Severe ocular manifestations of rosacea in adult

Abstract

PurposeOcular rosacea in adult is a rare condition that may be responsible for palpebral, cunjonctival and corneal complications with severe visual functional prognosis in some cases. The purpose of this study is to determine the nature and prognosis of corneal complications in this disease through our study and literature reviewMethodsWe report seven patients (14 eyes) with severe ocular rosacea requiring hospitalization.ResultsThe mean age of our patients was 59.6 years. Six patients (85.6%) were female. Visual acuity was <1/10 in 10 eyes. The complications were keratitis in 7 eyes, corneal ulcerations in 5 eyes, corneal perforation in 5 eyes, and catarrhal infiltrates in 6 eyes. Limbal neovascularization was noted in 11 eyes. Only one patient has ocular‐cutaneous form. All patients were treated with oral cycline, topical steroids in acute phase, artificial tears and eyelid hygiene. A bandage contact lens was applied to 4 eyes. Three eyes required penetrating keratoplasty. They were successfully treated with improvement of symptoms and cicatrisation of corneal lesions. One case of corneal graft failed secondary to infectious keratitis.ConclusionsThe diagnosis of ocular rosacea is difficult because it often occurs without skin involvement. Ocular rosacea is the only complication of cutaneous rosacea. Diagnosis should be as early as possible because ocular complications are possible, with blinding potential. The best treatment is prevention with regular eyelid hygiene.

Treatment of ocular rosacea: a systematic review

“…After title and abstract screening of 7,150 articles and full text review of 348 articles, 66 articles were ultimately included in our review (Figure 1). 3,9–73 Studies were published between 1915 and 2021. Treatment modality categories included oral antibiotics (45 studies), topical antimicrobials (8 studies), lid hygiene (7 studies), IPL (6 studies), combination treatments (5 studies), isotretinoin (4 studies), topical cyclosporine (3 studies), and no intervention (3 studies) (Table 1).…”

“…For example, Hassairi et al achieved good results in patients with severe rosacea using topical steroids in the acute phase in addition to lid hygiene and oral doxycycline. 37 This review has several limitations. First, small sample sizes limit the generalizability of results and make direct comparison of results between modalities difficult.…”

“…For example, Hassairi et al. achieved good results in patients with severe rosacea using topical steroids in the acute phase in addition to lid hygiene and oral doxycycline 37 …”

Therapie der okulären Rosazea: Eine systematische Literatur‐Übersicht

“…So konnten Hassairi et al bei Patienten mit einer schweren Rosazea gute Ergebnisse durch eine Kombination aus einer topischen Anwendung von Glukokortikosteroiden in der akuten Phase zusätztlich zur Lidhygiene und einer oralen Behandlung mit Doxycyclin erzielen. 37 Einige Limitationen dieser Übersichtarbeit sollten erwähnt werden: Erstens können Ergebnisse aus Studien mit kleinen Fallzahlen nicht ohne weiteres verallgemeinert werden, was einen direkten Vergleich der Ergebnisse zwischen verschiedenen Behandlungsmodalitäten erschwert.…”

“…Letztendlich wurden 66 Studien in unsere Übersichtsarbeit eingeschlossen (Abbildung 1). 3,9–73 Die Publikationsdaten der Studien liegen zwischen 1915 und 2021. Die Behandlungsmodalitäten lassen sich wie folgt charakterisieren: Antibiotikatherapie per os (45 Studien), topische Behandlung mit antimikrobiellen Substanzen (8 Studien), Lidhygiene (7 Studien), IPL (6 Studien), Kombinationstherapien (5 Studien), Isotretinoin (4 Studien), topische Therapie mit Ciclosporin (3 Studien) und „keine Intervention“ (3 Studien) (Tabelle 1).…”