Treatment of patients with neurotrophic keratitis stages 2 and 3 with plasma rich in growth factors (PRGF-Endoret) eye-drops

Int Ophthalmol. 2018 Jun;38(3):1193-1204. doi: 10.1007/s10792-017-0582-7. Epub 2017 Jun 15.

Abstract

Purpose: To provide preliminary data about efficacy and safety of plasma rich in growth factors (PRGF) eye-drops in neurotrophic keratitis (NK) and to analyze the possible influence of certain variables on treatment outcomes.

Methods: This retrospective study included patients with stages 2-3 of NK treated with PRGF eye-drops. Primary endpoint was the resolution time of corneal ulcer defect. Outcome measures including percentage of ulcer closure at 4 weeks, Ocular Surface Disease Index (OSDI), Best-Corrected Visual Acuity (BCVA) and Visual Analogue Scale (VAS) were also evaluated before and after treatment with PRGF. The influence of some patients' clinical variables on results was assessed. Safety assessment was also performed reporting all adverse events.

Results: Thirty-eight treated eyes in a total of thirty-one patients were evaluated, of which five cases had no prior response to autologous serum treatment. Most cases (97.4%) achieved the complete resolution of corneal defect/ulcer. Mean resolution time was 11.4 weeks (SD = 13.7). A statistical significant (p < 0.05) reduction in OSDI (60.9%), VAS frequency (59.9%), VAS severity (57.0%) and improvement in BCVA (52.8%) was observed. The results were stratified according to the pathology stage and to the identified potential effect modifiers variables. Only one adverse event was reported in one patient (2.6%).

Conclusions: PRGF eye-drops could be a safe and effective therapeutic option for patients with stages 2-3 of NK, showing high rates of corneal defect/ulcer resolution in short times, either in reducing signs and symptoms of NK, and therefore preventing the progression of NK to greater ocular complications.

Keywords: Corneal defects; Corneal ulcers; Neurotrophic keratitis; PRGF; Plasma rich in growth factors; Platelet rich plasma; Regenerative medicine.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Cornea / pathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Intercellular Signaling Peptides and Proteins / administration & dosage*
  • Keratitis / diagnosis
  • Keratitis / drug therapy*
  • Male
  • Middle Aged
  • Ophthalmic Solutions / administration & dosage
  • Plasma*
  • Retrospective Studies
  • Severity of Illness Index
  • Slit Lamp Microscopy
  • Treatment Outcome
  • Young Adult

Substances

  • Intercellular Signaling Peptides and Proteins
  • Ophthalmic Solutions