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I. Fregona, A. Leonardi, D. Violato, S. Miotto, M. Calore, E. Midena; Autologous Serum Eyedrops in Severe Dry Eye Syndrome: Tear Function, Conjuntival Cytology and Corneal Confocal Microscopy Investigations. Invest. Ophthalmol. Vis. Sci. 2008;49(13):103.
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To investigate tear function, conjunctival impression citology and corneal confocal microscopy in patients treated with autologous serum eye drops for severe dry eye syndrome (DES).
46 patients, non-responders to conventional eye lubricants, referred from March to September 2007 for severe DES, were treated with autologous serum eye drops (50% in BSS), 4 to 8 times a day. DES was associated to: graft vs. host disease (GVHD) in 10 patients, Sjogren syndrome in 10, neurotrophic keratitis in 12, post-LASIK treatment in 5, and in 9 patients without any other local or systemic disease. Symptoms score (Ocular Surface Disease Index -OSDI questionnaire), Shirmer test, fluorescein and lissamine green staining, tear-film break-up time (BUT), conjunctival impression cytology and corneal confocal microscopy (Confoscan 4, Nidek Technologies, Italy) were performed at baseline and after 3 months of treatment.
No side effects were observed. At three months, all patients reported a considerable subjective relief of symptoms (OSDI) compared to baseline (P<0.001). Fluorescein and lissamine green staining (P<0.025), Shirmer test and BUT (P<0.05) and conjunctival impression cytology score (P<0.01) significantly improved. Nerve and corneal epithelial cell morphology improved after treatment.
Autologous serum was found effective in the treatment of primary or secondary severe dry eye syndrome, improving ocular surface morphology, tear film function and ocular discomfort. Corneal confocal microscopy is an objective diagnostic technique useful to monitor ocular surface and tear film disorders.
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