Zhang Yu, Li Ning, Ge Ziying, Li Fang
Department of Ophthalmology, Zhangye People's Hospital Affiliated to Hexi University, Zhangye, China.
Front Med (Lausanne). 2024 Dec 16;11:1500160. doi: 10.3389/fmed.2024.1500160. eCollection 2024.
Blood component therapy has shown promising potential as an emerging treatment for dry eye disease; however, it remains unclear which specific blood component is the most effective. This study aims to compare the efficacy of different blood components in the treatment of dry eye disease through a network meta-analysis, with the goal of providing the latest and most reliable evidence for clinical practice.
We conducted a systematic search of the PubMed, Web of Science, Cochrane, Embase, and Scopus databases, with the search concluding on June 1, 2024. Two independent researchers performed literature screening, data extraction, and quality assessment.
A total of 16 randomized controlled trials (RCTs) involving 898 patients with dry eye disease were included. Six different blood components were utilized in treating dry eye disease, with platelet-rich plasma (PRP) being the most widely used. The results of the network meta-analysis indicated that platelet-rich plasma eye drops (PRPD) significantly outperformed artificial tears (AT) in improving the corneal fluorescein staining score (CFSS), while autologous serum (ALS) and umbilical cord serum (UCS) also demonstrated significantly better effects than AT in enhancing tear break-up time (TBUT). Additionally, ALS, PRP injection (PRPI), and PRPD showed significantly superior outcomes compared to AT in improving the ocular surface disease index (OSDI). However, no statistically significant differences were found among the various treatment modalities regarding their effects on Schirmer's I value, CFSS, TBUT, and OSDI. SUCRA analysis predicted that UCS was the most effective in improving Schirmer's I value and TBUT, while PRP excelled in enhancing CFSS and OSDI. Limitations such as publication bias and issues related to randomization, allocation concealment, and blinding may affect the reliability of the current findings.
Blood component therapy can significantly improve the pathological damage and ocular surface health in patients with dry eye disease. For those with aqueous-deficient dry eye, UCS may represent the optimal treatment option. In contrast, for patients with more severe corneal epithelial damage, PRP may offer a more effective therapeutic approach.
https://www.crd.york.ac.uk/PROSPERO/, CRD42024534091.
血液成分疗法作为一种新兴的干眼症治疗方法已显示出有前景的潜力；然而，哪种特定的血液成分最有效仍不清楚。本研究旨在通过网络荟萃分析比较不同血液成分治疗干眼症的疗效，为临床实践提供最新、最可靠的证据。
我们对PubMed、Web of Science、Cochrane、Embase和Scopus数据库进行了系统检索，检索于2024年6月1日结束。两名独立研究人员进行文献筛选、数据提取和质量评估。
共纳入16项涉及898例干眼症患者的随机对照试验（RCT）。六种不同的血液成分被用于治疗干眼症，其中富含血小板血浆（PRP）使用最为广泛。网络荟萃分析结果表明，富含血小板血浆滴眼液（PRPD）在改善角膜荧光素染色评分（CFSS）方面显著优于人工泪液（AT），而自体血清（ALS）和脐带血清（UCS）在延长泪膜破裂时间（TBUT）方面也显示出比AT明显更好的效果。此外，在改善眼表疾病指数（OSDI）方面，ALS、PRP注射（PRPI）和PRPD显示出比AT明显更优的结果。然而，在各种治疗方式对泪液分泌试验I值、CFSS、TBUT和OSDI的影响方面，未发现统计学上的显著差异。累积排序曲线下面积（SUCRA）分析预测，UCS在改善泪液分泌试验I值和TBUT方面最有效，而PRP在提高CFSS和OSDI方面表现出色。诸如发表偏倚以及与随机化、分配隐藏和盲法相关的问题等局限性可能会影响当前研究结果的可靠性。
血液成分疗法可显著改善干眼症患者的病理损伤和眼表健康。对于水样液缺乏性干眼症患者，UCS可能是最佳治疗选择。相比之下，对于角膜上皮损伤较严重的患者，PRP可能提供更有效的治疗方法。
