Abstract
Purpose :
Severe dry eye remains difficult to treat in a proportion of patients, and is recognized to cause significant visual impairment and alter quality of life.We performed a prospective interventional study to evaluate the efficacy of autologous blood eye drops in patients diagnosed with severe dry eye and ocular surface disease who were unresponsive to conventional therapy.
Methods :
19 patients attending the Hospital Eye Service at University Hospital Hairmyres, Scotland, were recruited. All had a diagnosis of severe non-resolving dry eye and ocular surface disease, which had been unresponsive to conservative treatment.
All patients were instructed on the use of autologous blood drops four times a day with the direct application of a fingerprick of their own blood directly into their eye. Informed consent was obtained at the initial assessment.
Slit lamp examination was performed at baseline and repeated at follow-up intervals.The primary outcome measure was the ocular surface staining score using the Oxford Grading Scheme.Tear film break-up time, Schirmer's test without anaesthetic, and visual acuity were also recorded. Patients' subjective symptoms were collected using a questionnaire (ocular surface disease index [OSDI] quality of life score) at each visit. A digital photograph of the cornea was also taken at each visit.
Follow–up consultations were completed at one, three and six months. A two-tailed paired student t-test was used to analyze outcome measures at the different time gates.
Results :
There was a significant improvement in the ocular surface staining score at all time gates. Mean score at presentation was 2.13 and this improved to 1.50 at one month (p<0.001), 1.29 at three months (p<0.01), and 1.42 at six months (p<0.01). There was an improvement in tear break up time from 4.75s at baseline to 6.79s at three months (p<0.01) and 7.0s at six months (p<0.001). An improvement in the Schirmer’s test was only found at six months with an improvement from 3.67mm to 13.33mm (p<0.05).
There was no statistical change in visual acuity at any time gate. While not statistically significant, 83% of patients reported an improvement in their OSDI quality of life score at six months.
There were no adverse events reported.
Conclusions :
Autologous blood eye drops are an effective and safe therapy for the treatment of recalcitrant cases of severe dry eye and ocular surface disease that are unresponsive to conventional therapy.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.