Corneal Ulcer in Dogs and Cats: Novel Clinical Application of Regenerative Therapy Using Subconjunctival Injection of Autologous Platelet-Rich Plasma

Background: Corneal ulcer could be a major source of distress in small animals, with many contributing agents. In recent years, few studies evaluated the efficacy of platelet-rich plasma (PRP) in healing corneal ulcers.Aim: This study aimed to assess the ability of subconjunctival injection of autologous PRP in the treatment of corneal ulcers in dogs and cats as well as estimate the expression of matrix metalloproteinase (MMP)-2, MMP-9, and oxidative stress biomarkers in these patients.Methods: A total number of 28 animals (16 cats and 12 dogs) were enrolled in this study. Each animal was subjected to clinical, neurologic, and ophthalmic examinations where the type of ulcer was documented. Tear samples were collected for evaluation of oxidative biomarkers and MMPs; conjunctival swabs were taken to identify the involved organism. PRP was prepared from each animal and given as subconjunctival injection; numbers of injections were done according to case response. Clinical follow-up was done and documented for each case.Results: In cat patients, female and Persian cats were most affected; unilateral and superficial ulcers were most recorded. In male dogs, unilateral, and superficial ulcers were most recorded. FHV-1 was most identified in cats, while Staphylococcus aureus was most identified in dogs. Numbers of injections needed to achieve healing were recorded, with 50% of dogs needing two injections with 1-week intervals and 50% of cats needed three injections with 1-week intervals. Alterations in both oxidative biomarkers and MMPs were recorded in affected animals.Conclusion: The use of autologous PRP as a subconjunctival injection in treating corneal ulcers in dogs and cats is effective. The number of injections is the case and corneal ulcer type-dependent.Clinical Significance: Autologous PRP as a subconjunctival injection in treating corneal ulcer is a relatively cheap, safe method and can be done in the clinical setting.

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Platelet-rich plasma to rescue an ulcerated orbital dermal fat graft

European Journal of Ophthalmology ◽

10.1177/1120672118805299 ◽

2018 ◽

Vol 29 (6) ◽

pp. 654-658 ◽

Cited By ~ 1

Author(s):

Tania Andrea Chaparro Tapias ◽

Alberto Luis Díaz Díaz ◽

Roberto Secondi ◽

Helena Coy Villamil ◽

Juan Carlos Sánchez España

Keyword(s):

Platelet Rich Plasma ◽

Rare Complication ◽

Treatment Protocol ◽

Fat Graft ◽

Subconjunctival Injection ◽

Epithelial Defect ◽

Plasma Injection ◽

Autologous Platelet Rich Plasma ◽

Artificial Prosthesis

Introduction: Central graft ulceration is a rare complication of an orbital dermal fat graft caused by diminished blood supply to the implant. This study reports on the efficacy and safety of the use of a single subconjunctival injection of autologous platelet-rich plasma to rescue an ulcerated orbital dermal fat graft. Methods: Three patients, who had undergone autologous dermal fat graft to treat their anophthalmic socket, were given a 2-mL subconjunctival platelet-rich plasma injection in the exposed graft margins. Demographic and clinical features, treatment protocol, clinical course, complications and follow-up time are reported. In the preoperative examination, all the patients presented a primary epithelial defect of the dermal fat graft. Results: There were no major complications such as necrosis or infection. One patient presented a small conjunctival granuloma at 1-month follow up. Mean postoperative follow-up duration was 13 (range: 10–16) months. By 1 month, the chronic epithelial defect had resolved with the graft integrated within the orbital tissues in all cases. All patients were referred for artificial prosthesis placement. Conclusion: Although further work is needed, our findings suggest that a single subconjunctival platelet-rich plasma injection could be an effective, safe and economic alternative to surgery to rescue an ulcerated orbital dermal fat graft.

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CASE REPORT: SUBCONJUNCTIVAL INJECTION WITH AUTOLOGOUS PLATELET-RICH PLASMA FOR REFRACTORY CORNEAL ULCERS IN A DOG

Taiwan Veterinary Journal ◽

10.1142/s1682648518720034 ◽

2018 ◽

Vol 44 (04) ◽

pp. 211-216

Author(s):

Shu-Fang Yang ◽

Heng-Leng Yang ◽

Sao-Ling Liang ◽

Peng-Chen Wang

Keyword(s):

Platelet Rich Plasma ◽

Corneal Edema ◽

Tissue Growth ◽

Autologous Serum ◽

Subconjunctival Injection ◽

Ophthalmological Examination ◽

Intact Male ◽

Corneal Ulcers ◽

Autologous Platelet Rich Plasma ◽

Autologous Platelet

A 12-year-old, intact, male Golden Retriever dog presented with a 1-month history of corneal ulcer, redness, and occasional squint in the left eye (oculus sinister [OS]). A thorough ophthalmological examination revealed corneal edema, diffuse corneal vascularization, and excessive granulation tissue growth. The tentative diagnosis was chronic superficial keratitis or pannus. After 3 weeks of treatment for OS, blepharospasm and superficial corneal ulceration with a lip of nonadherent epithelium of the right eye (oculus dexter [OD]) developed. No improvement was observed after autologous serum eye drop treatment combined with simple debridement and grid keratotomy on both eyes (oculi uterque [OU]) for 3 months; thereafter, blindness developed. The diagnosis was refractory corneal ulcers. The application of autologous platelet-rich plasma (PRP) was instilled via subconjunctival injection OU every 2 weeks for 2 months. The OU corneas started to re-epithelialize and heal, and the granulation tissues significantly decreased while the vision improved. Therefore, PRP was continued to be administered every 1–2 months for 6 months. After more than 1 year, the OU corneas have healed without recurrent ulceration and with only mild haze. In conclusion, autologous PRP subconjunctival injection is a potentially beneficial addition to the medical management of refractory corneal ulcers in dogs.

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Use of Plasma Rich in Growth Factors and ReGeneraTing Agent Matrix for the Treatment of Corneal Diseases

Vision ◽

10.3390/vision5030034 ◽

2021 ◽

Vol 5 (3) ◽

pp. 34

Author(s):

Ronald M. Sánchez-Ávila ◽

Edmar Uribe-Badillo ◽

Carlos Fernández-Vega González ◽

Francisco Muruzabal ◽

Borja de la Sen-Corcuera ◽

...

Keyword(s):

Growth Factors ◽

Corneal Ulcer ◽

Disease Index ◽

Eye Drops ◽

Analog Scale ◽

Ocular Surface Disease Index ◽

Corneal Ulcers ◽

Corrected Visual Acuity ◽

The Mean

This study aimed to investigate the use of Plasma Rich in Growth Factors (PRGF) associated with tissue ReGeneraTing Agent (RGTA) drops for the treatment of noninfectious corneal ulcers. RGTA treatment was applied (one drop every two days); however, if ulcer closure was not achieved, PRGF eye drops treatment was added (four times/day). The time taken to reach the ulcer closure, the Best Corrected Visual Acuity (BCVA), intraocular pressure (IOP), Visual Analog Scale (VAS, in terms of frequency and severity of symptoms), and Ocular Surface Disease Index (OSDI) were evaluated. Seventy-four patients (79 eyes) were included, and the mean age was 56.8 ± 17.3 years. The neurotrophic corneal ulcer was the most frequent disorder (n = 27, 34.2%), mainly for herpes virus (n = 15, 19.0%). The time of PRGF eye drops treatment associated with the RGTA matrix was 4.2 ± 2.2 (1.5–9.0) months, and the follow-up period was 44.9 ± 31.5 months. The ulcer closure was achieved in 76 eyes (96.2%). BCVA, VAS and OSDI improved from the baseline (p < 0.001), and IOP remained unchanged (p = 0.665). RGTA and PRGF in noninfectious ulcers were effective and could be a therapeutic alternative for this type of corneal disease.

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Long-term evaluation of autologous lamellar corneal grafts for the treatment of deep corneal ulcer in four dogs: a case report

Veterinární Medicína ◽

10.17221/139/2017-vetmed ◽

2019 ◽

Vol 64 (No. 02) ◽

pp. 84-91

Author(s):

SY Kim ◽

JY Kim ◽

SW Jeong

Keyword(s):

Case Report ◽

Corneal Ulcer ◽

Donor Site ◽

Ultrasound Biomicroscopy ◽

Corneal Graft ◽

Corneal Ulcers ◽

Term Evaluation ◽

The Aesthetic

Autologous lamellar corneal grafts were performed on four dogs with two deep corneal ulcers and two corneal perforations to achieve better visual and aesthetic outcomes. The donor corneal graft was harvested from the relatively normal corneal region of the affected eye and used to cover the corneal defect. At the two-year follow-up examination, ultrasound biomicroscopy was performed to confirm the thickness and endothelial continuity of the transplanted grafts and donor site of the cornea. The evaluations revealed that the dogs had healed without incident and that their vision had been maintained. Furthermore, the owners were satisfied with the aesthetic outcomes in all cases. Our findings show that autologous lamellar corneal grafts are useful and effective in treating canine corneal ulcers and perforations.

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Treatment of symptomatic degenerative intervertebral discs with autologous platelet-rich plasma: follow-up at 5–9 years

Regenerative Medicine ◽

10.2217/rme-2019-0040 ◽

2019 ◽

Vol 14 (9) ◽

pp. 831-840 ◽

Cited By ~ 4

Author(s):

Jennifer Cheng ◽

Kristen A Santiago ◽

Joseph T Nguyen ◽

Jennifer L Solomon ◽

Gregory E Lutz

Keyword(s):

Platelet Rich Plasma ◽

Controlled Trial ◽

Intervertebral Discs ◽

Discogenic Pain ◽

Autologous Platelet Rich Plasma ◽

Clinically Significant ◽

And Function ◽

Pain Patients ◽

Autologous Platelet

Aim: This study assessed pain and function at 5–9 years postinjection in a subset of patients who received intradiscal platelet-rich plasma (PRP) injections for moderate-to-severe lumbar discogenic pain. Patients & methods: All patients received injections of intradiscal PRP in a previous randomized controlled trial. Data on pain, function, satisfaction, and need for surgery were collected at one time point of 5–9 years postinjection and compiled with existing data. Results: In comparison to baseline, there were statistically significant improvements in pain and function (p < 0.001). All improvements were clinically significant. Six patients had undergone surgery during the follow-up period. Conclusion: This subset of patients demonstrated statistically and clinically significant improvements in pain and function at 5–9 years postinjection.

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A 5-Year Follow-Up After Cartilage Repair in the Knee Using a Platelet-Rich Plasma-Immersed Polymer-Based Implant

The Open Orthopaedics Journal ◽

10.2174/1874325001408010346 ◽

2014 ◽

Vol 8 (1) ◽

pp. 346-354 ◽

Cited By ~ 22

Author(s):

Alberto Siclari ◽

Gennaro Mascaro ◽

Christian Kaps ◽

Eugenio Boux

Keyword(s):

Clinical Outcome ◽

Cartilage Repair ◽

Platelet Rich Plasma ◽

Polyglycolic Acid ◽

Cartilage Defects ◽

Bone Marrow Stimulation ◽

Chondral Defects ◽

Autologous Platelet Rich Plasma ◽

Autologous Platelet

The aim of our study was to analyze the clinical outcome after repair of cartilage defects of the knee with subchondral drilling and resorbable polymer-based implants immersed with autologous platelet-rich plasma (PRP). Fifty-two patients with focal chondral defects were treated with subchondral drilling, followed by covering with a polyglycolic acid - hyaluronan (PGA-HA) implant (chondrotissue®) immersed with autologous PRP. At 5-year follow-up, patients’ situation was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and compared to the pre-operative situation. The KOOS showed clinically meaningful and significant (p < 0.05) improvement in all subcategories compared to baseline. Subgroup analysis showed that there were no differences in the clinical outcome regarding defect size and localization as well as degenerative condition of the knee. Cartilage repair was complete in 20 out of 21 patients at 4-year follow-up as shown by magnetic resonance observation of cartilage repair tissue (MOCART) scoring. Covering of focal cartilage defects with the PGA-HA implant and PRP after bone marrow stimulation leads to a lasting improvement of the patients’ situation.

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Easy-to-prepare autologous platelet-rich plasma in the treatment of refractory corneal ulcers

Taiwan Journal of Ophthalmology ◽

10.1016/j.tjo.2014.09.001 ◽

2015 ◽

Vol 5 (3) ◽

pp. 132-135 ◽

Cited By ~ 2

Author(s):

Tzu En Wu ◽

Chiung Ju Chen ◽

Chao-Chien Hu ◽

Cheng-Kuo Cheng

Keyword(s):

Platelet Rich Plasma ◽

Corneal Ulcers ◽

Autologous Platelet Rich Plasma ◽

Autologous Platelet

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Intradiscal Injection of Autologous Platelet-Rich Plasma Releasate to Treat Discogenic Low Back Pain: A Preliminary Clinical Trial

Asian Spine Journal ◽

10.4184/asj.2017.11.3.380 ◽

2017 ◽

Vol 11 (3) ◽

pp. 380-389 ◽

Cited By ~ 38

Author(s):

Koji Akeda ◽

Kohshi Ohishi ◽

Koichi Masuda ◽

Won C. Bae ◽

Norihiko Takegami ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Platelet Rich Plasma ◽

Low Back ◽

Discogenic Low Back Pain ◽

Intradiscal Injection ◽

Autologous Platelet Rich Plasma ◽

The Mean ◽

Autologous Platelet

<sec><title>Study Design</title>Preliminary clinical trial.</sec><sec><title>Purpose</title>To determine the safety and initial efficacy of intradiscal injection of autologous platelet-rich plasma (PRP) releasate in patients with discogenic low back pain.</sec><sec><title>Overview of Literature</title>PRP, which is comprised of autologous growth factors and cytokines, has been widely used in the clinical setting for tissue regeneration and repair. PRP has been shown <italic>in vitro</italic> and <italic>in vivo</italic> to potentially stimulate intervertebral disc matrix metabolism.</sec><sec><title>Methods</title>Inclusion criteria for this study included chronic low back pain without leg pain for more than 3 months; one or more lumbar discs (L3/L4 to L5/S1) with evidence of degeneration, as indicated via magnetic resonance imaging (MRI); and at least one symptomatic disc, confirmed using standardized provocative discography. PRP releasate, isolated from clotted PRP, was injected into the center of the nucleus pulposus. Outcome measures included the use of a visual analog scale (VAS) and the Roland-Morris Disability Questionnaire (RDQ), as well as X-ray and MRI (T2-quantification).</sec><sec><title>Results</title>Data were analyzed from 14 patients (8 men and 6 women; mean age, 33.8 years). The average follow-up period was 10 months. Following treatment, no patient experienced adverse events or significant narrowing of disc height. The mean pain scores before treatment (VAS, 7.5±1.3; RDQ, 12.6±4.1) were significantly decreased at one month, and this was generally sustained throughout the observation period (6 months after treatment: VAS, 3.2±2.4, RDQ; 3.6±4.5 and 12 months: VAS, 2.9±2.8; RDQ, 2.8±3.9; <italic>p</italic><0.01, respectively). The mean T2 values did not significantly change after treatment.</sec><sec><title>Conclusions</title>We demonstrated that intradiscal injection of autologous PRP releasate in patients with low back pain was safe, with no adverse events observed during follow-up. Future randomized controlled clinical studies should be performed to systematically evaluate the effects of this therapy.</sec>

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Treatment of Noninfectious Corneal Disorders With Plasma Rich in Growth Factors and ReGenerating Agent Matrix

10.21203/rs.3.rs-49518/v1 ◽

2020 ◽

Author(s):

Ronald Mauricio Sanchez-Avila ◽

Edmar Uribe-Badillo ◽

Carlos Fernandez-Vega Gonzalez ◽

Francisco Muruzabal ◽

Borja De la Sen Corcuera ◽

...

Keyword(s):

Growth Factors ◽

Adverse Events ◽

Corneal Ulcer ◽

Eye Drops ◽

Ocular Surface Disease Index ◽

Corneal Ulcers ◽

Corrected Visual Acuity ◽

The Mean ◽

Mean Time

Abstract Background: To provide the efficacy and safety of Plasma Rich in Growth Factors (PRGF) associated with tissue ReGeneraTing Agent (RGTA) drops for the treatment of noninfectious corneal ulcers.Methods: This retrospective study included patients from Fernandez-Vega University Institute between 2010 and 2019, with noninfectious corneal ulcers and no response to standard treatments. RGTA treatment was firstly applied (1 drop every two days), but if ulcer closure was not achieved, PRGF eye drops treatment was added (4 times/day). The time to reach the ulcer closure; the Best Corrected Visual Acuity (BCVA), intraocular pressure (IOP), Visual Analog Scale (VAS, in frequency and severity of symptoms), and Ocular Surface Disease Index (OSDI) were evaluated. The presence of adverse events along the follow-up period was also reported. Results: Seventy-four patients (79 eyes) were included in the study, forty-six eyes (62.2%) were women, and the mean age was 56.8 ± 17.3 years. The neurotrophic corneal ulcer was the most frequent disorder found in the patients of the study (n = 27, 34.2%), mainly due to the herpes virus (n = 15, 19.0%). The mean time of PRGF eye drops treatment associated with RGTA matrix was 4.2 ± 2.2 (1.5 -9.0) months, and the follow-up period was 44.9 ± 31.5 months. The ulcer closure was achieved in 76 eyes (96.2%). BCVA, VAS and OSDI improved significantly from the baseline (p<0.001), while IOP remained unchanged (p=0.665). No adverse events were recorded. Conclusions: The use of RGTA and PRGF in noninfectious ulcers was effective and safe, and it could be a therapeutic alternative for this type of corneal diseases.

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Effect of intralesional injection of autologous platelet rich plasma in patterned hair loss

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20204561 ◽

2020 ◽

Vol 6 (6) ◽

pp. 750

Author(s):

Priyam Bhaskar Rai ◽

Pragya Khushwaha

Keyword(s):

Hair Loss ◽

Platelet Rich Plasma ◽

Intralesional Injection ◽

Total Period ◽

Treatment Groups ◽

Topical Minoxidil ◽

Autologous Platelet Rich Plasma ◽

First Time ◽

To Receive

Background: Regenerative effects of platelet-rich plasma’s (PRP) are utilized in treating various dermatological conditions. The present study compared the efficacy of intradermal autologous PRP in various grades of patterned hair loss with topical minoxidil and finasteride.Methods: Patients with patterned hair loss were randomized to receive either minoxidil 5% in (male), 2% in (female) and finasteride 1 mg (only in male) or PRP in addition to the above treatment. A total of 6 sittings were given to PRP group patients at interval of 21 days each over a total period of 4 months. All patients were followed up for the first time after 21 days of initiating the treatment and then after four months of starting the treatment.Results: Baseline demographic and clinical characteristics were similar in both the treatment groups. When assessed at the second follow up, hair wash test, hair pull test, V/T ratio, yellow dot test, mean hair diameter and global photographic assessment were favourable in significantly higher proportion of patients in the PRP group as compared to non-PRP group. Five non-PRP patients (6.7%) perceived no change in hair fall as compared to none in the PRP group. None of the cases reported increase in hair fall. Adverse effects reported (itching, erectile dysfunction, decreased libido and dizziness) were similarly distributed among the patients in both the treatment groups.Conclusions: Minoxidil and finasteride form the backbone of patterned hair loss treatment; adding PRP can achieve clinically better results with minimal side effects.

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