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Purpose: Platelet-rich plasma (PRP) harbors high concentrations of growth factors related to the promotion of wound healing. We evaluated the efficacy of PRP eyedrops in the treatment of persistent epithelial defects (PEDs). Methods: Autologous PRP and autologous serum (AS) were prepared from whole blood. The concentrations of transforming growth factor (TGF)-β1, TGF-β2, epidermal growth factor (EGF), vitamin A and fibronectin in the PRP and AS were analyzed and compared. The corneal epithelial healing efficacy of PRP was compared with that of AS in patients with PED induced by post-infectious inflammation. Results: The concentrations of TGF-β1, TGF-β2, EGF, vitamin A and fibronectin in the PRP and AS were not statistically different. However, the concentrations of EGF in the PRP were significantly greater than in the AS. AS was used in 17 and PRP in 11 eyes of 28 patients. The healing rates of the corneal epithelia of the PRP-treated eyes were significantly higher than those treated with AS. Conclusions: The PRP was effective in the treatment of PEDs. This may be attributable to its high concentration of platelet-contained growth factors, most notably EGF. PRP could be an effective, novel treatment option for chronic ocular surface disease. [ABSTRACT FROM AUTHOR]

For the past 30 years, I have worked as a physician-scientist in both the clinic and laboratory setting at a number of university medical schools. Encountering patients in the clinic for whom treatment was not available led me to the laboratory in an attempt to develop the appropriate treatment for future patients. The main focus of my translational research has been the role of fibronectin in corneal epithelial wound healing and the development of fibronectin eyedrops for the treatment of patients with persistent corneal epithelial defects. An extension of this research led to the development of eyedrops containing the synthetic peptide proline-histidine-serine-arginine-asparagine (PHSRN), which corresponds to the second cell-binding site of fibronectin. My clinical experience with fibronectin eyedrops also prompted me to examine the role of the sensory neurotransmitter substance P and insulin-like growth factor-1 (IGF-1) in corneal wound healing, leading to the development of eyedrops containing peptides derived from these agents (peptides FGLM-amide and SSSR, respectively). Although the path from the laboratory to the clinic in these instances has been relatively short, the time required to establish the newly identified treatment modalities in the wider community has been long. In this review, I relate the trajectory of my translational research career. [ABSTRACT FROM AUTHOR]

Background/aims: To determine the possible roles of impaired corneal sensitivity and reduced tear secretion in various types of corneal epithelial disorders. Methods: A total of 99 patients (179 eyes) with corneal epithelial disorders classified as persistent epithelial defects (PED), corneal erosion, or superficial punctate keratopathy (SPK) and 115 individuals (230 eyes) without apparent ocular surface disorders (controls) were enrolled in a prospective study. Corneal sensitivity was measured with a Cochet-Bonnet esthesiometer, and tear secretion was measured by the Schirmer test in each subject. Results: Corneal sensitivity of eyes in the PED and corneal erosion groups was significantly lower than that in the control group. Schirmer test values for eyes in the SPK group were significantly reduced compared with those in the control group. Conclusion: A loss of corneal sensitivity may contribute to the development of PED and corneal erosion, whereas reduced tear secretion may be a contributing factor for SPK. Both results indicate the importance of corneal sensory innervation to the maintenance of corneal integrity. [ABSTRACT FROM AUTHOR]