Finger prick Autologous Blood

[Angela810]

Hi all,

Many of you may know about this trial happening in the UK. It's currently in Phase 3 - so I hope this will be out soon. It involves using a diabetic lancet to draw blood that is then applied to your eye 4 times a day. This is really exciting, especially for many dry eye sufferers who don't have access to serum or plasma.

Here's a link to the trial:

https://clinicaltrials.gov/ct2/show/NCT02153515


They have started to report some initial findings which look promising - see the link below.

http://www.google.co.uk/url?sa=t&rct...lm8U3l-fN8_xXw

[littlemermaid]

Angela810, thank you so much! Also interesting to see UK price for autologous serum eyedrops (initial visit only) £1,632.38, (subsequent visits) £1,116.79. Seems an unnecessary and cruel monopoly.

[lizlou29]

I think it's crazy that this should to be 'considered in management while waiting for autologous serum'. Why is autologous serum so expensive? PRP serum, considered to be superior, is a tenth of the price in Spain. Blood is drawn, put in the centrifuge and you take a 3 month supply home within an hour. I mean it is great that there is an option to do draw your own blood whilst waiting but it's basically so the NHS can fob you off for a few more months, not something that you are meant to do for years.

[Angela810]

I agree Liz - I'm not happy with NHS treatment of dry eye. Worse still, because of the NHS we can't buy serum or plasma privately in the UK. They do say the NHS won't be here in the next 2 to 5 years. Thereafter maybe when things are privatised maybe it will become available to buy.

However I think we need to think about the positives. FAB (fingerprick autologous blood) could be liberating. With this you wouldn't need to refrigerate your serum, allowing you apply the blood anywhere and anytime. That's discrete, especially in a work environment. Also you wouldn't need to worry about FAB becoming inactive after 3 months or inactive if it has been thawed for too long, like with plasma or serum. Also you wouldn't need to rely on a healthcare system that doesn't provide adequate treatment for this disabling condition. Lots of good points here....

Pricking myself 4 times a day is a small price to pay for more comfortable eyes. Putting this into context - some people with diabetes have to prick themselves up to 8 times a day to maintain their health.

I guess the next questions are how does this treatment compare to serum or plasma. However for now, we do know that FAB is better than nothing, since people with DES are getting better and are opting to stay on this treatment after the clinical trial has ended. Hopefully it will be rolled out soon.

x

[littlemermaid]

They do say the NHS won't be here in the next 2 to 5 years

Gosh, I hope that's not true. Let's hope NHS can shop around accredited formulating pharmacies soon.

Just to clarify for everyone, in UK, refractive surgery is by commercial private providers, entirely separate from NHS http://www.dailymail.co.uk/health/ar...gery-safe.html.

Can you buy blood products with your medical insurance, or through the lasik provider, as a co-pay or compensation? Nadz said her husband had a quote for AS eyedrops.

[grant555]

what exactly needs to be rolled out about it? don't you just use the lancet and put the drop of blood into your eye?

[feemac]

Hello, have seen the recent initial positive findings from this research; very seriously thinking about just buying myself some diabetic lancets and trialling it myself. Anyone else have any views or thoughts on this? (or tried it themselves?!) I know if I ask GP they'll probably say no (as the research info states you shouldn't just do it) but I can't see any problem as long as you use common sense and do it safely and hygienically. Would love to hear if anyone else has tried. Thanks

[PhoenixEyes]

Hi feemac,

I've been doing this for just over a month on recommendation of an ophthalmologist who is in contact with one of the trial researchers, if you can get your GP to refer you to one of the ophthalmologists mentioned in the trials then they would certainly supervise your progress with it.

I have a thread here about it:
http://www.dryeyezone.com/talk/forum...659#post206659

Make sure you not only use a new sterile lancet each time but wipe with a sterilizing "alcohol prep pad" too before pricking, as with autologous serum there's a small risk of infection if the blood gets contaminated so keeping things sterile is important. I'm not a doctor so can't really advice of course but if you have any questions from a patient's perspective of doing this feel free to ask.

[PotatoCakes]

This is fascinating. I'd love to see a side by side comparison to serum drops or the experience of someone who has tried both.

When you apply the blood, do you get enough that it will 'drop' into the eye or do you touch your eye or lower lid to get the drop in? I'm trying to imagine squeezing enough that you don't need to squeeze your finger while you're applying.

Does the blood, in any way, moisturize your eyes? I find that, at least, upon application, my serum drops give me a bit of moisture. In the morning, most of all, I depend on this as it seems to work better than my commercial drops.

Do you put in commercial drops or saline, before or after, to help the blood spread over your eye better or does it do it without something like that?

How long does it take for the blood to "sink in" so you don't have smeared blood on your eyeball (I know that sounds graphic but I don't know how else to put it)?

[PhoenixEyes]

This is fascinating. I'd love to see a side by side comparison to serum drops or the experience of someone who has tried both.

Yeah, I think that would be interesting. A longer term study would also be good since autologous serum has been in use for longer.

I did find an old study that compared the amount of thymosin beta 4 in whole blood versus serum or plasma. The whole blood had 16.3 micrograms/ml and plasma had less than 1% of that amount. "If serum was prepared and not immediately removed from the clotted blood" it had 2.1 micrograms/ml. A company is developing a thymosin beta 4 eye drop for dry eye pain and inflammation called RGN-259 RegeneRX.

https://www.ncbi.nlm.nih.gov/pubmed/3654821

When you apply the blood, do you get enough that it will 'drop' into the eye or do you touch your eye or lower lid to get the drop in? I'm trying to imagine squeezing enough that you don't need to squeeze your finger while you're applying.

You're meant to touch the inside of the lower eyelid, referred to as the fornix, and not the eye. I'm not very good at it though so I swipe my finger downwards so the lid margin brushes the blood off my finger which then pools down under the eyelid (I hope that makes sense).

The lancing device I use, Genteel, has a vacuum feature so that it sucks up on the finger a little to draw the blood out, so I only need to squeeze gently if at all. Another member on Facebook said they also were doing this but stopped because their fingers got too sore before they saw a benefit. I dunno whether a different lancing device would have helped with that, my fingers aren't sore so far after just over a month of pricking 4x daily.

The skin heals surprisingly fast so the amount I get just depends on how quickly the wound shuts up. I keep alternating putting drops in each eye until my finger stops bleeding, sometimes that's just enough for a drop or two in each eye, other times I get more.

I tried to transfer blood to a pipette so I could use other places on my body than my fingers e.g. my arm or leg, but the whole blood just stuck to the pipette and didn't drop out. I guess there is some other tool that could be used but no idea what. Of course that wasn't part of the study though, only fingers. It'd be great if they made a device to do that in the future assuming the blood is the same wherever you take it. I think if you prick certain places long enough the skin starts to harden making it tougher to get blood out without switching to a higher lancet depth so being able to use other body parts would be good. I try to use different fingers but I only have a certain amount of them!

Does the blood, in any way, moisturize your eyes? I find that, at least, upon application, my serum drops give me a bit of moisture. In the morning, most of all, I depend on this as it seems to work better than my commercial drops.

I don't think so but I've read posts on the forum where people don't seem to find serum lubricating and use it more as a treatment to help inflammation and heal the surface as in keratitis etc. so I guess as with everything some may find it does while others won't. This dry eye malarky is so variable

Do you put in commercial drops or saline, before or after, to help the blood spread over your eye better or does it do it without something like that? How long does it take for the blood to "sink in" so you don't have smeared blood on your eyeball (I know that sounds graphic but I don't know how else to put it)?

I don't make a special effort to put anything in just before or been instructed to do so, I do use artificial tears regularly anyway though. I think the action of blinking is meant to spread it up from the lower eyelid. When I get a good amount of blood it clouds my vision for awhile, so it must spread over the cornea / pupil. I don't see red, it's just hazy.

I treat it like if I were putting in prescription eye drops and give it some time to absorb before putting in artificial tears like Hylo-Forte. I haven't paid much attention to how long it takes to sink in, don't think it's long though. Putting in an eye drop awhile after of course also will wash away any blood stain assuming there is some.

Just like if you were to put in an eye drop, the usual drainage occurs so the blood travels to the tear duct and some will spill out, especially if you have lower tear ducts plugged, essentially crying blood. Also sometimes I do end up accidentally smearing a bit around my eyes. I have had some laughs showing people my vampire-style Halloween make-up. I use WaterWipes (99.9% water, 0.1% grapefruit extract) and a bit of antibacterial hypochlorous water (e.g. Avenova, Heyedrate, Ocusoft Hypochlor, Aquaint, Natrasan) to clean the excess blood off closed eyelids.

[Feli12]

Thank you for writing up your experience. I just bought a supply of lancets, and I'm going to start doing this today.

Have you had issues with the skin on your fingers from having to prick them 4 times per day? It does make me feel for diabetics who must deal with this every day of their lives. Is there ever a concern for contamination, either in your eyes or in your finger, from directly pressing your bleeding finger to your eye?

I wonder if anyone has ever gotten a quantity of blood drawn, so that they have a big batch of it (refrigerated, I guess?) to go to for eye drops. Basically the same as getting a supply of serum drops made. It would eliminate having to do the finger prick all the time. (It might also be awkward at house parties. "Hey guys, just a heads up -- that's not Kool-Aid in the fridge!")