The Royal College of Ophthalmologists guidelines on serum eye drops for the treatment of severe ocular surface disease: full report

Rauz, Saaeha; Koay, S-Y; Foot, B; Kaye, Stephen B.; Figueiredo, Francisco C; Burdon, Michael; Dancey, E; Chandrasekar, Akila; Lomas, Richard

doi:10.1038/eye.2017.209

Cited by 24 publications

(16 citation statements)

References 31 publications

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“…Only one study has been carried out in pSjS-2002 patients, which showed significant improvement in some ocular outcomes 43. The difficulties in preparation, the need to refrigerate the drops, and the potential risk of contamination should be taken into account 37 44. The TF recommended that serum tear drops may be considered in patients who are non-responders or intolerant to topical CyA tear drops.…”

Section: Resultsmentioning

confidence: 99%

EULAR recommendations for the management of Sjögren’s syndrome with topical and systemic therapies

et al. 2019

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The therapeutic management of Sjögren syndrome (SjS) has not changed substantially in recent decades: treatment decisions remain challenging in clinical practice, without a specific therapeutic target beyond the relief of symptoms as the most important goal. In view of this scenario, the European League Against Rheumatism (EULAR) promoted and supported an international collaborative study (EULAR SS Task Force) aimed at developing the first EULAR evidence and consensus-based recommendations for the management of patients with SjS with topical and systemic medications. The aim was to develop a rational therapeutic approach to SjS patients useful for healthcare professionals, physicians undergoing specialist training, medical students, the pharmaceutical industry and drug regulatory organisations following the 2014 EULAR standardised operating procedures. The Task Force (TF) included specialists in rheumatology, internal medicine, oral health, ophthalmology, gynaecology, dermatology and epidemiology, statisticians, general practitioners, nurses and patient representatives from 30 countries of the 5 continents. Evidence was collected from studies including primary SjS patients fulfilling the 2002/2016 criteria; when no evidence was available, evidence from studies including associated SjS or patients fulfilling previous sets of criteria was considered and extrapolated. The TF endorsed the presentation of general principles for the management of patients with SjS as three overarching, general consensus-based recommendations and 12 specific recommendations that form a logical sequence, starting with the management of the central triplet of symptoms (dryness, fatigue and pain) followed by the management of systemic disease. The recommendations address the use of topical oral (saliva substitutes) and ocular (artificial tear drops, topical non-steroidal anti-inflammatory drugs, topical corticosteroids, topical CyA, serum tear drops) therapies, oral muscarinic agonists (pilocarpine, cevimeline), hydroxychloroquine, oral glucocorticoids, synthetic immunosuppressive agents (cyclophosphamide, azathioprine, methotrexate, leflunomide and mycophenolate), and biological therapies (rituximab, abatacept and belimumab). For each recommendation, levels of evidence (mostly modest) and TF agreement (mostly very high) are provided. The 2019 EULAR recommendations are based on the evidence collected in the last 16 years in the management of primary 2002 SjS patients and on discussions between a large and broadly international TF. The recommendations synthesise current thinking on SjS treatment in a set of overarching principles and recommendations. We hope that the current recommendations will be broadly applied in clinical practice and/or serve as a template for national societies to develop local recommendations.

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Section: Resultsmentioning

confidence: 99%

EULAR recommendations for the management of Sjögren’s syndrome with topical and systemic therapies

et al. 2019

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“…The use of serum eye drops (SED) – which contain key epitheliotropic factors found in natural tears and are used in the treatment of dry eye disease and persistent corneal epithelial defects (PED) (Marks et al, ; Rauz et al, ) – is steadily increasing internationally. Transfusion medicine services are concerned with all aspects of the manufacture of SED.…”

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confidence: 99%

“…Autologous SED are an established treatment of dry eye and PED (Marks et al, ; Rauz et al, ). There is less experience with allogeneic SED, but these also appear to be clinically beneficial (Chiang et al, ; Harritshøj et al, ).…”

mentioning

confidence: 99%

A retrospective crossover study of autologous and allogeneic serum eye drops for the management of ocular surface disease

Hung

Elder

Rawstron

et al. 2018

Transfusion Medicine

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“…Preparation of this product is expensive and time consuming. Moreover, it needs to be refrigerated and there is high potential risk of contamination with this product [ 47 ]. Yet there is inconsistency in the benefits of autologous serum in patients with dry eye disease [ 48 , 49 , 50 ].…”

Section: Management Of Dry Eyementioning

confidence: 99%

Autoimmune Dry Eye without Significant Ocular Surface Co-Morbidities and Mental Health

Ashena

Dashputra

Nanavaty

2020

Vision

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Dry eye symptoms can negatively affect the psychological, physical, and social functioning, which can potentially impair the health-related quality of life. This review evaluated the association between autoimmune related dry eye in the absence of significant ocular surface co-morbidities and mental health. This review found a significantly higher prevalence of mental health disorders (such as depression and anxiety) in systemic lupus erythematous, rheumatoid arthritis, systemic sclerosis, Behcet’s disease, and primary Sjogren’s syndrome patients when compared to the general population. Moreover, patients with depression and anxiety interpret ocular sensations differently than healthy controls and the perception of dry eye symptoms can be influenced by their mood. Somatization is common in depression, and this could influence the perception of ocular discomfort. Anti-depressants and anxiolytics with their potential side effects on the tear film status may also contribute or aggravate the dry eye symptoms in these patients. Although ophthalmologists manage the dry eye disease, as per standardized algorithms, they should be mindful of different ocular sensation interpretation and coexistent mental health issues in a large number of this patient group and initiate a multidisciplinary management plan in certain cases. While rheumatologists look after their autoimmune condition, it may be worth liaising with GP and/or psychiatrist colleagues in order to address their neuropathic type pain and mental health co-morbidities.

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The Royal College of Ophthalmologists guidelines on serum eye drops for the treatment of severe ocular surface disease: full report

Cited by 24 publications

References 31 publications

EULAR recommendations for the management of Sjögren’s syndrome with topical and systemic therapies

EULAR recommendations for the management of Sjögren’s syndrome with topical and systemic therapies

A retrospective crossover study of autologous and allogeneic serum eye drops for the management of ocular surface disease

Autoimmune Dry Eye without Significant Ocular Surface Co-Morbidities and Mental Health

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