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Journal Article Review Ppublish 5 citations

PubMed: 38648544 DOI: 10.1089/jop.2023.0155

Blood-Derived Eye Drops for the Treatment of Corneal Neuropathic Pain.

J Ocul Pharmacol Ther 40(5):281-292

Authors: Ansa Anam, Chang Liu, Louis Tong, Yu-Chi Liu

Affiliations

  • Department of Ophthalmology, MTI Khyber Teaching Hospital, Peshawar, Pakistan.
  • Cornea and Refractive Surgery Group, Singapore Eye Research Institute, Singapore, Singapore.
  • Department of Corneal and External Eye Disease, Singapore National Eye Centre, Singapore, Singapore.
  • Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
  • Ocular Surface Group, Singapore Eye Research Institute, Singapore, Singapore.

Abstract

Blood-derived preparations, including autologous or allogenic serum, umbilical cord serum/plasma, and platelet-rich plasma eye drops, contain various growth factors, cytokines, and immunoglobulins that resemble natural tears. These components play important roles in corneal cell migration, proliferation, and wound healing. Blood-derived eye drops have demonstrated clinical effectiveness across a spectrum of ocular surface conditions, encompassing dry eye disease, Sjögren's syndrome, graft-versus-host disease, and neuropathic corneal pain (NCP). Currently, management of NCP remains challenging. The emergence of blood-derived eye drops represents a promising therapeutic approach. In this review, we discuss the benefits and limitations of different blood-derived eye drops, their mechanisms of action, and treatment efficacy in patients with NCP. Several studies have demonstrated the clinical efficacy of autologous serum eye drops in relieving pain and pain-like symptoms, such as allodynia and photoallodynia. Corneal nerve parameters were also significantly improved, as evidenced by increased nerve fiber density, length, nerve reflectivity, and tortuosity, as well as a decreased occurrence of beading and neuromas after the treatment. The extent of nerve regeneration correlated with improvement in patient-reported photoallodynia. Cord plasma eye drops also show potential for symptom alleviation and corneal nerve regeneration. Future directions for clinical practice and research involve standardizing preparation protocols, establishing treatment guidelines, elucidating underlying mechanisms, conducting long-term clinical trials, and implementing cost-effective measures such as scaling up manufacturing. With ongoing advancements, blood-derived eye drops hold promise as a valuable therapeutic option for patients suffering from NCP.

MeSH

Platelet-Rich Plasma, Eye, Blood, Serum, Pain, Nerve Regeneration, Graft Vs Host Disease, Therapeutics, Neuralgia

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