Abstract
Purpose :
This retrospective study describes symptoms and signs of ocular surface disease in patients receiving autologous serum tears (AST) treatment for refractory ocular surface disorders.
Methods :
Charts of 48 patients receiving orders for AST compounded at Mayo Clinic in Arizona from June 1, 2018 through June 30, 2019 were examined. The patient population in this study comprised 33 females and 15 males, and their mean age was 62.875. The mean length of follow-up was 17.13 months, with a range of 2 months to 55 months. For objective and subjective measures of AST efficacy, respectively, presence and degree of punctate epithelial erosions for patients (graded from 0-2) on exam, and values from the Ocular Surface Disease Index and SPEED II Questionnaire just before AST usage were compared to those at most recent follow-up. AST dilutions, adverse events, frequencies of shared conditions and indications for use were also recorded.
Results :
Of 48 patients using AST, 47.9% (23/48) demonstrated improvement with AST usage over follow-up, as measured by either subjective or objective outcome measures. Five patients showed worsening of symptoms, six showed no change in objective measures, and two showed improvement in either objective or subjective measures but worsening in the other. Four adverse events were recorded, with two patients experiencing burning with AST usage and two experiencing symptom exacerbation. In regards to serum percentage in AST preparation, 89.6% (43/48) of our patient population used AST at 20% dilution; 10.4% (5/48) either used AST at 50% dilution throughout follow-up, or started with 20% dilution and then used 50% dilution for the majority of the follow-up period. The most common shared condition was ocular graft-versus-host disease (GVHD) (31.3%, 15/48), followed by ocular rosacea (25.0%, 12/48), and dry eye disease with meibomian gland dysfunction (14.6%, 7/48). The predominant indication for usage was keratoconjunctivitis sicca (87.5%, 42/48); corneal ulcers (10.4%, 5/48) and neuropathic eye pain (2.1%, 1/48) were much less frequent indications.
Conclusions :
The American Academy of Ophthalmology Ophthalmic Technology Assessment found AST to be safe and effective for ocular surface disease in 2019. AST results confirm efficacy without severe adverse effects in alleviation of refractory ocular surface disorders including ocular GVHD.
This is a 2020 ARVO Annual Meeting abstract.