title: Autologous serum eye drops diluted with sodium hyaluronate: clinical and experimental comparative study.
abstract: OBJECTIVE
  To assess the efficacy of sodium hyaluronate as vehicle for diluting autologous serum.
  
  
  METHODS
  The concentration and temporal stability of EGF, TGF-β, PDGF-AB and albumin in fresh and frozen samples of autologous serum diluted with sodium hyaluronate and saline solution, as well as the pH, osmolarity and density was studied. In parallel, the clinic effects of autologous serum diluted to 20% with sodium hyaluronate were compared with another solution of autologous serum diluted to 20% with saline in a prospective, comparative, randomized and double-blind study in 26 patients (52 eyes) with Sjögren syndrome. Patients underwent a complete ophthalmic assessment including tear film evaluation and corneal and conjunctival impression cytology at the beginning of the study and 2 months later.
  
  
  RESULTS
  The growth factor (GF) concentration remained stable during 1 month at 4°C both in fresh and defrosted samples without any differences being found between both preparations. No differences were found related to osmolarity, pH and density between these preparations before and after frosting. Autologous serum diluted with sodium hyaluronate caused a significant improvement of the tear film stability, fluorescein and rose Bengal stain, break-up time, corneal and conjunctival squamous metaplasia as well as in the patient subjective perception.
  
  
  CONCLUSIONS
  Sodium hyaluronate is an excellent vehicle for diluting autologous serum due to the gradual release of GF and increasing their duration and effect on the ocular surface. Preparations diluted with sodium hyaluronate are better tolerated by patients and require a lower number of drops administrations.
authors.affiliation: Ophthalmology Department, Cruz Roja Hospital, Madrid, SpainDry Eye Unit, Research Laboratory, Ophthalmology Department, Ramón and Cajal Hospital, Madrid, SpainOphthalmology Department, Infanta Sofia Hospital, Madrid, SpainClinical Analysis School, Pharmacy College, Complutense University of Madrid, Madrid, Spain.
authors.forename: José S
authors.initials: JS
authors.lastname: López-García
authors.forename: Isabel
authors.initials: I
authors.lastname: García-Lozano
authors.forename: Luis
authors.initials: L
authors.lastname: Rivas
authors.forename: Nuria
authors.initials: N
authors.lastname: Ramírez
authors.forename: Rafaela
authors.initials: R
authors.lastname: Raposo
authors.forename: Maria T
authors.initials: MT
authors.lastname: Méndez
mesh_terms: D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D004797:Enzyme-Linked Immunosorbent Assay; D004815:Epidermal Growth Factor / Q000097:blood; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D009994:Osmolar Concentration; D014677:Pharmaceutical Vehicles; D010982:Platelet-Derived Growth Factor / Q000378:metabolism; D011446:Prospective Studies; D044967:Serum / Q000502:physiology*; D012709:Serum Albumin / Q000378:metabolism; D012859:Sjogren's Syndrome / Q000097:blood / Q000628:therapy*; D016212:Transforming Growth Factor beta / Q000097:blood
chemical_list: D009883:Ophthalmic Solutions; D014677:Pharmaceutical Vehicles; D010982:Platelet-Derived Growth Factor; D012709:Serum Albumin; D016212:Transforming Growth Factor beta; C095477:platelet-derived growth factor AB; D004815:Epidermal Growth Factor; D006820:Hyaluronic Acid
keywords: Sjögren syndrome; autologous serum eye drops; conjunctival cytology; corneal impression cytology; hyaluronic acid; sodium hyaluronate