Autologous serum tears are safe and effective for treating ocular surface disorders and may become more accessible in the future.
Reviewed by Victor L. Perez, MD
Topical hematopoietic therapy has been shown to be a safe, effective modality for the treatment of severe ocular surface disease (OSD) and may become an option for a broader group of patients through future innovations that could improve accessibility, said Victor L. Perez, MD.
“Hematopoietic therapy with autologous serum tears has been moving up the ladder in the stepwise treatment algorithm for OSD, but the indications are still somewhat limited,” said Dr. Perez, professor of ophthalmology, and director, Foster Center for Ocular Immunology, Duke University School of Medicine, Durham, NC.
“Increased use of this or another blood-derived biologic modality will depend on developments that make it more physician- and patient-friendly.” The study and use of platelet preparation and other biologics are our next frontier for achieving this goal, he added.
The use of serum to treat OSD was first described in 1975 by Ralph e al., and in 1984, Fox et al. first reported on the efficacy of autologous serum tears as a tear substitute. The therapeutic benefit of autologous serum tears is explained by the fact that serum contains a host of epitheliotrophic factors, including growth factors, immunoglobulins, vitamins, and substance P.
“There are probably other elements in autologous serum tears that benefit the ocular surface through mechanisms that are not yet understood,” Dr. Perez said. “As another advantage, there are no preservatives in autologous serum tears.”
Evidence from a growing number of publications allay concerns about potential risks accompanying the use of autologous serum tears when the product is prepared correctly.
“In addition, we showed in a recently published study that while the biochemical composition of serum in patients with systemic autoimmune diseases may be altered, autologous serum tears was a safe and effective adjunctive treatment in this patient population,” Dr. Perez said.
Victor L. Perez, MD
This article was adapted from Dr. Perez’s presentation during Cornea Subspecialty Day at the 2018 meeting of the American Academy of Ophthalmology. Dr. Perez disclosed financial interests in Cambium Medical Technologies and OBT Inc.