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Ahmad Kheirkhah, Shruti Aggarwal, Bernardo Cavalcanti, Deborah Witkin, Nadia Wong, Monique Trinidad, Candice Williams, Reza Dana, Pedram Hamrah; Autologous Serum Tears May Result in Subclinical Changes in Corneal Immunity: An In Vivo Confocal Microscopy Study. Invest. Ophthalmol. Vis. Sci. 2013;54(15):978.
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To evaluate the effect of autologous serum tears treatment on corneal immune cells including dendritic cell (DC) density with laser in vivo confocal microscopy (IVCM).
This retrospective study included 23 patients who received 20% autologous serum tears (4-8 x/day), were on concurrent anti-inflammatory treatment, and were followed with serial laser IVCM. Only patients were included who did not have any change in anti-inflammatory regimen during the follow-up period. Three IVCM images of one randomly selected eye for each patient were analyzed by two masked observers for DC density. Images were analyzed for baseline, as well as 3 and 6 months after treatment with serum tears, and compared to 23 age-matched control subjects. Student’s t-test and ANOVA were used for analysis.
Nineteen female and 4 males with a mean age of 53.3 ± 18.92 years (range, 19-97 years) were included. The indications for using serum tears were dry eye disease (20 eyes) and keratoneuralgia (3 eyes). At baseline, DC density was significantly higher in patients with dry eye disease (55.8 ± 9.9 cells/mm2, P=0.01), but not in keratoneuralgia (40.3 ± 18.4, P=0.37), compared to the control group (19.1± 3.1). DC density increased from 53.8 ± 8.9 cells/mm2 before treatment, to 103.1 ± 22.4 at 3 months (191% increase, P=0.04) and to 165.1 ± 57.8 at 6 months (307% increase, P=0.06).
Treatment with autologous serum tears may be associated with increased density of corneal epithelial DC in patients with concurrent anti-inflammatory treatment, demonstrating changes in corneal immunity. Additional prospective clinical trials are required to confirm the data and determine clinical implications.
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