Application of umbilical cord serum eyedrops for the treatment of neurotrophic keratitis.
OBJECTIVE
To investigate the efficacy of umbilical cord serum eyedrops for the treatment of neurotrophic keratitis.


METHODS
Prospective noncomparative case series.


METHODS
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.


METHODS
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.
Yoon
Kyung-Chul
KC
Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwang-Ju, South Korea. kcyoon@chonnam.ac.kr
You
In-Cheon
IC
Im
Seong-Kyu
SK
Jeong
Tae-Sun
TS
Park
Yeoung-Geol
YG
Choi
Jin
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003315:Cornea / Q000294:innervation* / Q000503:physiopathology; D003389:Cranial Nerve Diseases / Q000097:blood / Q000628:therapy*; D005260:Female; D005312:Fetal Blood; D015590:Fluorophotometry; D006801:Humans; D006987:Hypesthesia / Q000097:blood / Q000628:therapy*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007634:Keratitis / Q000097:blood / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020932:Nerve Growth Factor / Q000097:blood; D009882:Ophthalmic Nerve; D009883:Ophthalmic Solutions / Q000008:administration & dosage*; D011379:Prognosis; D011446:Prospective Studies; D044967:Serum / Q000737:chemistry; D013373:Substance P / Q000097:blood; D013666:Tears / Q000378:metabolism; D014792:Visual Acuity
D009883:Ophthalmic Solutions; D013373:Substance P; D007334:Insulin-Like Growth Factor I; D020932:Nerve Growth Factor