1. Siamak Zarei-Ghanavati M.D., FICO
Autologous Serum Tears for the Treatment of Ocular Surface Disease Secondary to Systemic Autoimmune Diseases
Tayyeba K. Ali M.D.
Allister Gibbons M.D.
Siamak Zarei-Ghanavati M.D., FICO
Carolina Betancurt O.D.
Alma Michelle Mas M.D.
Victor L. Perez M.D.
The authors have no financial interests to disclose, relevant to the topic of this poster.

2. Autologous Serum Tears (AST)
Effectively treat DES and PED
Low frequency of complications (that all cease once discontinued)
But, patients with systemic autoimmune disorders have:
Circulating immune-complexes
Systemic medication
These accumulate in the serum and could potentially lead to local side effects.
Harloff S, et al. Epitheliotrophic capacity of serum eye drops from healthy donors versus serum from immunosuppressed patients with rheumatoid arthritis. Klin Monbl Augenheilkd Mar;225(3):200-6.
Poon AC, et al. Autologous serum eyedrops for dry eyes and epithelial defects: clinical and in vitro toxicity studies. Br J Ophthalmol Oct;85(10):

3. Purpose
To determine the safety and efficacy of autologous serum tears, diluted with normal saline, in patients with systemic autoimmune diseases.

4. Methods Retrospective non-comparative case series Inclusion criteria
Systemic autoimmune disease
Serum tear use
Exclusion Criteria
Serum tear use less than 2 months
Incomplete medical records

5. Methods Definition of Success Duration of the study:
Time the patients were using AST
We studied the short term effect
Longer term effects of AST remain to be seen and are currently being studied.
Definition of Success
0 – No improvement
1 – Partial improvement
2 – Complete improvement
3 – Worsening of condition

6. Results 79 eyes of 40 patients Mean age: 60 ±14 years (28-89 years)
Sex: 60 % Female
Mean (months) SD
+/-
Range (months)
Follow-up 23 16
2-59
AST use 15 13
2-50

7. Diagnoses Some patients have more than one diagnosis
Sjögren = Sjögren Syndrome; GVHD = Graft Versus host disease; RA = Rheumatoid Arthritis; OCP = Ocular Cicatricial Pemphigoid; SLE = Systemic Lupus Erythematosus

8. Previous Treatment Medicine % Lubricants 100 Steroids 67
Cyclosporine 0.05% 65
Glaucoma 20
Systemic 66
Systemic medication included:
Prednisone, Methotrexate, Tacrolimus & Mycophenolate

9. Objective Findings Initial BCVA 20/40 (logMAR 0.3±20 letters)
*p <0.01
Initial BCVA 20/40 (logMAR 0.3±20 letters)
Final BCVA 20/40
*p <0.01
*NSS
PEE = persistent epithelial defect
FK = filamentary keratitis
PED = persistent epithelial defect
*Fisher’s exact test

10. Objective Response to AST
85%
30%
55%
15%
15%

11. Subjective Response to AST
85%
15%
70%
15%
15%

12. In Conclusion
No complications or adverse events were reported in this series.
AST are safe and effective as an adjunct treatment in the stepwise approach to the treatment of ocular surface disease, in the context of autoimmune diseases.