Abstract
Purpose:
To evaluate the effectiveness of autologous serum tears for treatment of severe dry eye syndrome (DES) in patients with Graft Versus Host Disease (GVHD).
Methods:
Retrospective review of 30 eyes of 15 patients with GVHD and severe DES was performed at baseline and after initiating treatment with autologous serum tears. Severity of ocular surface disease was evaluated using the Schirmer test, fluorescein staining and Ocular Surface Disease Index (OSDI). Paired t-tests were performed to compare baseline assessment to post-treatment scores.
Results:
The study population included 15 total patients, 7 female and 8 male; the average age was 54 years (s.d =9, range 40-67). Follow-up duration averaged 11 months (range 1-40), and 60% were concurrently using the Prosthetic Replacement of Ocular Surface Environment (PROSE) lens. Patients had an average of 3 blood draws (s.d.=2, range: 1-8) for serum tears in this time period. There was a statistically-significant improvement in OSDI scores at 1 month and final time-points compared to pre-treatment (baseline: 59.7 +/- 27.0; 1 month: 42.5 +/- 22.1, p=0.03; 3 month: 49.5 +/-37.0, p=0.07; final: 40.1 +/- 26.7, p=<0.001). Schirmer score significantly improved at 1 month compared to pre-treatment (baseline: 2.6 +/- 3.1; 1 month: 5.0 +/-4.0, p=0.01). Schirmer scores did not significantly differ at 3 month and final time points (3 month: 4.7 +/-5.9; final: 4.6 +/- 6.5). Fluorescein staining score did not significantly differ from pre-treatment at any time points (baseline: 2.3 +/- 1.1; 1 month: 2.5 +/- 1.5; 3 month: 1.2 +/- 1.5; final: 1.9 +/- 1.3).
Conclusions:
Autologous serum tears are an effective treatment for DES in patients with GVHD. Additional studies are needed to compare the effectiveness of autologous serum tears to other treatments for patients with severe DES from GVHD.
Keywords: 486 cornea: tears/tear film/dry eye •
482 cornea: epithelium •
479 cornea: clinical science