Autologous hemoderivative eye drops have been clinically proven effective in treating persistent epithelial defects, but this option tends to be limited by cost and availability. Researchers from the United Kingdom suggest a different alternative: a finger-prick autologous blood (FAB) treatment they say is less expensive—around $26 a month vs. autologous serum’s $412 monthly price tag. The novel treatment may also provide an increased concentration of growth factors compared with other therapies, and comes with no requirements for anticoagulants, antibiotics, excipients or storage facilities, the study authors noted.
The pilot study enrolled 10 patients who had persistent epithelial defects in one eye for roughly nine months. The causes for the defects included diabetic neurotrophic keratopathy, herpetic keratitis, post-penetrating keratoplasty, keratoconjunctivitis sicca, postradiotherapy and neuropathic ulcer. Participants were first trained to properly draw a drop of blood from a fingertip using a 28-gauge spring-loaded lancing device. They were then instructed to apply the drop to the lower conjunctival fornix of the eye with the persistent epithelial defects four times daily for 28 days in addition to receiving conventional therapies. Of note: all subjects previously had not been successful with conventional therapy alone, and none had undergone surgical treatment for the condition.
At the end of the study, researchers reported the persistent epithelial defects had healed in six (60%) of the eyes (two by day three, two by day14 and two by day 28). In one eye, the defect reduced in size by half. Three patients (30%) had incomplete follow-up data by the end of the study.
Researchers observed no adverse events from the treatment.
“In essence, FAB offers a simple, cheap and readily available treatment for persistent epithelial defects which are resistant to conventional treatment,” says researcher Anant Sharma, FRCOphth, of the Moorfields Eye Centre in Bedford, UK. “FAB has the potential to be used earlier in corneal ulcer treatment which may reduce corneal scarring.”
|Balal S, Nitiahpapand R, Hassan A, et al. Finger-prick autologous blood in the treatment of persistent corneal epithelial defects. Cornea. December 20, 2019. [Epub ahead of print].|