Our first patient to have Cord Blood Serum for corneal neuropathy and trigeminal neuralgia reported a significant improvement in pain scores from 9/10 pain to 2/10 pain in the one eye the patient is using the CBS.
We are very excited about her initial pain scores. This patient will be returning for formal testing of Tear Break Up Times (TBUT), meibography, Schirmers and microscopic exams as well.
SLC
More data on Cord Blood Serum or Umbilical Cord Blood Serum and trigeminal neuralgia.
Int J Ophthalmol. 2014; 7(5): 807–810.
Published online 2014 Oct 18. doi: 10.3980/j.issn.2222-3959.2014.05.12
PMCID: PMC4206885
PMID: 25349797
Umbilical cord blood serum therapy for the management of persistent corneal epithelial defects
Abstract
AIM
To evaluate the role of umbilical cord blood serum (CBS) therapy in cases with persistent corneal epithelial defects (PED).
METHODS
Sixteen eyes of 14 patients with PED who were resistant to conventional treatment were treated with 20% umbilical cord serum eye drops. Patients were followed-up weekly until epithelization was complete. The collected data included the grade of corneal lesion (Grade I: epithelial defect+superficial vascularization, Grade II: epithelial defect+stromal edema, Grade III: corneal ulcer+stromal melting), the size of epithelial defect (pretreatment, 7th, 14th and 21st days of treatment), and follow-up time was evaluated retrospectively.
RESULTS
The mean size of epithelial defect on two perpendicular axes was 5.2×4.6-mm2 (range: 2.5-8×2.2-9 mm2). Mean duration of treatment was 8.3±5wk. CBS therapy was effective in 12 eyes (75%) and ineffective in 4 eyes (25%). The epithelial defects in 4 ineffective eyes were healed with amniotic membrane transplantation and tarsorrhaphy. The rate of complete healing was 12.5% by 7d, 25% by 14d, and 75% by 21d. The healing time was prolonged in Grade III eyes in comparison to eyes in Grade I or Grade II.
CONCLUSION
The results of the current study indicated the safety effectiveness of CBS drops in the management of PED. The grade of disease seems have a role on the healing time.
CBS therapy has many advantages over autologous serum therapy. One of these is, a large amount of blood can be drawn from umbilical vein, so it can be prepared for several patients at the same time[15],[16]. CBS contains some special growth factors such as TGF-b, EGF which are three times higher than those in autologous serum[6].
Recent studies reported the efficiency of umbilical cord serum eyedrops in the treatment of dry eye, recurrent corneal epithelial erosions, acute ocular chemical burn, and neurotrophic keratitis[6],[8],[16]–[19]. The common point of these reports was the assistance of CBS therapy in restoration of damaged ocular surface. Our cases had various ethiological factors for development of PED (neurotrophic, alkaline, exposure, bullous, and TAD abuse keratopathy). The common points for these cases were the efficiency of CBS and the role of PED grade on healing.
Versura et al[20] reported that a favorable effect of cord serum drop on ocular discomfort symptoms and tear osmolarity results. They also showed a significant improvement at corneal esthesiometry score with cord serum therapy. Our observations indicated that CBS treatment was not adequate for managament of deep corneal ulcers. Additional surgical options such as amniotic membrane transplantation or tarsoraphy were necessary for high grade PED. CBS treatment seems effective for PED in corneas without stromal bed thinning.
The healing rate of cases with neurotrophic keratitis related PED has been reported as 28.6% within 2wk and 78.6% within 4wk[7]. The results of current study were similar with previous reports, healing rate was 25% at the end of 2nd wk and 75% 4th wk. We concluded that CBS therapy should be continued at least 3wk for complete healing.
REFERENCES
1. Dua HS, Azuara-Blanco A. Allo-limbal transplantation in patients with limbal stem cell deficiency. Br J Ophthalmol. 1999;83(4):414–419. [PMC free article] [PubMed]
2. Pfister RR. Clinical measures to promote corneal epithelial healing. Acta Ophthalmol Suppl. 1992;(202):73–83. [PubMed]
3. Poon AC, Geerling G, Dart JK, Fraenkel GE, Daniels JT. Autologous serum eyedrops for dry eyes and epithelial defects: clinical and in vitro toxicity studies. Br J Ophthalmol. 2001;85(10):1188–1197.[PMC free article] [PubMed]
4. Tsubota K, Goto E, Shimmura S, Shimazaki J. Treatment of persistent corneal epithelial defect by autologous serum application. Ophthalmology. 1999;106(10):1984–1989. [PubMed]
5. del Castillo JM, de la Casa JM, Sardiña RC, Fernández RM, Feijoo JG, Gómez AC, Rodero MM, Sánchez JG. Treatment of recurrent corneal erosions using autologous serum. Cornea. 2002;21(8):781–783. [PubMed]
6. Yoon KC, Im SK, Park YG, Jung YD, Yang SY, Choi J. Application of umbilical cord serum eyedrops for the treatment of dry eye syndrome. Cornea. 2006;25(2):268–272. [PubMed]
7. Yoon KC, You IC, Im SK, Jeong TS, Park YG, Choi J. Application of umbilical cord serum eyedrops for the treatment of neurotrophic keratitis. Ophthalmology. 2007;114(9):1637–1642. [PubMed]
8. Vajpayee RB, Mukerji N, Tandon R, Sharma N, Pandey RM, Biswas NR, Marhotra N, Melki SA. Evaluation of umbilical cord serum therapy for persistent corneal epithelial defects. Br J Ophthalmol. 2003;87(11):1312–1316. [PMC free article] [PubMed]
9. Bonini S, Rama P, Olzi D, Lambiase A. Neurotrophic keratitis. Eye (Lond) 2003;17(8):989–995.[PubMed]
10. Ohashi Y, Motokura M, Kinoshita Y, Mano T, Watanabe H, Kinoshita S, Manabe R, Oshiden K, Yanaihara C. Presence of epidermal growth factor in human tears. Invest Ophthalmol Vis Sci. 1989;30(8):1879–1882. [PubMed]
11. van Setten GB, Tervo T, Tervo K, Tarkkanen A. Epidermal growth factor (EGF) in ocular fluid: presence, origin and therapeutic considerations. Acta Ophthalmol Suppl. 1992;(202):54–59. [PubMed]
12. Ang LP, Do TP, Thein ZM, Reza HM, Tan XW, Yap C, Tan DT, Beuerman RW. Ex vivo expansion of conjunctival and limbal epithelial cells using cord blood serum-supplemented culture medium. Invest Ophthalmol Vis Sci. 2011;52(9):6138–6147. [PubMed]
13. Shen EP, Hu FR, Lo SC, Chen YM, Sun YC, Lin CT, Chen WL. Comparison of corneal epitheliotropic capacity among different human blood-derived preparations. Cornea. 2011;30(2):208–214. [PubMed]
14. López-Plandolit S, Morales MC, Freire V, Etxebarría J, Duran JA. Plasma rich in growth factors as a therapeutic agent for persistent corneal epithelial defects. Cornea. 2010;29(8):843–848. [PubMed]
15. Yoon KC, Heo H, Im SK, You IC, Kim YH, Park YG. Comparison of autologous serum and umbilical cord serum eye drops for dry eye syndrome. Am J Ophthalmol. 2007;144(1):86–92. [PubMed]
16. Yoon KC, Heo H, Jeong IY, Park YG. Therapeutic effect of umbilical cord serum eyedrops for persistent epithelial defect. Korean J Ophthalmol. 2005;19(3):174–178. [PubMed]
17. Sharma N, Goel M, Velpandian T, Titiyal JS, Tandon R, Vajpayee RB. Evaluation of umbilical cord serum therapy in acute ocular chemical burns. Invest Ophthalmol Vis Sci. 2011;52(2):1087–1092.[PubMed]
18. Yoon KC, Jeong IY, Im SK, Park YG, Kim HJ, Choi J. Therapeutic effect of umbilical cord serum eyedrops for the treatment of dry eye associated with graft-versus-host disease. Bone Marrow Transplant. 2007;39(4):231–235. [PubMed]
19. Yoon KC, Choi W, You IC, Choi J. Application of umbilical cord serum eyedrops for recurrent corneal erosions. Cornea. 2011;30(7):744–748. [PubMed]
20. Versura P, Profazio V, Buzzi M, Stancari A, Arpinati M, Malavolta N, Campos EC. Efficacy of standardized and quality-controlled cord blood serum eye drop therapy in the healing of severe corneal epithelial damage in dry eye. Cornea. 2013;32(4):412–418. [PubMed]
Application of Umbilical Cord Serum Eyedrops for the Treatment of Neurotrophic Keratitis
Abstract
To investigate the efficacy of umbilical cord serum eyedrops for the treatment of neurotrophic keratitis. Prospective noncomparative case series. Twenty-eight eyes of 28 patients with neurotrophic keratitis who were refractory to conventional treatment. The patients with neurotrophic keraitis were treated with 20% umbilical cord serum eyedrops 6 to 10 times a day. Ophthalmic examinations including best-corrected visual acuity (VA) measurement, corneal sensitivity test, corneal fluorescein staining, and anterior segment photography were performed before and after the treatment. Concentrations of substance P, insulinlike growth factor 1 (IGF-1), and nerve growth factor (NGF) in umbilical cord serum, normal peripheral blood serum, and tears were measured. Epithelial healing time; changes of VA and corneal sensitivity after treatment; and levels of substance P, IGF-1, and NGF in umbilical cord serum, normal peripheral blood serum, and tears. The epithelial defect healed completely in all eyes, with a mean healing time of 4.4+/-4.0 weeks. The epithelial defect healed within 2 weeks in 8 eyes (28.6%), between 2 and 4 weeks in 14 eyes (50.0%), and after 4 weeks in 6 eyes (21.4%). After treatment, VA improved by >2 lines in 17 eyes (60.7%). Mean pretreatment corneal sensitivity was 21.1+/-10.5 mm, and mean posttreatment corneal sensitivity was 24.3+/-11.7 mm (P<0.01). Mean concentrations of substance P, IGF-1, and NGF were 245.3+/-53.9 pg/ml, 239.0+/-77.1 ng/ml, and 729.7+/-72.0 pg/ml in umbilical cord serum; 169.5+/-81.0 pg/ml, 375.5+/-51.3 ng/ml, and 401.7+/-98.1 pg/ml in peripheral blood serum; and 69.8+/-24.9 pg/ml, 75.7+/-50.5 ng/ml, and 107.5+/-70.9 pg/ml in tears, respectively. Umbilical cord serum contains many neurotrophic factors, and umbilical cord serum eyedrops appeared to be effective for the treatment of neurotrophic keratitis.
Application of Umbilical Cord Serum Eyedrops for the Treatment of Neurotrophic Keratitis | Request PDF. Available from: https://www.researchgate.net/publication/6425776_Application_of_Umbilical_Cord_Serum_Eyedrops_for_the_Treatment_of_Neurotrophic_Keratitis [accessed Sep 06 2018].