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Serum eye drops for the treatment of ocular surface diseases: a systematic review and meta-analysis.

ABSTRACT: 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.

SUBMITTER: Franchini M

PROVIDER: S-EPMC6596382 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Serum eye drops for the treatment of ocular surface diseases: a systematic review and meta-analysis.

Franchini Massimo M Cruciani Mario M Mengoli Carlo C Marano Giuseppe G Capuzzo Enrico E Pati Ilaria I Masiello Francesca F Veropalumbo Eva E Pupella Simonetta S Vaglio Stefania S Liumbruno Giancarlo M GM

Blood transfusion = Trasfusione del sangue 20190501 3

<h4>Background</h4>The use of blood-derived eye drops for topical treatment of ocular surface diseases has progressively increased in recent years.<h4>Materials and methods</h4>To evaluate the use of serum eye drops in ocular surface disorders, we performed a systematic search of the literature.<h4>Results</h4>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, ...[more]

PMID: 31246562

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Project description:PurposeChronic graft versus host disease is a major consequence after allogeneic stem cell transplantation (allo-SCT) and has great impact on patients' morbidity and mortality. Besides the skin, liver, and intestines, the eyes are most commonly affected, manifesting as severe ocular surface disease. Treatment protocols include topical steroids, cyclosporine, tacrolimus, and ASED. Since these patients often receive systemic immunosuppressant therapy from their oncologists, a topical re-administration of these drugs via ASED with potentially beneficial or harmful effects is possible. The purpose of the study was to determine whether and to which extent systemic immunosuppressants are detectable in ASED.MethodsA total of 34 samples of ASED from 16 patients with hemato-oncological malignancies after allo-SCT were collected during the manufacturing process and screened for levels of cyclosporine, mycophenolic acid, everolimus, and tacrolimus via liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). The study followed the tenets of the Declaration of Helsinki and informed consent was obtained from the subjects after explanation of the nature and possible consequences of the study.ResultsCyclosporine was found in 18 ASED samples in concentrations ranging from 6.5-105.0 ng/ml (32.0?±?22.8 ng/ml, mean ± SD). The concentration range of mycophenolic acid in 19 samples was 0.04-25.0 mg/l (4.0?±?5.4 mg/l, mean ± SD). Everolimus and tacrolimus concentrations were well below the respective limits of quantification (<?0.6 and <?0.5 ng/ml) of the established LC-MS/MS method in all samples.ConclusionsOur study suggests that orally administered cyclosporine and mycophenolic acid for the treatment of systemic GvHD, but not everolimus and tacrolimus, are distinctly detectable in ASED in relevant concentrations. It is highly likely that these agents affect topical therapy of ocular GvHD. However, the extent of this effect needs to be evaluated in further studies.

Project description:BackgroundAzithromycin 1% and 1.5% ophthalmic preparations are used widely in clinical practice for the treatment of signs and symptoms of eye diseases. The aim of this study was to render conclusive evidence by comparing the efficacy of azithromycin 1% and 1.5% over tobramycin 0.3% ophthalmic solutions for the treatment of eye diseases in a short duration in terms of bacterial resolution, the cure rate, and resolving clinical sign and symptoms.MethodsSystematic searches were performed in the electronic database (MEDLINE, Embase, Emcare, CINAHL, Scopus, PubMed, ProQuest, and Web of Science) and other sources. Multicenter randomized controlled trial studies conducted in English were identified and screened. Analysis of individual studies was conducted using the OpenMeta-analyst and Review Manager Version 5.3 software.ResultsEleven studies were included in the systematic review and meta-analysis. In clinical cure rate, azithromycin 1% and 1.5% eye drops were more effective than tobramycin 0.3% eye drops in short duration dosing (⩽5 days) with a twice-a-day regimen (relative risk = 1.13; 95% confidence interval: 1.008, 1.28), whereas on increased duration (>5 days), azithromycin is almost similarly as effective as tobramycin (relative risk = 1.007; 95% confidence interval: 0.96, 1.05). There was no significant difference in efficacy of bacterial resolution of azithromycin (1%, 1.5%) eye drops compared to tobramycin (0.3%) eye drops (relative risk = 0.99; 95% confidence interval: 0.96, 1.018). Azithromycin eye drops are effective in improving the signs and symptoms of eye disease.ConclusionAzithromycin 1% or 1.5% is more effective in the clinical cure rate of eye disease than tobramycin 0.3% eye drops in ⩽5 days of treatment. It is also the best choice of treatment for improving the signs and symptoms of eye disease. So that we recommend clinicians to use azithromycin 1% or 1.5% eye drops.Systematic review registrationPROSPERO 2019 CRD42019139911.

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Serum eye drops for the treatment of ocular surface diseases: a systematic review and meta-analysis.

Publications

Serum eye drops for the treatment of ocular surface diseases: a systematic review and meta-analysis.

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