Blood-derived topical therapy for ocular surface diseases

This literature review reveals that though the body of clinical data is small, autologous serum (ASE), allogenic serum, umbilical cord serum and platelet-derived plasma preparation eye drops have consistently shown positive results in treating dry eye disease and persistent epithelial defects (PEDs) with low incidence of adverse reaction.

In non-masked studies on dry eye disease, patients using ASE showed greater objective and subjective improvement of symptoms compared to those using control lubricating drops. Blind crossover studies have also revealed significant improvement on subjective OSDI scores, and some objective success on TBUT tests. As ASEs are preservative-free and require specific storage conditions, the main concern over their use is microbial contamination. Additionally, differing formulation protocols impede comparing outcomes and expanding its use in practice.

Allogenic serum drops are faster to prepare, cheaper and more convenient than ASEs because they do not require a patient blood draw. Despite the presence of ABO antigens on the eye surfaces, 3 out of 4 studies that did not take blood type into account found no inflammatory reactions after use, and drops made from AB donor serum have successfully treated 73 patients with no inflammation.

Umbilical cord serum is an alternative for individuals with immune conditions where inflammatory cytokines present in the blood serum make ASE and allogenic drops risky, and may be more effective than ASE for PED and ocular chemical burns.

While research on platelet-derived plasma preparations is still in the early stages, it has so far demonstrated a favorable efficacy and safety profile.