The use of self-retained, cryopreserved amniotic membrane for the treatment of Sjögren syndrome: a case series

Shafer, Brian M.; Fuerst, Nicole; Massaro-Giordano, Mina; Palladino, Vincent S.; Givnish, Taylor; Macchi, Ilaria; Sulewski, Michael E.; Orlin, Stephen E.; Bunya, Vatinee Y.

doi:10.5693/djo.01.2019.02.005

Cited by 16 publications

(12 citation statements)

References 17 publications

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“…166 Regarding AMT, Shafer et al evaluated the use of self-retained, cryopreserved AMT in six eyes of patients with refractory DED related to SS. 168 In all cases, staining of the conjunctiva and cornea improved, as well as referred symptoms. Unfortunately, signs and symptoms relapsed in 24.6 days (range 19 – 29 days).…”

Section: Management Of Dry Eye In Patients With Autoimmune Diseasesmentioning

confidence: 81%

Dry eye disease, a prominent manifestation of systemic autoimmune disorders

Bustamante-Arias

Ruiz-Lozano

Rodríguez-García

2022

European Journal of Ophthalmology

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Objectives Dry eye disease (DED) is arguably the most frequent ocular disease encountered in ophthalmic clinical practice. DED is frequently an underestimated condition causing a significant impact on visual function and quality of life. Many systemic autoimmune diseases (SAIDs) are related to moderate to severe DED. The main objective of this review is to enhance the awareness among ophthalmologists of the potential association of an underlying SAID in a high-risk patient with DED. Methods An exhaustive literature search was performed in the National Library of Medicine's Pubmed, Scopus, Web of Science, and Google Scholar databases for all English language articles published until November 2021. The main keywords included “dry eye disease” associated with autoimmune, connective tissue, endocrine, gastrointestinal, hematopoietic, vascular, and pulmonary diseases. Case reports, series, letters to the editor, reviews, and original articles were included. Results Although DED is frequently associated with SAIDs, its diagnosis is commonly delayed or missed, producing significant complications, including corneal ulceration, melting, scleritis, uveitis, and optic neuritis resulting in severe complications detrimental to visual function and quality of life. SAID should be suspected in a woman, 30 to 60 years old with a family history of autoimmunity, presenting with DED symptoms and extraocular manifestations including arthralgias, dry mouth, unexplained weight and hair loss, chronic fatigue, heat or cold intolerance, insomnia, and mood disorders. Conclusions Establishing the correct diagnosis and treatment of DED associated with SAIDs is crucial to avoid its significant burden and severe ocular complications.

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Section: Management Of Dry Eye In Patients With Autoimmune Diseasesmentioning

confidence: 81%

Dry eye disease, a prominent manifestation of systemic autoimmune disorders

Bustamante-Arias

Ruiz-Lozano

Rodríguez-García

2022

European Journal of Ophthalmology

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“…Yi et al managed to prepare a contact lens-shaped AM using glutaraldehyde and dialdehyde starch as a cross-linking agent [39]. The literature reports the use of a self-retaining cryopreserved amniotic membrane (PROKERA ® Slim, Bio-Tissue, Miami, FL, USA) for the treatment of dry eye disease [40], corneal ulcers [41], Stevens-Johnson syndrome/toxic epidermal necrolysis [42], and Sjögren's syndrome [43]. Some authors reported the use of a symblepharon ring in order to fix the AM to the ocular surface in patients with chemical injuries or toxic epidermal necrosis/Stevens-Johnsons syndrome [44,45].…”

Section: Discussionmentioning

confidence: 99%

Sutureless Amniotic Membrane Transplantation in Inflammatory Corneal Perforations

et al. 2022

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Introduction: The aim of this study was to evaluate the efficacy of sutureless amniotic membrane transplantation (SAMT) in patients with corneal perforation secondary to ocular surface inflammatory diseases. Methods: Twelve eyes of eleven patients with corneal perforation associated with Sjögren’s syndrome and ocular cicatricial pemphigoid were included. Surgical procedure consisted in the application of two layers of amniotic membrane covering the corneal perforation and a therapeutic contact lens placed above the two layers, followed by sutureless tarsorrhaphy with Steri-strip applied for 15 days to immobilize the eyelids. All patients underwent slit-lamp examination, fluorescein corneal staining, and anterior segment optical coherence tomography (AS-OCT), preoperatively and post-surgery, weekly for one month, and then every two weeks for three months. Results: All 12 eyes had complete resolution of corneal perforation. Pachymetry measurements improved in all eyes, and complete healing of the corneal ulcer was obtained following treatment and maintained up to 3 months follow-up in all patients. Conclusions: SAMT was proven to be a safe and effective option for the management of inflammatory corneal perforation. The procedure is non-traumatic and easy to perform since the surgical technique is sutureless and does not require topical therapy because it takes advantage of the intrinsic properties of the membrane itself.

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“…[ 60 ] In cases that are refractory to standard therapies, the use of ProKera ® is beneficial in the improvement of symptoms and ocular surface staining in patients with SS. [ 62 ] Moreover, AMT can promote the healing of corneal melting and ulceration. [ 63 64 ] The inflammation in immune-related DED is more severe and progressive than nonimmune-related DED.…”

Section: Clinical Evidence Of Amniotic Membrane Transplantation In Sjogren's Syndromementioning

confidence: 99%

Update on the application of amniotic membrane in immune-related ocular surface diseases

Chen

Lao

Liang

2021

Taiwan Journal of Ophthalmology

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Immune-related ocular surface diseases, a group of diseases in which immune dysregulation damages the ocular surface, can induce uncontrolled inflammation and persistent epithelial defect, thus leading to the most severe forms of acute keratoconjunctivitis, dry eye disease, epithelial keratitis, stromal ulceration, and corneal perforation. As these diseases are often refractory to treatments, they have a threatening impact on the vision and life quality of patients. This review summarizes the current literature regarding the clinical application of sutured and self-retained cryopreserved amniotic membrane (AM) in treating Stevens–Johnson syndrome/toxic epidermal necrolysis, ocular graft-versus-host disease, Sjögren's syndrome, Mooren's ulcer, and peripheral ulcerative keratitis. Current evidence supports the safety and effectiveness of AM, especially self-retained cryopreserved AM, in decreasing ocular surface inflammation, promoting corneal epithelial and stromal healing, improving visual acuity, and preventing sight-threatening complications. Future studies are still required to validate the above findings and explore the varied application methods of AM to improve the clinical efficacy in maintaining ocular surface health.

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The use of self-retained, cryopreserved amniotic membrane for the treatment of Sjögren syndrome: a case series

Cited by 16 publications

References 17 publications

Dry eye disease, a prominent manifestation of systemic autoimmune disorders

Dry eye disease, a prominent manifestation of systemic autoimmune disorders

Sutureless Amniotic Membrane Transplantation in Inflammatory Corneal Perforations

Update on the application of amniotic membrane in immune-related ocular surface diseases

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