Comparative Benefit of Two Concentrations of Autologous Serum Eyedrops in Patients wtih Ocular Surface Disease Associated to Topical Preserved Glaucoma Therapy

Abstract

Purpose : Ocular surface disease (OSD) is a defying condition affecting patients under preserved topical glaucoma therapy. Even when the safety and effectiveness of both short-term and long-term use of autologous serum (AS) eyedrops has been studied in a myriad of diseases affecting the ocular surface, there is scarce information regarding AS benefit on OSD derived from preserved topical glaucoma therapy. The aim of this study is to compare effectiveness and safety AS eyedrops (comparing 30%AS vs 50%AS concentrations) in glaucoma patients with severe/persistent OSD using topical hypotensive treatment.

Methods : A retrospective assessment of all consecutive patients under glaucoma treatment in a specialized center was performed. A total of 396 patients with severe OSD under glaucoma treatment were ideintified. Twenty-nine cases had AS eyedrops in concentrations 30%AS and 50%AS, As well as other treatment regimes. Variables included BCVA, TBUT, ocular surface staining (OSS) percentage, presence of Meibomian gland dysfunction and ocular-surface disease index (OSDI). A p value ≤ 0.05 was considered as statistically significant.

Results : Fifty-eight eyes from 29 patients were included in the study (22 females, 7 males) had a mean age of 67.0±16.1 years. According to AS concentration, 56% of the eyes were treated with a 30%AS and 44% witha 50%AS. Mean time of preserved topical treatment was 1.6±1.0 years. Baseline IOP (RE, 19.2±5.9 mmHg; LE, 19.1±8.8 mmHg) was not different as compared to the measurements at the last visit (RE, 18.9±6.1 mmHg; LE, 19.4±7.3 mmHg; p≥0.05). Mean time of AS administration (RE, 8.9±7.5 weeks; LE, 9.7±8.3 weeks; p=0.5). Overall, a comparative improvement was significant in regards of BCVA (RE, p=0.001; LE, p=0.007), OSS (RE, p=0.045; LE, p=0.035), OSDI (RE, p=0.04; LE, p=0.03). No significant change was demonstrated in TBUT (RE, p=0.12; LE, p=0.08). Comparative success rate between groups are not significantly different (30%AS, 84%; 50%AS, 86%). One non-infectious ulcer was present in the group treated with 30%AS eyedrops but it healed without further complication.

Conclusions : Current study results suggest that ASE of either concentration is effective and safe for treating severe ocular surface diseases caused by glaucoma eyedrops containing preservatives.

This is a 2021 ARVO Annual Meeting abstract.