Application of Umbilical Cord Serum Eyedrops for the Treatment of Neurotrophic Keratitis
Received 29 July 2006; received in revised form 7 December 2006; accepted 7 December 2006. published online 22 March 2007.
Purpose
To investigate the efficacy of umbilical cord serum eyedrops for the treatment of neurotrophic keratitis.
Design
Prospective noncomparative case series.
Participants
Twenty-eight eyes of 28 patients with neurotrophic keratitis who were refractory to conventional treatment.
Methods
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.
Main Outcome Measures
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.
Results
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.
Conclusions
Umbilical cord serum contains many neurotrophic factors, and umbilical cord serum eyedrops appeared to be effective for the treatment of neurotrophic keratitis.
Available online: March 22, 2007.
1Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwang-Ju, South Korea.
2Department of Obstetrics, Eun Hospital, Gwang-Ju, South Korea.
Correspondence to Kyung-Chul Yoon, MD, Department of Ophthalmology, Chonnam National University Hospital, 8 Hak-Dong, Dong-Gu, Gwang-Ju, 501-757, South Korea.
ABSTRACT