Plasma rich in growth factors eye drops to treat secondary ocular surface disorders in patients with glaucoma

Abstract

PurposeTo evaluate the efficacy and safety of plasma rich in growth factors (PRGF) eye drops in patients with glaucoma with secondary ocular surface disorders (OSDs) due to surgeries and topical hypotensive drugs use.Materials and methodsA retrospective case-series study design was used including six patients (eight eyes) diagnosed with glaucoma who received surgical (nonpenetrating deep sclerectomy and/or trabeculectomy) and medical treatments (hypotensive eye drops) to control intraocular pressure (IOP) and who developed secondary OSDs, unresponsive to conventional treatments. Patients were treated with PRGF eye drops (four times a day). Outcome measures were ocular surface disease index (OSDI), best-corrected visual acuity (BCVA, in logarithm of the minimum angle of resolution), visual analog scale (VAS), frequency and severity of symptoms, and IOP. The safety of the treatment was also evaluated.ResultsSix patients (seven eyes with open-angle glaucoma and one eye with uveitic glaucoma) treated with PRGF eye drops were evaluated. Mean age was 71 years (SD=7.2, range 58–79 years). Five were female and one was male. The mean treatment time was 21.8 weeks (SD=9.0, range 12–36 weeks). The mean time to reach closure of the corneal ulcer was 14.5 (SD=5.5) weeks. A statistical significant reduction in OSDI scale (50.6%), VAS frequency (53.1%), VAS severity (42.0%), and a 41.8% improvement in BCVA were observed (p<0.05). IOP also decreased by 16.6% (p=0.010). Only one of the six patients reported itching in both eyes as an adverse event (AE); however, the patient continued with the PRGF eye drops until the end of therapy; the remaining patients did not report any AEs during the follow-up period.ConclusionsIn patients with glaucoma and secondary OSDs refractive to conventional treatments, the treatment with PRGF eye drops could be considered a possible therapeutic option, because it demonstrates an improvement in the signs and symptoms of the ocular surface, as well as a better control of the IOP. This is an initial research work that can open doors for future research to confirm these findings.

<p>Plasma Rich in Growth Factors for the Treatment of Cicatrizing Conjunctivitis</p>

“…Ten out of 10 eyes treated presented an inflammation grade improvement (p < 0.004) and from 5 eyes initially considered as severe CC, only 1 remained with this status (p < 0.046). The IOP also showed a significant improvement (p < 0.027), results similar to those obtained in other PRGF related studies, 8,10,25 being some of these directly or indirectly related to glaucoma. 27 Further studies may be beneficial to clarify the role of PRGF for the management of the IOP and its clinical applications.…”

“…5 The regenerative effect of plasma rich in growth factors (PRGF) in the ophthalmology field has been demonstrated in different pathologies of the ocular surface and cornea. Some examples include dry eye disease with different etiologies, neurotrophic keratopathies, corneal ulcers, 6,7 patients with compromised inflammatory disorders (glaucoma), 8 or even patients who have been previously treated with other blood derivatives or amniotic membranes having unsatisfactory results. 11,12 Several in vitro and in vivo studies have been carried out to illustrate some of the most relevant biological effects of PRGF.…”

Development and Optimization of Freeze-Dried Eye Drops Derived From Plasma Rich in Growth Factors Technology

“…[8][9][10] In recent years, PRGF eye drops have been widely used in the treatment of several ocular surface diseases, including dry eye, corneal ulcers, and persistent epithelial defects. [11][12][13][14][15][16][17][18] The biochemical and biophysical properties of PRGF eye drops like pH, osmolarity, proteins, and growth factors content, which are similar to the artificial tears, are responsible for the successful results obtained in the treatment of these different ocular pathologies. 19,20 Ocular surface disorders are usually chronic diseases that require medium-or long-term treatment.…”

Plasma Rich in Growth Factors Enhances Cell Survival after in Situ Retinal Degeneration

“…It has been used in oral implantology and traumatology. In ophthalmology, it has been used for treating eye surface disorders such as PED or dry eye [ 25 , 27 , 28 , 29 , 31 , 47 , 49 ]. In terms of pathologies related to the retina, PRGF has also been used to treat macular holes, producing good results in both anatomical closure and vision recovery [ 32 , 33 ].…”

“…For instance, plasma rich in growth factors (PRGF), which is a serum obtained from a patient’s blood, has been already proven to enhance cell proliferation, help with wound healing, and act as a neuroprotector or an anti-inflammatory agent [ 22 , 23 , 24 ]. It has been widely used in oral implantology and traumatology, and in ophthalmology for treating ocular surface diseases, such as persistent epithelial defects (PEDs) [ 25 , 26 , 27 , 28 , 29 ], conjunctivitis, or other ocular surface pathologies [ 30 , 31 ]. In the retina, PRGF has been proven to reduce macular holes [ 32 , 33 ].…”