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Neuropathic PainNCT07566806

Evaluation of the Clinical Efficacy and Mechanisms of Cord Plasma Eye Drops in the Treatment of Neuropathic Corneal Pain

A study testing Cord plasma eye drops in people with Neuropathic Pain and Corneal Disease, run by Singapore Eye Research Institute at 1 site in Singapore.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to investigate the efficacy and work of action of cord plasma eye drops in the treatment of neuropathic corneal pain (NCP). The main question it aims to answer if the cord plasma eye drops are effective for the treatment of NCP through its neurotrophic and anti-neuroinflammatory… Read more about this study

Who is it for?
Ages 21 years and older
Conditions the study is for
Neuropathic Pain, Corneal Disease
What is being tested?
Cord plasma eye drops
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteSingapore
Study dates
16 Sep 2023to 15 Sep 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 21 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Persistent ocular pain or pain-like symptoms, including burning sensation, allodynia, photoallodynia, stinging, hyperalgesia, throbbing, shooting, sharp, cramping, gnawing, or a feeling of electric shock, with a minimum score of 30% for more than 3 questions in the OPAS questionnaire (see below section for OPAS questionnaire), for at least 3 months;
  • Presence of corneal nerve abnormalities, including microneuromas, beading, nerve tortuosity, decreased in corneal nerve fiber density (CNFD) or corneal nerve fiber length (CNFL), on IVCM images;
  • Minimal or no ocular surface fluorescein staining, with the National Eye Institute (NEI) and ocular surface Oxford score <2;
  • Patients who will receive cord plasma eye drops treatment

Who cannot join

  • Presence of active ocular surface diseases, such as active infective keratitis, the presence of epithelial defect or any other conditions that may cause nociceptive pain
  • Active anterior or posterior blepharitis;
  • Presence of concomitant ocular diseases that may cause ocular pain, such as uveitis or other ocular inflammatory diseases;
  • Concurrent treatment with immunosuppressants, such as topical cyclosporin or steroid eye drops
  • Concurrent use of oral Nonsteroidal anti-inflammatory drugs (NSAID) or other medications that may affect the pain scores

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Yu-Chi Liu, PhD contact

65 65767493

liu.yu.chi@snec.com.sg

Singapore1 site, 1 recruiting
  • Singapore Eye Research Institute

    Singapore, Singapore, 169856

    Yu-Chi Liu, PhD, 65 65767493, liu.yu.chi@snec.com.sg

    Recruiting

Other trials in Singapore

About this study

The goal of this clinical trial is to investigate the efficacy and work of action of cord plasma eye drops in the treatment of neuropathic corneal pain (NCP). The main question it aims to answer if the cord plasma eye drops are effective for the treatment of NCP through its neurotrophic and anti-neuroinflammatory effects.

Read the detailed description

Neuropathic corneal pain (NCP) is characterized by dysfunctional corneal nerves and ocular symptoms including pain, discomfort, burning, stinging, allodynia, and photophobia, are typically not relieved by conventional dry eye treatment due to its neurobiological nature. NCP can be associated with systemic diseases, such as diabetes mellitus and trigeminal neuralgia, or various ocular conditions such as severe dry eye disease, herpes simplex keratitis, or post-refractive surgery. The incidence of NCP is approximately 11-13% after refractive surgery (unpublished data), and it is likely to increase with the growing prevalence of dry eye and diabetes mellitus, as well as the growing popularity of ocular surgery. Moreover, the symptoms of NCP can greatly impact the quality of life and can cause a significant psychological and economic burden. It is often refractory to conventional treatments, leading to a significant impact on patients' quality of life and present as a challenge for clinicians seeking effective treatment strategies. The limited effectiveness of existing therapies for NCP has prompted the investigation of novel treatment options, including blood-derived eye drops.

Blood-derived eye drops, including serum-derived and plasma-derived eye drops, have been employed in a variety of clinical applications in ocular surface diseases because of their advantageous qualities and ability to enhance the ocular surface. Blood-derived eye drops can be prepared either from patients' own blood, such as autologous serum tears (AST) and Platelet-rich Plasma, or from allogeneic donors such as Umbilical Cord blood serum. A variety of bioactive compounds packed in blood-derived eye drops have equipped them with neuroprotective and regenerative properties that aid in corneal repair and nerve regeneration. Several mechanisms, including neuroprotection, anti-inflammatory effects, control of neuronal sensitization, and promotion of corneal epithelial repair, have been shown.

The potential efficacy of blood-derived eye drops on NCP has previously been studied. Aggarwal et al. have found that AST treatment reduced NCP patients' symptoms and enhanced the recovery of corneal nerve morphology. AST has also been reported to be beneficial for patients with photoallodynia in NCP. With the treatment with 20% AST, patients' allodynia and photoallodynia symptoms significantly improved within 3.6 months. Moreover, using autologous serum has been shown to reduce the appearance of neuromas and sub-basal corneal nerve beading. Additionally, serum tears have been shown to improve corneal nerve total length and number, as well as to reduce neural reflectivity and nerve tortuosity. Aggarwal et al. further found that the quantity of corneal nerve regeneration following treatment with AST correlated with the improvement in patients' symptoms of NCP. Another study investigated the neurotrophic potential of human platelet lysate (HPL) for corneal nerve regeneration in rat models. HPL has significantly higher concentrations of neurotrophic factors compared with human peripheral serum (HPS), and it showed corneal neurotrophic abilities both in vitro and in vivo. Taken together, blood-derived eye drops provide growth factors and cytokines that support corneal nerve regeneration, suppress ocular surface inflammation, and modulate the pain signaling pathways. However, the detailed mechanisms have not been investigated yet. Studies on the clinical efficacy and molecular profiles of the use of cord plasma eye drops in the treatment of NCP are also lacking.

SNEC has collaborated with Singapore Cord Blood Bank to provide cord blood plasma service, and cord blood plasma eye drops have been used as standard clinical care for patients with ocular surface diseases, severe dry eye, and NCP in SNEC. In the pilot study, the size of corneal neuromas has been found to be decreased after 3-month cord plasma eye drops treatment in patients with NCP (please find section 5 for preliminary data). The present proposal aim to evaluate the clinical efficacy and mechanisms of cord plasma eye drops in the treatment of NCP.

Being tested
Cord plasma eye drops
Keywords
Neuropathic corneal pain, Cord plasma eye drops, Blood-derived eye drops, Corneal nerves, Tear mediators
Medical subject headings
Neuralgia, Corneal Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cord plasma eye dropsDrug

    SNEC has collaborated with Singapore Cord Blood Bank to provide cord blood plasma service, and cord blood plasma eye drops have been used as standard clinical care for patients with ocular surface diseases, severe dry eye, and NCP in SNEC.

Study groups in NCT07566806
Study groupRoleWhat they receive
Patients with NCPExperimentalPatients who have been advised and scheduled to receive cord plasma eye drops treatment for their NCP will be recruited. The NCP will be diagnosed based on the following criteria.
Receives: Drug: Cord plasma eye drops

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pain symptoms evaluated by Ocular Pain Assessment Survey (OPAS) questionnaire

    Ocular pain will be assessed using the Ocular Pain Assessment Survey (OPAS) questionnaire. The Ocular Pain Assessment Survey (OPAS) is a 27-item questionnaire to evaluate the eye pain from 6 dimensions, including pain intensity for the last 24h, pain intensity for the last 2 weeks, non-eye pain intensity, quality of life, aggravating factors, associated factors and symptom relief. Each question was scored on a scale of 0-10 or 100%, with higher score representing worse pain.

    Measured: 3 months

  2. Corneal nerve morphology assessment by in vivo confocal microscopy (IVCM)

    IVCM (Heidelberg Retina Tomography III. Rostock Cornea Module, Heidelberg Engineering GmbH) will be used to examine the subbasal nerve plexus. The images will be analyzed using ACCMetrics software and get the quantitative nerve parameters.

    Measured: 3 months

Secondary outcomes (9)
  1. Tear neuromediator levels

    Tear samples will be taken from the wetted Schirmer strips, and will be subjected to neuromediators analysis using enzyme-linked immunosorbent assay (ELISA): Substance P (pg/ml; 6x dilution), CGRP (pg/ml; 4x dilution), and NGF (pg/ml; 1.5x dilution), respectively (CGRP from Phoenix Pharmaceuticals, Runcorn, UK; Substance P and NGF from R\&D Systems, Minneapolis, USA).

    Measured: 3 months

  2. Ocular Surface Disease Index (OSDI) questionnaire to measure eye symptoms and the impact of quality of life.

    The Ocular Surface Disease Index (OSDI), a 12-item questionnaire, will be also used to assess the symptoms of dry eye. The OSDI is a 12-item questionnaire that used to assess the eye symptoms and and their impact on vision-related quality of life.

    Measured: 3 months

  3. Amount of tear production measured by Schirmer's I test

    Schirmer's I test is a diagnostic method used to measure tear production by placing a standard 5 mm wide Test Strips inside the lower lid margin and assessing the amount of tear absorbed over 5 minutes.

    Measured: 3 months

  4. Corneal sensitivity measurements assessed by Cochet-Bonnet esthesiometer

    Corneal sensitivity measurements assess the responsiveness of the cornea to external stimuli using a contact Cochet-Bonnet esthesiometer, which employs a retractable nylon filament marked from 0 to 6 cm. The filament is progressively shortened in 0.5 cm increments until the participant perceives the stimulus. The maximum filament length that successfully triggers a response is recorded in centimeters as a measure of corneal sensitivity.

    Measured: 3 months

  5. Tear film stability

    Tear Break-up time (TBUT) will be measured by determining the time interval between a complete blink and the first appearance of a dry spot on the corneal surface, indicating tear film stability.

    Measured: 3 months

  6. National Eye Institute (NEI) Score

    The cornea will be divided into five regions, each scored ranging from 0 (no fluorescein staining) to 3 (severe fluorescein staining) according to the grading scheme. The total NEI score will range from 0 to 15.

    Measured: 3 months

  7. Oxford scores

    The staining intensity on the ocular surface will be assessed according to the Oxford score scheme: the staining pattern will be graded on a scale from 0 to 5, indicating the intensity from no staining to severe.

    Measured: 3 months

  8. Corneal microneuromas morphology profiles

    IVCM will be used to capture images of corneal microneuromas, which are characterized by irregularly shaped enlargements of terminal nerve endings with poorly defined margins and variable hyper-reflectivity. The images containing corneal microneuromas will be manually identified and the total area and perimeter will be quantified using Image J software.

    Measured: 3 months

  9. Abundance of tear proteins assessed by quantitative proteomic analysis

    Tear fluid samples will be collected by the strips from Schirmer's I test. Quantitative proteomic analysis technique will be used to measure and compare the abundance of proteins across different samples, providing insights into protein expression, functions, and molecular interactions.

    Measured: 3 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 May 2026
  2. Study start16 Sep 2023
  3. Primary completion15 Sep 2026 (estimated)
  4. Study completion15 Sep 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
20 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07566806
Sponsor's protocol ID
2023-2597
Status last verified
Apr 2026
First submitted
1 Apr 2026
Last updated
5 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Dieckmann G, Goyal S, Hamrah P. Neuropathic Corneal Pain: Approaches for Management. Ophthalmology. 2017 Nov;124(11S):S34-S47. doi: 10.1016/j.ophtha.2017.08.004.

    PubMed 29055360
  • Gendrel D, Nardou M, Mouba JF, Gahouma D, Moussavou A, Boguikouma JB. [Hepatotoxicity of the combination of isoniazid-rifampicin in African children. Role of malnutrition and HB virus]. Arch Fr Pediatr. 1989 Nov;46(9):645-8. French.

    PubMed 2604523
  • Aggarwal S, Colon C, Kheirkhah A, Hamrah P. Efficacy of autologous serum tears for treatment of neuropathic corneal pain. Ocul Surf. 2019 Jul;17(3):532-539. doi: 10.1016/j.jtos.2019.01.009. Epub 2019 Jan 24.

    PubMed 30685437
  • Wong J, Govindasamy G, Prasath A, Hwang W, Ho A, Yeo S, Tong L. Allogeneic Umbilical Cord Plasma Eyedrops for the Treatment of Recalcitrant Dry Eye Disease Patients. J Clin Med. 2023 Oct 25;12(21):6750. doi: 10.3390/jcm12216750.

    PubMed 37959215
  • Anam A, Liu C, Tong L, Liu YC. Blood-Derived Eye Drops for the Treatment of Corneal Neuropathic Pain. J Ocul Pharmacol Ther. 2024 Jun;40(5):281-292. doi: 10.1089/jop.2023.0155. Epub 2024 Apr 22.

    PubMed 38648544
  • Norkett B. The role of nursing in marketing health care. Nurs Adm Q. 1985 Fall;10(1):85-9. doi: 10.1097/00006216-198510010-00009. No abstract available.

    PubMed 3852115

Questions about this trial

What is this clinical trial studying?

A study testing Cord plasma eye drops in people with Neuropathic Pain and Corneal Disease, run by Singapore Eye Research Institute at 1 site in Singapore.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 5 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Singapore. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Yu-Chi Liu, PhD (65 65767493, liu.yu.chi@snec.com.sg), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pain symptoms evaluated by Ocular Pain Assessment Survey (OPAS) questionnaire (time frame: 3 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07566806, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 May 2026; AzTrials last refreshed its copy on 8 Nov 2026.

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