Soni NG, Jeng BH.
University of Maryland School of Medicine, Baltimore, MD, USA.
Br J Ophthalmol 2016;100:22–7.
Scott Robbie’s review: The use of blood-derived therapies for ocular surface disease was first described in 1975 (Arch Ophthalmol 1975;93:1039–43). In this review article, the authors focus on the latest evidence for their use in the treatment of Sjogren’s syndrome-related dry eye disease (DED) and persistent epithelial defects, although they have also been tried in recurrent epithelial erosion syndrome, chemical injury, and superior limbic keratoconjunctivitis.
The consistency and appearance of autologous serum eye drops is difficult to replicate, so adequate masking of placebos can be problematic in clinical trials. Nevertheless, the authors cite the results of six randomized controlled trials, some with a crossover design, that suggest the drops are effective, even as early as 2 weeks after commencement. Outcome measures for these trials included tear break-up time, conjunctival impression cytology, and Ocular Surface Disease Index scoring. Similarly, autologous serum eye drops have been demonstrated to be effective in facilitating the healing of persistent epithelial defects – which were previously aggressively managed – within 1month of starting treatment. Although etiologies vary, the more established the persistent epithelial defect, the longer it takes to heal. A success rate of approximately 60% seems to be typical of these small studies and case series.