Oral azithromycin and oral doxycycline for the treatment of Meibomian gland dysfunction: A 9-month comparative case series

Purpose: To report the clinical profile and effectiveness of oral doxycycline as a non-invasive treatment for glaucoma filtering surgery complications. Method: Prospective case series. Results: Doxycycline is widely used in treating corneal melts, ocular surface diseases, meibomian gland disease, recurrent epithelial cell erosion, rosacea, and keratitis sicca. This prospective case series highlights the successful treatment of five patients with leaking blebs and conjunctiva erosion from glaucoma filtration surgery with the use of oral doxycycline. There was no adverse event reported in our cases. Conclusions: This study suggests that oral doxycycline may be a feasible non-surgical treatment modality due to its ability to inhibit collagenolysis, restore the Meibomian gland function, thereby stopping breakdown and promote conjunctival tissue healing.

Download Full-text

Topical Azithromycin and Oral Doxycycline Therapy of Meibomian Gland Dysfunction

Cornea ◽

10.1097/ico.0b013e318254205f ◽

2013 ◽

Vol 32 (1) ◽

pp. 44-53 ◽

Cited By ~ 78

Author(s):

Gary N. Foulks ◽

Douglas Borchman ◽

Marta Yappert ◽

Shelley Kakar

Keyword(s):

Meibomian Gland ◽

Meibomian Gland Dysfunction ◽

Oral Doxycycline

Download Full-text

Oral azithromycin versus doxycycline in meibomian gland dysfunction: a randomised double-masked open-label clinical trial

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2014-305410 ◽

2014 ◽

Vol 99 (2) ◽

pp. 199-204 ◽

Cited By ~ 42

Author(s):

Mohsen Bahmani Kashkouli ◽

Ali Jalili Fazel ◽

Victoria Kiavash ◽

Marzieh Nojomi ◽

Leila Ghiasian

Keyword(s):

Clinical Trial ◽

Meibomian Gland ◽

Meibomian Gland Dysfunction ◽

Open Label ◽

Oral Azithromycin

Download Full-text

Significant correlation between meibomian gland dysfunction and keratitis in young patients with Demodex brevis infestation

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-310302 ◽

2017 ◽

Vol 102 (8) ◽

pp. 1098-1102 ◽

Cited By ~ 11

Author(s):

Lingyi Liang ◽

Yan Liu ◽

Xiaohu Ding ◽

Hongmin Ke ◽

Chuan Chen ◽

...

Keyword(s):

Multivariate Analyses ◽

Young Patients ◽

Case Series ◽

Meibomian Gland ◽

Meibomian Gland Dysfunction ◽

Demodex Folliculorum ◽

Demodex Brevis ◽

Upper Lid ◽

Punctate Keratitis ◽

Microscopic Counting

AimsTo report the clinical characteristics and correlation between meibomian gland dysfunction (MGD) and keratitis in young patients with ocular demodicosis.MethodsObservational case series of 60 patients younger than 35 years with ocular demodicosis, of which the diagnosis was based on microscopic counting of Demodex folliculorum and D. brevis of epilated lashes. Severity of keratitis and MGD was graded by photography and meibography, respectively, in a masked fashion.ResultsMGD was detected in 54/60 (90%) patients with the loss of meibomian gland in the upper lid more than the lower lid (p<0.001). Blepharoconjunctivitis and a variety of corneal pathologies were noted in 47/60 (78.3%) and 39/60 (65%) patients, respectively. For a total of 120 eyes, normal cornea was noted in 53 (44.2%) eyes, superficial punctate keratitis or limbitis was noted in 17 (14.2%), while corneal stromal infiltration was found in 50 (41.7%) eyes. Both univariate and multivariate analyses showed that the severity of meibomian gland loss was significantly correlated with higher D. brevis count and more severe keratitis (all p<0.05). Rapid resolution of keratitis and blepharoconjunctivitis was accompanied by significant reduction of the Demodex count in 48 patients receiving lid scrub directed to kill mites.ConclusionsThere is a significant correlation between MGD and keratitis in young patients with ocular demodicosis especially inflicted by D. brevis.

Download Full-text

Characterization and Prediction of the Clinical Outcome of Intense Pulsed Light-Based Treatment in Dry Eye Associated to Meibomian Gland Dysfunction

Journal of Clinical Medicine ◽

10.3390/jcm10163573 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3573

Author(s):

María T. Iradier ◽

María Ángeles del Buey ◽

Cristina Peris-Martínez ◽

Priscilla Cedano ◽

David P Piñero

Keyword(s):

Case Series ◽

Tear Film ◽

Meibomian Gland ◽

Intense Pulsed Light ◽

Meibomian Gland Dysfunction ◽

Successful Outcome ◽

Pulsed Light ◽

Ocular Surface Disease Index ◽

Non Invasive ◽

Break Up

This non-comparative prospective case series was conducted to characterize the clinical impact of intense pulsed light (IPL)-based treatment in dry eyes associated to Meibomian gland dysfunction (MGD), defining the predicting factors for a successful outcome with this therapy in a large case series. A total of 390 eyes (195 patients, range: 23–93 years) received four sessions of Optima IPL system (Lumenis, Yokneam, Israel). Significant changes were observed in tear film osmolarity in both eyes (p < 0.001) and in meibum quality (p < 0.001), with more eyes showing clear or yellow secretions after therapy. Mean change in the ocular surface disease index (OSDI) was −8.61, ranging from −27.00 to 11.00. This change was significantly correlated with the baseline value of OSDI (r = −0.489, p < 0.001). The change in osmolarity correlated significantly with the baseline osmolarity in both eyes (right r = −0.636, left r = −0.620, p < 0.001). A linear predicting model of the change in OSDI with therapy was obtained: change OSDI = 10.99 − 0.35 × OSDI − 1.03 × NIBUTRE-LE (mean non-invasive break up time of right and left eye) −2.03 × Meibum quality grade (p = 0.001; R2: 0.325). In conclusion, the improvement in symptomatology achieved with an IPL-based therapy can be predicted at baseline using a linear model considering the level of MGD and the magnitude of OSDI and NIBUT (non-invasive break-up time).

Download Full-text

Comparative study on the effect of hyperthermic massage and mechanical squeezing in the patients with mild and severe meibomian gland dysfunction: An interventional case series

PLoS ONE ◽

10.1371/journal.pone.0247365 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0247365

Author(s):

Dongkyun Han ◽

Hoon Kim ◽

Sehwan Kim ◽

Yuli Park ◽

Kyong Jin Cho

Keyword(s):

Ocular Surface ◽

Clinical Signs ◽

Case Series ◽

Meibomian Gland ◽

Meibomian Gland Dysfunction ◽

Significant Difference ◽

Before And After ◽

Group 2 ◽

Group 1 ◽

Mechanical Squeezing

Background Meibomian glands exist beneath the palpebral conjunctiva; thus, it is invisible to the naked eye without infrared imaging. This study used meibography to group patients with meibomian gland dysfunction (MGD) and assessed the effects of hyperthermic massage and mechanical squeezing in both groups. Materials and methods Patients with MGD were divided into two groups, according to the degree of meibomian gland loss: group 1, in which the sum of eyelid scores ranged from 0 to 4 (mild to moderate gland loss) and group 2, in which the sum of eyelid scores ranged from 5 to 6 (severe gland loss). Hyperthermic massage and mechanical squeezing were given to both groups once a week for 4 weeks, and only non-preservative artificial tears were allowed. Ocular surface disease index (OSDI), Schirmer’s test, meibography score, tear break-up time (TBUT), ocular surface staining, expressible meibomian gland, and quality before and after treatment were compared. Results Of the 49 patients who completed the 4 weeks of treatment and the evaluation at week 5, 29 were assigned to group 1 and 20 were assigned to group 2. Meibography scores, OSDI, TBUT, and expressibility of meibum had significant differences before and after treatments in both groups. However, there was no significant difference between the changes in clinical signs between group 1 and 2 after treatment. Without grouping, all patients showed significant decreases in meibography score, OSDI, cornea staining score, and increases in TBUT and expressibility of meibum after treatment. Conclusions Considering the results of the current study, hyperthermic massage and mechanical squeezing may be effective in patients with meibomian gland loss, regardless of the degree of severity.

Download Full-text