Comparison between 100% autologous serum and 100% platelet‐rich plasma eye drops and their impact on the treatment efficacy of dry eye in primary Sjogren syndrome

Abstract

Purpose: The aim of the study was to compare the difference in the composition of 100% autologous serum (AS) and 100% platelet‐rich plasma (PRP) eye drops and assess their impact on the clinical out‐comes after the treatment of severe dry eye (DE) in primary Sjogren Syndrome patients (pSS).Methods: 22 patients with severe DE in pSS were treated with 100% AS (22 eyes) and 100% PRP (22 eyes) eye drops 5 times per day as monotherapy. The quantification of growth factors (GFs) as fibroblast growth factor (FGF), epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), platelet‐derived growth factor (PDGF), nerve growth factor (NGF), transforming growth factor (TGF‐b), insulin‐like growth factor(IGF), fibronectin and substance P in hemoderivates was performed. The main outcomes: Ocular Surface Disease Index (OSDI), Best Corrected Visual Acuity (BCVA), the Schirmer test, tear break‐up time (TBUT), corneal and conjunctival staining according to the Oxford scale, conjunctival hyperaemia and Meibomian gland parameters. The results were compared at the baseline, 1 and 3 months after the treatment. The clinical results were correlated with the concentration of GFs.Results: Significant differences were observed in the concentration of FGF, EGF, fibronectin, VEGF, PDGF AB, NGF, PDGF, substance P, TGF‐β in PRP compared to AS. There was a statistically significant improvement in BCVA, the Schirmer test, TBUT, Meibomian gland parameters, and the reduction of the OSDI scores, Oxford staining and conjunctiva hyperaemia in each group. There were many correspondences between the level of GFs and the mean change of the clinical outcomes. No adverse events were reported.Conclusions: Despite the fact that blood derivatives differ in their composition, they seem to be effective, safe in the treatment of severe DE in pSS patients. The signs and symptoms of DE were reduced in both groups. The obtained clinical results and the composition of hemoderivates may indicate the superiority of PRP in relieving the signs and symptoms of DE in pSS patients.