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M. Preciado, L. Arellanes–García; Efficacy of Autologous Serum as an Adjuvant in the Treatment of Peripheral Ulcerative Keratitis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3583.
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To determinate the efficacy of autologous serum drops (ASD) as an adjuvant in the treatment of patients with peripheral ulcerative keratitis (PUK).
We included patients with autoimmune PUK. All patients were treated with systemic immunosuppressors and showed no improvement. All patients received treatment with ASD at 50% quid. Minimum follow–up time was 3 months. Demographic variables, associated systemic disease, eye examination and response to the treatment were evaluated.
Three women and two men were included. Average age was 41 ± 6.3 years. Wegener’s granulomatosis (WG) was diagnosed in two patients, rheumatoid arthritis (RA) in two and one was diagnosed with Stevens – Johnson syndrome (SJS). All the patients had systemic immunosuppression therapy with prednisone (1 mg/Kg/day). The patients with WG had additional therapy with cyclofosfamide (100 mg/day) and the patients with AR received metotrexate (10 – 12.5 mg/week). Mean time of ASD treatment was 3.2 ± 0.9 months. A conjunctival overgrowth covering the ulcerated area was observed, in 6 weeks in three patients; two of them had AR and the other one had WG. A corneal re–epithelization was observed in the patient with SJS in 8 weeks. Only one patient with WG developed a corneal perforation underneath the conjunctival overgrowth at week 8.
ASD may be an adjuvant in the treatment of PUK. It seems to promote ulcer healing stimulating, and in some cases, a conjunctival overgrowth. ASD may be helpful in autoimmune PUK cases unresponsive to systemic immunosuppressive therapy.
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