Effect of Autologous Serum Eye Drops in Patients with Sjogren Syndrome-related Dry Eye: Clinical and In Vivo Confocal Microscopy Evaluation of the Ocular Surface

Aim: To evaluate in vivo changes after therapy using autologous serum (AS) eye drops in Sjogren's syndrome (SS)-related dry eyes by confocal microscopy. Patients and Methods: In this study, 24 patients with SS-related dry eyes [12 in AS eye drop therapy and 12 in artificial tear (AT) therapy] and 24 healthy volunteers were recruited. Ocular Surface Disease Index (OSDI), central corneal thickness, tear film, break-up time, corneal and conjunctival staining, Schirmer's test and corneal confocal microscopy were investigated. Results: Tear production, tear stability, corneal staining, inflammation, and central corneal thickness, Langherans cells, activated keratocytes, intermediate epithelial cell density, nerve tortuosity, number of sub-basal nerve branches, and number of bead-like formations differed between patients and controls (p<0.0001). The AT and AS groups differed in the OSDI, number of branches, and number of beadings (p<0.0001). Conclusion: AS eye drops improve symptoms and confocal microscopy findings in SS-related dry eyes.