Clinical Scorecard: The Growing Use of Amniotic Membranes in Dry Eye Disease

At a Glance

Key Highlights

• Amniotic membranes are increasingly utilized for treating dry eye disease.
• Corneal nerve damage is a significant factor in dry eye pathology.
• Cryopreserved amniotic membranes (CAM) improve signs and symptoms of DED.
• Early intervention with CAM can restore corneal nerves and prevent further damage.
• Documenting treatment failures is crucial for insurance coverage and prior authorizations.

Guideline-Based Recommendations

Diagnosis

• Assess corneal sensitivity to identify neurotrophic keratitis.

Management

• Start with conservative therapies before considering amniotic membranes.

Monitoring & Follow-up

• Monitor corneal nerve density as a potential gauge for DED severity.

Risks

• Consider comorbid conditions such as glaucoma when selecting treatment.

Patient & Prescribing Data

Patients with chronic dry eye, including those with neurotrophic keratitis.

CAM is preferred due to its retention of growth factors and effectiveness in reducing inflammation.

Clinical Best Practices

• Individualize treatment based on patient history and corneal sensitivity.
• Use documented treatment failures to support prior authorization for CAM.
• Evaluate the appropriateness of CAM types based on patient comfort and specific conditions.

Related Resources & Content

• Utilization patterns and costs of ocular amniotic membrane grafts in the Medicare population
• TFOS DEWS II definition and classification report