The use of autologous serum for the treatment of ocular surface disease at a Swedish tertiary referral center

Joanna von Hofsten,1,2 Maria Egardt,2 Madeleine Zetterberg2–41Department of Ophthalmology, Halland Hospital Halmstad, Halmstad, 2Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, 3Department of Clinical Neuroscience and Rehabilitation, 4Department of Ophthalmology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenPurpose: The study aims to describe an intact cohort with mixed ocular surface disease (OSD) treated with autologous serum (AS) eye drops in a tertiary eye center.Patients and methods: All cases (n=32 eyes, 24 patients) treated with AS for OSD at the Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, between 2002 and 2013 were included and medical records were reviewed retrospectively.Results: Mean duration of treatment with 20% AS was 28.3±56.1 (median: 12, range: 3–217) days. The most common indication for AS treatment was a persistent epithelial defect (PED), which was seen in 16 eyes of 14 patients. Mean duration of PED prior to treatment was 19.3±18.9 (median: 10, range: 5–68) days. Complete or partial epithelial healing occurred in nine eyes (56.2%). The remaining seven eyes (44%) did not respond to treatment or data were missing. The second group consisted of nine eyes of five patients with superficial punctate keratitis (SPK) secondary to dry eye syndrome. Complete or partial healing of the epithelium occurred in five eyes (56%), and the remaining four eyes (44%) were lost to follow-up. A third group included five eyes with AS as an adjuvant treatment after corneal perforation, whereas a fourth group consisted of one patient with dry eye after laser-assisted in situ keratomileusis (LASIK).Conclusion: In this cohort, patients with PED or SPK responded well to treatment with AS. Standardized preparation protocols, defined optimal serum concentrations for various indications, and large randomized clinical trials are needed to fully comprehend the role of AS in the treatment of OSD.Keywords: dry eye syndrome, persistent epithelial defect, superficial punctate keratitis