J Korean Ophthalmol Soc.  2018 May;59(5):403-409. 10.3341/jkos.2018.59.5.403.

The Effect of 5% Serum Albumin on Intractable Corneal Epithelial Keratitis: a Case Series and Literature Review

• Hwang Y
• Cho YK

• KMID: 2411448
• DOI: http://doi.org/10.3341/jkos.2018.59.5.403

Abstract

PURPOSE
We report five cases of intractable epithelial keratitis in which 5% serum albumin showed significant effects as a topical treatment when compared with other previous conservative treatments based on a literature review.
METHODS
This was a retrospective observational case series of five patients with intractable corneal epithelial keratitis who used serum albumin as a topical treatment. All patients had already been using other conservative treatments such as non-preserved artificial tears and autologous serum eye drops. The size of the epithelial defect and the time taken for closure of the epithelial defect were observed.
RESULTS
The study involved five patients with intractable corneal epithelial disease with a mean follow-up time of 6 months. The epithelial lesions improved with the use of 5% serum albumin from the beginning of treatment and lasted throughout the follow- up period. The mean time to complete epithelial closure using 5% serum albumin eye drops was 21 days.
CONCLUSIONS
Treatment with 5% serum albumin eye drops may have a significant and stable effect in the treatment of intractable corneal epithelial disease.

Keyword

Intractable corneal epithelial keratitis; Serum albumin eye drop

MeSH Terms

Follow-Up Studies
Humans
Keratitis*
Lubricant Eye Drops
Ophthalmic Solutions
Retrospective Studies
Serum Albumin*
Lubricant Eye Drops
Ophthalmic Solutions
Serum Albumin

Figure

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  Figure 1. Persisted corneal epithelial defects after alkaline chemical burn. (A) Immediately after chemical burn. (B) Immediately before using 5% serum albumin. (C) 3 weeks after using 5% serum albumin. (D) 6 weeks after using 5% serum albumin.

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  Figure 2. Corneal epithelial defect due to Graft-versus-host reaction after allograft rejection. (A) Continous corneal epithelial defect. (B) Immediately before using 5% serum albumin. (C) 2 weeks after using 5% serum albumin.

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  Figure 3. Epithelial defect due to exposure keratopathy after blepharoplasty. (A) Epithelial defect due to persistent corneal exposure. (B) Immediately before using 5% serum albumin. (C) 4 weeks after using 5% serum albumin.

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  Figure 4. Epithelial defect in patients with postherpeticneurotrophic keratitis. (A) Repeated corneal epithelial defect. (B) Immediately after amniotic transplantation. (C) Corneal epithelium deteriorating again after amniotic transplantation. (D) 1 weeks after using 5% serum albumin. (E) 4 weeks after using 5% serum albumin.

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  Figure 5. Epithelial defect persisted after penetrating keratoplasty. (A) Before using 5% serum albumin, 3 weeks after penetrating keratoplasty (punctal plug, autologous serum eye drops, preservativefree artificial tears are already in use). (B) 1 weeks after using 5% serum albumin. (C) 3 weeks after using 5% serum albumin.

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  Figure 6. The Cohn process, developed by Edwin J. Cohn, is a series of purification steps with the purpose of extracting albumin from blood plasma. The process is based on the differential solubility of albumin and other plasma proteins based on pH, ethanol concentration, temperature, ionic strength, and protein concentration. Albumin has the highest solubility and lowest isoelectric point of all the major plasma proteins. This makes it the final product to be precipitated, or separated from its solution in a solid form. vWF = von willebrand factor.

Reference

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