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. 2016:2016:8406832.
doi: 10.1155/2016/8406832. Epub 2016 Apr 20.

The Effect of Autologous Platelet Lysate Eye Drops: An In Vivo Confocal Microscopy Study

Antonio M Fea  1 , Vittoria Aragno  1 , Valeria Testa  1 , Federica Machetta  1 , Simone Parisi  2 , Sergio D'Antico  3 , Roberta Spinetta  1 , Enrico Fusaro  2 , Federico M Grignolo  1
Affiliations

The Effect of Autologous Platelet Lysate Eye Drops: An In Vivo Confocal Microscopy Study

Antonio M Fea et al. Biomed Res Int. 2016.

Abstract

Purpose. To determine the effectiveness of autologous platelet lysate (APL) eye drops in patients with primary Sjögren syndrome (SS) dry eye, refractory to standard therapy, in comparison with patients treated with artificial tears. We focused on the effect of APL on cornea morphology with the in vivo confocal microscopy (IVCM). Methods. Patients were assigned to two groups: group A used autologous platelet lysate QID, and group B used preservative-free artificial tears QID, for 90 days. Ophthalmological assessments included ocular surface disease index (OSDI), best corrected visual acuity (BCVA), Schirmer test, fluorescein score, and breakup time (BUT). A subgroup of patients in group A underwent IVCM: corneal basal epithelium, subbasal nerves, Langerhans cells, anterior stroma activated keratocytes, and reflectivity were evaluated. Results. 60 eyes of 30 patients were enrolled; in group A (n = 20 patients) mean OSDI, fluorescein score, and BUT showed significant improvement compared with group B (n = 10 patients). The IVCM showed a significant increase in basal epithelium cells density and subbasal nerve plexus density and number and a decrease in Langerhans cells density (p < 0.05). Conclusion. APL was found effective in the treatment of SS dry eye. IVCM seems to be a useful tool to visualize cornea morphologic modifications.

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Figures

Figure 1
Figure 1
An example of neuron tracing with NeuronJ software. The plugin facilitates the tracing and quantification of nerves.
Figure 2
Figure 2
Comparison of OSDI score between patients in group A (APL) and patients in group B (artificial tears). OSDI score was significantly lower in group A patients compared with the group B patients after treatment (p < 0.05).
Figure 3
Figure 3
Comparison of BUT values between patients in group A (APL) and patients in group B (artificial tear). BUT increased significantly in group A patients compared with the group B patients after treatment (p < 0.05).
Figure 4
Figure 4
Comparison of fluorescein score between patients in group A (APL) and patients in group B (artificial tear). Fluorescein score was significantly lower in group A patients compared with the group B patients after treatment (p < 0.05).
Figure 5
Figure 5
Confocal images of subbasal nerves, in central corneal sectors. At baseline (a–c), many Langerhans cells can be observed at this level; after 3-month-long treatment (b–d), a decreased number of inflammatory cells and an increased number of nerves were found. Figures show the improvement in corneal subbasal nerve plexus for two representative patients treated with APL.
See this image and copyright information in PMC

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