Role of <i>Demodex folliculorum</i> in the pathogenesis of blepharitis

Kosik-Bogacka, Danuta; Lanocha, Natalia; Łanocha, Aleksandra; Czepita, Damian; Grobelny, Andrzej; Zdziarska, Barbara; Kalisińska, Elżbieta

doi:10.1111/j.1755-3768.2012.02391.x

Cited by 15 publications

(15 citation statements)

References 3 publications

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“… 13 This alteration in the ocular flora enhances the production of lipid-degrading lipases and esterases, increasing the viscosity of the meibum. 38 , 39 Consequently, the highly viscous meibum further aggravates the blockage and inflammation of the MG, which forms a vicious self-sustaining loop. Inflammation was the target in this study, and breaking any of the links within the loop might alleviate the symptoms of MGD.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of intra-meibomian gland injection of the anti-VEGF agent bevacizumab for the treatment of meibomian gland dysfunction with lid-margin vascularity

Jiang¹,

Wang²,

Lv³

et al. 2018

DDDT

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PurposeTo investigate the efficacy of a novel treatment – intra-meibomian gland (MG) injection of the anti-VEGF agent bevacizumab – for MG dysfunction (MGD) with eyelid-margin vascularity.MethodsA total of 26 eyes from 13 patients diagnosed with MGD and eyelid-margin vascularity were included in our study. Patients received intra-meibomian gland injections of bevacizumab (150 μL, 2.5 mg/0.1 mL) at multiple sites with a 29 G needle where telangiectasia was severe. The Ocular Surface Disease Index (OSDI), tear film, tear-breakup time (TBUT), eyelid-margin features, MG features, conjunctiva, and corneal staining were assessed at 1 day before injection and 1 week, 1 month, and 3 months after injection. Blood pressure, best-corrected visual acuity, intraocular pressure, and slit lamp examinations were performed to assure the safety of patients at 1 day before and 1 day, 1 week, 1 month, and 3 months after injection.ResultsLid-margin vascularity, conjunctival injection, expressed secretion quality, expressivity of the MG, TBUT, corneal staining, and OSDI were significantly improved 1 week, 1 month, and 3 months after injection compared to baseline values. Lid-margin vascularity, conjunctival injection, meibomian gland expressivity, TBUT, and OSDI continued to improve; the greatest improvements were observed at 1 month and sustained for 3 months. Spearman’s correlation analysis indicated that age and sex significantly influenced TBUT improvement. Females and older patients tended to have shorter baseline TBUT that followed a different trend from that of males and younger patients during postinjection visits, revealed by subgroup analysis. No local or systemic side effects were observed at follow-up visits.ConclusionThis study is the first to explore a novel therapy for MGD – intra-MG injection of the anti-VEGF agent bevacizumab – and it demonstrates that the treatment is effective and safe in eliminating eyelid-margin vascularity, improving MG function and relieving clinical signs and symptoms of MGD.

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Section: Discussionmentioning

confidence: 99%

Efficacy of intra-meibomian gland injection of the anti-VEGF agent bevacizumab for the treatment of meibomian gland dysfunction with lid-margin vascularity

Jiang¹,

Wang²,

Lv³

et al. 2018

DDDT

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“…D. folliculorum is known to promote bacterial proliferation and cause inflammation of the eyelid and possibly the conjunctiva. 37 38 This ingrowth of bacteria enhances the production of lipid-degrading lipases and esterases that increase the viscosity and melting temperature of the meibum, reducing its secretion onto the surface of the tear film and thus closing the self-sustaining MGD circle. 1 Furthermore, upper and lower eyelid laxity may exacerbate reduced meibum drainage through decreased muscle pressure on the meibomian glands.…”

Section: Ded and Mgd: The Double Vicious Circlementioning

confidence: 99%

Revisiting the vicious circle of dry eye disease: a focus on the pathophysiology of meibomian gland dysfunction

et al. 2016

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Meibomian gland dysfunction (MGD) is the most frequent cause of dry eye disease (DED). Eyelid inflammation, microbial growth, associated skin disorders as well as potentially severe corneal complications culminate to make MGD a complex multifactorial disorder. It is probable that MGD is a heterogeneous condition arising from any combination of the following five separate pathophysiological mechanisms: eyelid inflammation, conjunctival inflammation, corneal damage, microbiological changes and DED resulting from tear film instability. The pathogenesis of both MGD and DED can be described in terms of a ‘vicious circle’: the underlying pathophysiological mechanisms of DED and MGD interact, resulting in a double vicious circle. The MGD vicious circle is self-stimulated by microbiological changes, which results in increased melting temperature of meibum and subsequent meibomian gland blockage, reinforcing the vicious circle of MGD. Meibomian gland blockage, dropout and inflammation directly link the two vicious circles. MGD-associated tear film instability provides an entry point into the vicious circle of DED and leads to hyperosmolarity and inflammation, which are both a cause and consequence of DED. Here we propose a new pathophysiological scheme for MGD in order to better identify the pathological mechanisms involved and to allow more efficient targeting of therapeutics. Through better understanding of this scheme, MGD may gain true disease status rather than being viewed as a mere dysfunction.

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“…It is believed that the mites may also participate in the development and intensification of other types of dermatitis, and recently interest has grown in this regard [ 25 , 26 ]. Among eye diseases, a positive correlation was mostly observed between the presence of Demodex and inflammation of the eyelid margins [ 17 , 24 , 25 , 27 , 28 ]. Therefore, a knowledge of the potential of Demodex as an etiological agent is not only important for the sake of research, but it can also contribute to more effective treatment of certain diseases of the eyes and skin.…”

Section: Introductionmentioning

confidence: 99%

Demodexsp. as a Potential Cause of the Abandonment of Soft Contact Lenses by Their Existing Users

Tarkowski¹,

Moneta-Wielgoś

Młocicki

2015

BioMed Research International

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Demodex mites may be a potential etiological factor in the development of various eye and skin disorders. The aim of the study was to investigate the presence of Demodex in the hair follicles of eyelashes and their potential influence on abandoning soft contact lenses which had been previously well tolerated by their users. A group of 62 users of contact lenses (28 with emerging discomfort and 34 without discomfort) were examined. There is a need to check the existence of a relationship between D. folliculorum or/and D. brevis infestation and the emergence of intolerance to the presence of soft contact lenses. The removed lashes were examined under light microscopy, applying standard parasitological methods if demodicosis is suspected. A positive result was assumed if at least one adult stage, larva, protonymph/nymph, or egg of D. folliculorum and/or D. brevis was present. A positive correlation was observed between the presence of Demodex and intolerance to contact lenses by their existing users (p < 0.05), and Demodex sp. infections were observed in 92.86% of patients with intolerance to contact lenses. Our results provide further evidence for the pathogenic role played by the mites in the development of eye diseases.

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Role of Demodex folliculorum in the pathogenesis of blepharitis

Cited by 15 publications

References 3 publications

Efficacy of intra-meibomian gland injection of the anti-VEGF agent bevacizumab for the treatment of meibomian gland dysfunction with lid-margin vascularity

Efficacy of intra-meibomian gland injection of the anti-VEGF agent bevacizumab for the treatment of meibomian gland dysfunction with lid-margin vascularity

Revisiting the vicious circle of dry eye disease: a focus on the pathophysiology of meibomian gland dysfunction

Demodexsp. as a Potential Cause of the Abandonment of Soft Contact Lenses by Their Existing Users

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