Comparison of clinical efficacies of autologous serum eye drops in patients with primary and secondary sjögren syndrome

PURPOSE: Autologous serum eye drops are considered to be safe and efficient for the treatment of dry eyes associated with Sjögren syndrome (SS). The purpose of this study was to compare the clinical efficacies of autologous serum eye drops in the management of primary and secondary SS. METHODS: Patients with primary (n = 20; 35 eyes) and secondary (n = 14; 27 eyes) SS dry eye were included. Serum concentrations of proinflammatory cytokines [tumor necrosis factor α, interleukin (IL)-1β, IL-6, and IL-8] were measured by a multiplex immunobead assay. The ocular symptom scores, ocular staining grades, and tear break-up time were evaluated before and after 4 weeks of 50% autologous serum eye drop application. RESULTS: At enrollment, patients with secondary SS had higher serum proinflammatory cytokine levels (tumor necrosis factor α, IL-1β, IL-6, and IL-8) than patients with primary SS (P < 0.01). After 4 weeks of autologous serum eye drop treatment, patients with primary SS had significantly improved ocular symptoms (P < 0.01), ocular surface staining grades (P < 0.01), and tear break-up time (P < 0.05). However, patients with secondary SS had no improvement (P > 0.05). CONCLUSIONS: Our results suggest that autologous serum eye drops might not be effective for the treatment of secondary SS because of elevated serum proinflammatory cytokine levels.