Serum eye drops for the treatment of ocular surface diseases: a systematic review and meta-analysis.
Journal
Blood transfusion = Trasfusione del sangue
ISSN: 2385-2070
Titre abrégé: Blood Transfus
Pays: Italy
ID NLM: 101237479
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
03
04
2019
accepted:
15
05
2019
entrez:
28
6
2019
pubmed:
28
6
2019
medline:
26
12
2019
Statut:
ppublish
Résumé
The use of blood-derived eye drops for topical treatment of ocular surface diseases has progressively increased in recent years. To evaluate the use of serum eye drops in ocular surface disorders, we performed a systematic search of the literature. In this systematic review, we included 19 randomised controlled trials (RCTs) investigating the use of serum eye drops in 729 patients compared to controls. For the quantitative synthesis, we included only 10 RCTs conducted in patients with dry eye syndrome comparing autologous serum to artificial tears. At 2-6 weeks, no clear between-group differences in Schirmer test (MD 1.05; 95% CI: -0.17-2.26) and in fluorescein staining (MD -0.61; 95% CI: -1.50-0.28) were found (very low-quality evidence, down-graded for inconsistency, serious risk of biases, and serious imprecision). Slightly higher increase in tear film break-up time (TBUT) scores in autologous serum compared to control (MD 2.68; 95% CI: 1.33-4.03), and greater decrease in ocular surface disease index (OSDI) in autologous serum compared to control (MD -11.17; 95% CI: -16.58 - -5.77) were found (low quality evidence, down-graded for serious risk of bias, and for inconsistency). For the Schirmer test, fluorescein staining and TBUT, data were also available at additional follow-up timing (2-12 months): no clear between-group differences were found, and the quality of the evidence was graded as low/very-low. In patients with dry eye syndrome, it is unclear whether or not the use of autologous serum compared to artificial tears increases Schirmer test and fluorescein staining scores at short-term and medium-/long-term follow up. Some benefit at short-term follow up for the outcome of TBUT and OSDI was observed, but the quality of the evidence was low.
Sections du résumé
BACKGROUND
The use of blood-derived eye drops for topical treatment of ocular surface diseases has progressively increased in recent years.
MATERIALS AND METHODS
To evaluate the use of serum eye drops in ocular surface disorders, we performed a systematic search of the literature.
RESULTS
In this systematic review, we included 19 randomised controlled trials (RCTs) investigating the use of serum eye drops in 729 patients compared to controls. For the quantitative synthesis, we included only 10 RCTs conducted in patients with dry eye syndrome comparing autologous serum to artificial tears. At 2-6 weeks, no clear between-group differences in Schirmer test (MD 1.05; 95% CI: -0.17-2.26) and in fluorescein staining (MD -0.61; 95% CI: -1.50-0.28) were found (very low-quality evidence, down-graded for inconsistency, serious risk of biases, and serious imprecision). Slightly higher increase in tear film break-up time (TBUT) scores in autologous serum compared to control (MD 2.68; 95% CI: 1.33-4.03), and greater decrease in ocular surface disease index (OSDI) in autologous serum compared to control (MD -11.17; 95% CI: -16.58 - -5.77) were found (low quality evidence, down-graded for serious risk of bias, and for inconsistency). For the Schirmer test, fluorescein staining and TBUT, data were also available at additional follow-up timing (2-12 months): no clear between-group differences were found, and the quality of the evidence was graded as low/very-low.
CONCLUSIONS
In patients with dry eye syndrome, it is unclear whether or not the use of autologous serum compared to artificial tears increases Schirmer test and fluorescein staining scores at short-term and medium-/long-term follow up. Some benefit at short-term follow up for the outcome of TBUT and OSDI was observed, but the quality of the evidence was low.
Identifiants
pubmed: 31246562
pii: 2019.0080-19
doi: 10.2450/2019.0080-19
pmc: PMC6596382
doi:
Substances chimiques
Lubricant Eye Drops
0
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
200-209Références
Control Clin Trials. 1986 Sep;7(3):177-88
pubmed: 3802833
Cochrane Database Syst Rev. 2017 Feb 28;2:CD009327
pubmed: 28245347
Blood Transfus. 2018 May;16(3):221-223
pubmed: 28488970
Blood Transfus. 2018 Nov;16(6):502-513
pubmed: 30201082
Graefes Arch Clin Exp Ophthalmol. 2018 Oct;256(10):1939-1943
pubmed: 30022252
Curr Eye Res. 2012 Aug;37(8):684-8
pubmed: 22670856
Blood Transfus. 2017 Jan;15(1):57-65
pubmed: 27177403
In Vivo. 2016 11-12;30(6):931-938
pubmed: 27815483
Arch Ophthalmol. 1975 Oct;93(10):1039-43
pubmed: 1180750
Br J Ophthalmol. 2015 Jan;99(1):108-12
pubmed: 25138758
Br J Ophthalmol. 2003 Nov;87(11):1312-6
pubmed: 14609821
Eye (Lond). 2017 Nov 17;:
pubmed: 29148532
Acta Ophthalmol. 2015 Dec;93(8):e605-14
pubmed: 25832910
Blood Transfus. 2018 Nov;16(6):473-474
pubmed: 30388071
Chonnam Med J. 2014 Dec;50(3):82-5
pubmed: 25568842
Prog Retin Eye Res. 2000 Jan;19(1):113-29
pubmed: 10614683
J Refract Surg. 2006 Jan-Feb;22(1):61-6
pubmed: 16447938
Cornea. 2012 Sep;31(9):989-93
pubmed: 22759830
Acta Ophthalmol. 2014 Feb;92(1):e22-9
pubmed: 23890196
BMC Med Res Methodol. 2014 Dec 19;14:135
pubmed: 25524443
Transfus Apher Sci. 2016 Feb;54(1):164-7
pubmed: 26847866
Am J Ophthalmol. 2006 Aug;142(2):207-11
pubmed: 16876497
Stat Med. 2002 Aug 15;21(15):2161-73
pubmed: 12210631
Transfus Apher Sci. 2017 Aug;56(4):595-604
pubmed: 28844373
J Ophthalmol. 2015;2015:396410
pubmed: 26504592
Cornea. 2001 Nov;20(8):802-6
pubmed: 11685055
Cont Lens Anterior Eye. 2016 Dec;39(6):425-430
pubmed: 27349951
Br J Ophthalmol. 2016 Jan;100(1):22-7
pubmed: 26178904
N Engl J Med. 2018 Jun 07;378(23):2212-2223
pubmed: 29874529
Blood Transfus. 2018 May;16(3):313-320
pubmed: 28488969
Curr Eye Res. 2017 Jun;42(6):827-831
pubmed: 28139163
Blood Transfus. 2017 Jul;15(4):333-340
pubmed: 27483482
Invest Ophthalmol Vis Sci. 2011 Feb 25;52(2):1087-92
pubmed: 20538982
Graefes Arch Clin Exp Ophthalmol. 2014 Apr;252(4):619-26
pubmed: 24566903
Br J Ophthalmol. 2004 May;88(5):647-52
pubmed: 15090417
Blood Transfus. 2017 Oct;15(6):587-588
pubmed: 27893359
Am J Ophthalmol. 2005 Feb;139(2):242-6
pubmed: 15733983
Cornea. 2015 Sep;34(9):1072-8
pubmed: 26147835
Clin Exp Optom. 2018 Jan;101(1):34-37
pubmed: 28718904
Arthritis Rheum. 1984 Apr;27(4):459-61
pubmed: 6712760
Consult Pharm. 2016 Feb;31(2):96-106
pubmed: 26842687
BMJ. 2008 May 3;336(7651):995-8
pubmed: 18456631
Curr Eye Res. 2013 Jan;38(1):9-17
pubmed: 22928476