Clinical Efficacy of Platelet-Rich Plasma in the Treatment of Neurotrophic Corneal Ulcer

Purpose. Platelet-rich plasma (PRP) is an autologous blood product without preservatives and rich in proteins and growth factors which make it possible for cells to differentiate, proliferate, and migrate, thus stimulating healing and regeneration of tissues. The aim of this study was to evaluate the efficiency of autologous platelet-rich plasma in the treatment of neurotrophic keratopathy. Methods. The study group consists of 25 patients with nonhealing corneal ulcers due to herpes simplex or herpes zoster infection and facial nerve or trigeminal nerve paralysis as a result of a neurosurgical operation caused by a tumour or stroke. The patients were given autologous platelet-rich plasma drops five times a day and additionally preservative-free artificial tears and a vitamin A ointment at night for maximum 3 months. The following were evaluated: best corrected visual acuity (BCVA), healing of corneal surface, subjective symptoms, and changes in corneal thickness with the use of anterior segment optical coherent tomography (AS-OCT). Results. BCVA before the treatment was 0.10 ± 0.14, and after the treatment it was –0.3 ± 0.27 (p=0.001). Improved visual acuity and less subjective symptoms were observed in all patients. Complete healing of the ulceration was observed in 20 patients (80%). Four patients (16%) experienced considerable improvement of their clinical condition (reduced size and depth of the ulceration and inflammatory state: smaller conjunctival injection and swelling, improved visual acuity, and less subjective symptoms). In one of the patients, an amniotic membrane was transplanted due to the lack of improvement of his local condition. In all patients, the progression of corneal thinning was stopped. An average corneal thickness in its thinnest point was 322.3 ± 125.8 µm before the treatment, and 404.5 ± 118.7 µm (p<0.05) after the treatment. None of the patients reported general or local side effects of the treatment. Conclusions. Autologous platelet-rich plasma is a blood-based product which seems efficient in the treatment of neurotrophic keratopathy.

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ROLE OF PLATELET RICH PLASMA IN TREATMENT OF CHRONIC NON-HEALING VENOUS ULCER

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i2.982 ◽

2020 ◽

Vol 4 (2) ◽

Author(s):

Firdaus A. Dekhaiya ◽

Jignesh K. Joshi ◽

Sarav Bamania

Keyword(s):

Growth Factors ◽

Platelet Rich Plasma ◽

Autologous Blood ◽

Healing Process ◽

Venous Ulcer ◽

Lower Limbs ◽

Venous Ulcers ◽

Autologous Platelet Rich Plasma ◽

Adhesive Proteins ◽

Autologous Platelet

Introduction: Venous ulcers are wounds that are thought to occur due to improper functioning of venous valves, usually of the lower limbs. Considering that PRP is a source of growth factors, and consequently has mitogenic, angiogenic, and chemotactic properties, it represents an adjunctive treatment for recalcitrant wounds. Moreover, PRP provides the wound with adhesive proteins, such as fibrinogen, which are important in wound healing. PRP contain more amount of platelets, cytokines and growth factors which are dispersed in a very small amount of plasma which can be prepared from a sample of centrifuged autologous blood. Application of PRP has been reported to be effective in both acute as well as chronic non healing venous ulcers. Aim and Objective: To evaluate the efficacy of autologous platelet rich plasma in the management of chronic venous ulcer. Material and Method: A Prospective study conducted on 100 patients of chronic venous ulcers admitted in Sir T. Hospital Bhavnagar from June 2018 to June 2019 after fulfilled our inclusion and exclusion criteria. PRP then injected intalesionally inside and around the periphery of the wound/ulcer. This process was done once/week for 12 weeks. At every week, the area and volume of ulcer was calculated and photographs were taken. Result: All the patients showed healing of the ulcer with reduction in size of ulcer more than 90% was observed in 72 patients, followed by 80–90% reduction in wound size in 18 patients after the 12 weeks follow-up. Overall, significant reduction in size of ulcer was observed in all the treated patients. Conclusion: Autologous platelet rich plasma (PRP) as an autologous method, it is biocompatible, simple, safe, affordable and less expensive procedure in the treatment of chronic venous ulcers. PRP is found to be useful in improving and enhancing the healing process in chronic venous leg ulcers without any side effect. Keywords: Venous ulcer, Platelet rich plasma

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Comprehensive Treatment of Noninfectious Uveitis Accompanied by Macular Edema with the Use of Autologous Platelet-Rich Plasma

Acta biomedica scientifica ◽

10.29413/abs.2019-4.4.12 ◽

2019 ◽

Vol 4 (4) ◽

pp. 83-90

Author(s):

N. S. Arbenyeva ◽

V. I. Bratko ◽

A. N. Trunov ◽

G. V. Bratko ◽

V. V. Chernykh

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Platelet Rich Plasma ◽

Federal State ◽

Comprehensive Treatment ◽

Complex Treatment ◽

Infectious Uveitis ◽

Autologous Platelet Rich Plasma ◽

Anti Inflammatory ◽

Autologous Platelet

Background. A common cause of visual impairment in patients with non-infectious uveitis is macular edema, developing in 38–84 % of cases. Plasma enriched with platelets is widely used in various branches of medicine, the effectiveness of its use in the treatment of non-infectious uveitis, accompanied by macular edema, has not been sufficiently investigated. Aim: To evaluate the effectiveness of autologous platelet-rich plasma in the complex treatment of non-infectious uveitis accompanied by macular edema.Material and methods. The study was conducted on the basis of the academician S.N. Fyodorov Eye Microsurgery Federal State Institution in the period from 2016 to 2018, which included 123 people (176 eyes) from 18 to 50 years with non-infectious uveitis, accompanied by macular edema: 46 men, 77 women. Patients were divided into 2 groups. The main group consisted of patients receiving autologous platelet-rich plasma and anti-inflammatory treatment; the comparison group consisted of patients receiving anti-inflammatory treatment. The results of visual acuity, intraocular pressure, biomicroophthalmoscopy, optical coherence tomography of the macular zone, microperimetry, ultrasound examination on the side of the affected eye were evaluated. Statistical processing of the data was carried out in the program Statistica 10.Results. Maintenance of autologous platelet-rich plasma contributes to a statistically significant improvement in visual acuity on the 10th day of treatment by 64.2 %, a decrease in the thickness of the retina in fovea by 36.3 % and an increase in retinal photosensitivity by 34.6 % compared to the group of patients receiving only anti-inflammatory treatment. Conclusions. The use of autologous platelet-rich plasma in the complex treatment of non-infectious uveitis allows to accelerate the natural mechanisms of tissue regeneration, contributing to the reduction of macular edema, and improve visual performance.

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Improving morphological outcome in lamellar macular hole surgery by using highly concentrated autologous platelet-rich plasma

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-021-05486-5 ◽

2021 ◽

Author(s):

Felix Hagenau ◽

Nikolaus Luft ◽

Matthias Nobl ◽

Denise Vogt ◽

Julian E. Klaas ◽

...

Keyword(s):

Visual Acuity ◽

Macular Hole ◽

Platelet Rich Plasma ◽

Fundus Photography ◽

Lamellar Macular Hole ◽

Epiretinal Membranes ◽

Corrected Visual Acuity ◽

Autologous Platelet Rich Plasma ◽

Autologous Platelet ◽

Best Corrected Visual Acuity

Abstract Purpose To evaluate the use of highly concentrated autologous platelet-rich plasma (PRP) in lamellar macular hole (LMH) surgery with regard to function and morphology. Methods We included 12 eyes of 12 patients with progressive LMH in this interventional case series. After 23/25-gauge pars plana vitrectomy, 0.1ml highly concentrated autologous platelet-rich plasma was applied under air tamponade. Induction of posterior vitreous detachment and peeling of tractive epiretinal membranes were performed whenever present. Phacovitrectomy was undertaken in cases of phakic lens status. Postoperatively, all patients were instructed to rest in a supine position for the first two postoperative hours. Best-corrected visual acuity (BCVA) testing, microperimetry, spectral-domain optical coherence tomography (SD-OCT), and fundus photography were carried out preoperatively and 6 months postoperatively. Results Foveal configuration was restored in 10 of 12 patients (83.3%) at 6 months postoperatively. Two patients who had not undergone ILM peeling showed a recurring defect at 6-month follow-up. Best-corrected visual acuity improved significantly from 0.29 ± 0.08 to 0.14 ± 0.13 logMAR (Wilcoxon: p=0.028). Microperimetry remained unchanged (23.38 ± 2.53 preoperatively; 23.0 ± 2.49 dB postoperatively; p=0.67). No patient experienced vision loss after surgery, and no significant intra- or postoperative complications occurred. Conclusion The application of PRP in the surgical therapy of LMH results in good morphological and functional outcomes. Additional peeling of the ILM seems to be mandatory when using PRP to prevent the recurrence of LMH. Strict postoperative supine positioning for 2 h avoids PRP dislocation. Larger sample sizes are needed to confirm the results.

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The Effect of Type 1 Atellocolagen in Association with Blood Self-derivatives in Alveolar Bone Augumentation

Revista de Chimie ◽

10.37358/rc.20.4.8079 ◽

2020 ◽

Vol 71 (4) ◽

pp. 390-400

Author(s):

Bogdan-Catalin Alexandru ◽

Monica Popa ◽

Cosmin Pestean ◽

Robert Purdoiu ◽

Liviu Oana ◽

...

Keyword(s):

Growth Factors ◽

Bone Morphogenetic Proteins ◽

Alveolar Bone ◽

Platelet Rich Plasma ◽

Autologous Blood ◽

Bovine Bone ◽

Cartilaginous Tissue ◽

Autologous Platelet Rich Plasma ◽

Autologous Platelet

The current experimental study was conducted in sheep, which present bone anisotropy and a predisposition to periodontal disease, with alveolar bone resorption, similar to that found in humans. In this study, alveolar bone augmentation was performed using a lyophilized bovine bone xenograft enriched with type 1 atelocollagen, which was combined with autologous platelet-rich plasma (PRP) and advanced platelet-rich fibrin (A-PRF) as a membrane. The results were radiologically and histologically evaluated at six weeks postoperatively. At that time, the transformation of the composite biomaterial was clearly visible, suggesting that the regeneration process started from the periphery of the augmentation mass, which was progressively transformed from a granular eosinophilic material into an undifferentiated hypercellular one, then into fibroblastic, cartilaginous tissue, and finally into new bone and desmodontal-like tissue. This process was most probably induced by all the compounds used, the growth factors found in autologous blood derivatives, including bone morphogenetic proteins (BMPs), as well as type 1 atelocollagen from the graft composition, especially in combination. The composite biomaterial at six weeks postoperatively provided excellent results regarding alveolar bone regeneration, and without any risk, as opposed to that found in overdose of recombinant growth factors.

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