Autologous serum tears shown to improve corneal pain

ORLANDO, Fla. — Patients with chronic pain from corneal neuropathy showed significant improvement with the use of 20% autologous serum tears, as reported in a poster here at the Association for Research in Vision and Ophthalmology meeting.

Shruti Aggarwal, MD, and colleagues from the Massachusetts Eye and Ear Infirmary treated 16 patients who had corneal neuropathy-induced pain with 20% autologous serum tears eight times a day, according to the poster. The patients had no ocular surface disease and had been unresponsive to conventional therapy.

Laser in vivo confocal microscopy imaging with the HRT3 (Heidelberg Engineering) with the Rostock Cornea Module was performed before and after treatment to evaluate changes in the subbasal corneal nerve density and morphology. The images were compared with those from 12 age-matched controls, the abstract stated.

The authors explained in the poster that laser in vivo confocal microscopy was used because slit lamp exam does not show underlying nerve alterations.

After 3.8 ± 0.5 months of treatment, corneal pain severity, on a scale of 0 to 10,  improved from a baseline of 9.4 ± 0.2 to 3.4 ± 0.4 (P < .001), the authors reported in the abstract.

The study patients displayed significantly decreased density and altered morphology of the subbasal nerve plexus at baseline compared with controls, they said. However, after treatment, the total nerve number and density improved, as did the main nerve number and density and nerve branch number and density.

“Improvement and increase in corneal subbasal nerves is seen after therapy and correlates with patient symptoms,” the authors said in the poster.

They explained: “Injury to nerves results in microneuroma formation following degeneration and subsequent aberration regeneration. Hyperexcitability of nociceptors is responsible for irregular and spontaneous discharges. Thus, directing therapeutic strategies toward nerve regeneration may help alleviate symptoms.”

The authors stated that autologous serum tears are rich in neurotrophic factors and, therefore, may help regenerate nerves and recover functional tears.

Disclosure: Aggarwal and colleagues have no relevant financial disclosures.

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