地评估PRGF在角膜病变治疗手段中的作用。
