Abstract
Purpose :
To evaluate the efficacy of human umbilical cord blood serum(UCBS) in a comparative model of ocular surface disorders(OSD),for quantitative assessment of surface restoration& to identify the overall best predictor of improvement.Study tested the hypothesis that UCBS being an inflammatory modulator possesses the potential for restoration of ocular surface in common OSD
Methods :
This prospective randomized controlled study was conducted on 101 patients of OSD comprising of 40 dry eye disease(DED); 21 acute chemical burns(ACB)& 40 ocular allergy(OA) randomized into two groups.Group I(control) was administered autologous serum(AS)& group II(test) was given UCBS. Primary and secondary outcome measures were evaluated in between groups.Primary outcome-improvement in visual acuity(VA), time for reepithelisation, objective improvement in terms of Schirmer test, Fluorescein tear breakup time (FTBUT),corneal clarity and corneal fluorescein staining (CFS) score.Secondary outcome -Subjective improvement concerning eye sensation score(ESS), ocular surface disease index(OSDI) and persistence /intermittence of symptoms.Wilcoxon signed ranked,Kruskal Wallis and chi-square tests with P≤0.05 was considered significant.Patients were followed up on day7, month(M)1 and M 3.
Results :
In DED, group II showed significant improvement in VA(0.22 ± 0.04) at day7,ESS at Day 7,OSDI(20.2 ± 4) at 1M,TBUT(12.6 ± 0.4) at 3M & CFS score at 3M(p<0.05).In ACB, group II showed significant improvement in VA(0.2 ± 0.0) at 3M,re-epithelisation(0.0 ± 0.00)at 3M, percentage decrease in limbal ischemia(11.8±1) at 3M & corneal clarity at 3M(p<0.05).In OA, group II showed significant improvement in VA(0.06±0.02) at 1M and ESS on day 7(Fig 1).Overall best predictor of improvement in DED was ESS(P-0.013) followed by VA & OSDI with percentage improvement of 33% & 50% respectively within 7 days(P-.005) .In ACB & OA it was ESS(P-0.02)& response to severity (P-0.02) respectively.
Conclusions :
Our results are consistent with the hypothesis that UCBS is more effective than AS eye drops in ocular surface restoration owing to a significant concentration of growth factors. This study for the first time established the role of UCBS in patients of ocular allergies.UCBS can be used for long term therapy with minimal toxicity unlike other agents of medical management in OSD .
This is a 2020 ARVO Annual Meeting abstract.