Changes in Corneal Expression of MUC5AC after Autologous Serum Eyedrop Treatment in Patients with Limbal Stem Cell Deficiency

ABSTRACT

Purpose

To evaluate the effect of autologous serum eyedrops treatment on corneal expression of the MUC5AC in patients with limbal deficiency.

Methods

A prospective and comparative interventional case series study of 42 eyes of 21 patients was performed before and 8 weeks after treatment with autologous serum. All patients underwent a complete ophthalmic assessment of the tear film and ocular surface, corneal impression cytology (IC) and MUC5AC detection by Reverse Transcription-Polymerase Chain Reaction (RT-PCR).

Results

Forty-one of the 42 eyes studied were available for both conventional cytology and MUC5AC analysis prior to and after treatment. Differences between outcomes obtained by impression cytology and MUC5AC detection were found in 9 of 82 samples (11%). We found changes in the corneal expression of MUC5AC after treatment in 19 of 41 eyes (46.3%): 18 of them (94.7%) changed from positive to negative expression, and 1 eye (5.3%) changed from negative to positive MUC5AC expression after autologous serum eyedrops. These changes were related with the corneal involvement prior to treatment (15 of them (78.9%) occurred in patients with slight corneal involvement), and with the improvement in the degree of squamous metaplasia after treatment (P = .001 and P = .003, respectively).

Conclusions

The treatment significantly improved tear stability, squamous metaplasia, and subjective patient perception. Autologous serum eyedrops treatment diminished the corneal expression of MUC5AC mainly in patients with slight corneal involvement before treatment.

KEYWORDS:

• Autologous serum eyedrops
• MUC5AC
• impression cytology
• limbal stem cell deficiency
• reverse transcription-polymerase chain reaction

Acknowledgments

This paper was partly funded with the help of the Carlos III Health Institute (Madrid. Spain) and the Santander-UAX Foundation (Madrid. Spain). The funding organization had no role in the design or conduct of this research. The authors have no proprietary or commercial interests in any concept or product discussed in this article.

Declaration of interest

The authors have no proprietary or commercial interests in any concept or product discussed in this article. The authors do not have any conflict of interest.

Financial support/Conflict of interest

This paper was partly funded with the help of the Carlos III Health Institute (Madrid. Spain) and the Santander-UAX Foundation (Madrid. Spain). The funding organization had no role in the design or conduct of this research. The authors have no proprietary or commercial interests in any concept or product discussed in this article.

Responsible establishment

Hospital Cruz Roja (Madrid-Spain).

Additional information

Funding

This work was supported by the Instituto de Salud Carlos III [1];Santander-UAX Foundation (Madrid. Spain) [2];