Treatment of severe chronic ocular graft-versus-host disease using 100% autologous serum eye drops from a sealed manufacturing system: a retrospective cohort study.
To analyse patients with chronic ocular graft-versus-host disease (GvHD) under treatment with 100% autologous serum eye drops from a sealed manufacturing system.



17 patients with chronic ocular GvHD received 100% autologous serum eye drops from single use vials manufactured in a sealed system. Retrospective analysis included visual acuity, corneal staining, frequency of artificial tears, ocular symptoms by means of a questionnaire and information on subjective side effects and cost compensation.



Data of prior to autologous serum eye drops therapy and at a 6-month follow-up were obtained. They demonstrated a significant increase in visual acuity (logMAR oculus dexter/right eye (OD) 0.5±0.32 to 0.4±0.3; oculus sinister/left eye (OS) 0.6±0.35 to 0.3±0.35; p=0.177/0.003) and significant improvement in corneal staining (Oxford grading scheme: OD from 3±1.03 to 2±1.43, OS from 4±1.0 to 2±1.09, p=0.004/0.001) and ocular symptoms (ocular surface disease index: 88±20.59 to 63±22.77; p=0.02). Frequency of artificial tears was reduced and no side effects were reported. Patient satisfaction was 100%, and cost compensation by health insurance reached 80%.



100% autologous serum eye drops using a sealed manufacturing system were efficient in improving the ocular surface, patient symptoms and visual acuity without side effects. It seems to be safe to use 100% autologous serum despite earlier suspicions regarding immune complex accumulations and exacerbation of ocular surface inflammation. The potential effects of serum levels of systemic immunosuppressives through readministration onto the ocular surface need to be elucidated.
Department of Ophthalmology, Medical Faculty, University of Cologne, Cologne, Germany.|Competence Center for Ocular GvHD, Medical Faculty, University of Cologne, Cologne, Germany.|Cluster of Excellence: Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
Volkan
V
Tahmaz
Department of Ophthalmology, Medical Faculty, University of Cologne, Cologne, Germany.|Competence Center for Ocular GvHD, Medical Faculty, University of Cologne, Cologne, Germany.|Cluster of Excellence: Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
Uta
U
Gehlsen
Department of Ophthalmology, Medical Faculty, University of Cologne, Cologne, Germany.|Competence Center for Ocular GvHD, Medical Faculty, University of Cologne, Cologne, Germany.|Cluster of Excellence: Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
Laura
L
Sauerbier
Department I of Internal Medicine, Medical Faculty, University of Cologne, Cologne, Germany.
Udo
U
Holtick
Department of Ophthalmology, Medical Faculty, University of Cologne, Cologne, Germany.|Competence Center for Ocular GvHD, Medical Faculty, University of Cologne, Cologne, Germany.
Lisa
L
Engel
Institute of Transfusion Medicine, Medical Faculty, University of Cologne, Cologne, Germany.
Stela
S
Radojska
Institute of Transfusion Medicine, Medical Faculty, University of Cologne, Cologne, Germany.
Viorica-Maria
VM
Petrescu-Jipa
Competence Center for Ocular GvHD, Medical Faculty, University of Cologne, Cologne, Germany.|Department I of Internal Medicine, Medical Faculty, University of Cologne, Cologne, Germany.
Christof
C
Scheid
Competence Center for Ocular GvHD, Medical Faculty, University of Cologne, Cologne, Germany.|Cluster of Excellence: Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.|Department I of Internal Medicine, Medical Faculty, University of Cologne, Cologne, Germany.
Michael
M
Hallek
Competence Center for Ocular GvHD, Medical Faculty, University of Cologne, Cologne, Germany.|Institute of Transfusion Medicine, Medical Faculty, University of Cologne, Cologne, Germany.
Birgit
B
Gathof
Department of Ophthalmology, Medical Faculty, University of Cologne, Cologne, Germany.|Competence Center for Ocular GvHD, Medical Faculty, University of Cologne, Cologne, Germany.
Claus
C
Cursiefen
Department of Ophthalmology, Medical Faculty, University of Cologne, Cologne, Germany.|Competence Center for Ocular GvHD, Medical Faculty, University of Cologne, Cologne, Germany.|Cluster of Excellence: Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
Philipp
P
Steven
D000328:Adult; D000368:Aged; D001798:Blood Proteins / Q000008:administration & dosage*; D002908:Chronic Disease; D015352:Dry Eye Syndromes / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications / Q000188:drug therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D065346:Lubricant Eye Drops / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000627:therapeutic use*; D012189:Retrospective Studies; D044967:Serum; D014792:Visual Acuity
D001798:Blood Proteins; D065346:Lubricant Eye Drops; D009883:Ophthalmic Solutions
Cornea; Inflammation; Treatment Medical; Wound healing