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Gao YY, Wang T, Jiang YT, Yang MJ, Lu XH, Zheng L, Wang ST, Shi WY. Should ocular Demodex be checked and treated in refractory keratitis patients without blepharitis? Int J Ophthalmol 2023; 16:201-207. [PMID: 36816200 PMCID: PMC9922622 DOI: 10.18240/ijo.2023.02.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/27/2022] [Indexed: 02/05/2023] Open
Abstract
AIM To evaluate the correlation between Demodex infestation and keratitis, and to assess demodicosis using a simple approach. METHODS A modified slit lamp illumination (at 40× magnification) was used to observe Demodex tails in 40 patients with refractory keratitis and 80 healthy controls. Bacterial smear and culture of the conjunctival sac and corneal lesion were performed to identify the pathogen. Tea tree oil ointment (TTOO) was added as a Demodex killing agent for lid scrubs to the treatment when Demodex infestation was confirmed. RESULTS Demodex tails were found in all patients compared to 42/80 of the controls (P<0.01). Seventeen patients presented blepharitis, while 23 were free of scales and inflammation at the lid margin. The demodicosis was mild, moderate, and severe in 8, 19, and 13 patients, respectively, compared to mild in 42 controls (P<0.01). The keratitis was mild, moderate, and severe in 13, 19, and 8 patients, respectively. The severity of Demodex infestation was not correlated to the severity of keratitis (P=0.126). The growth of Staphylococcus was revealed in nine patients who did not react to antibiotic eye drops prior to the TTOO treatment. Patients' signs and symptoms got resolved after the lid scrub with TTOO. CONCLUSION Ocular Demodex needs to be checked and treated in refractory keratitis patients with or without blepharitis. A slit-lamp illumination under high magnification favors the judgment of the severity of Demodex infestation.
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Affiliation(s)
- Ying-Ying Gao
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Ting Wang
- Eye Hospital of Shandong First Medical University, Jinan 250021, Shandong Province, China,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Yu-Ting Jiang
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Ming-Jun Yang
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Xiu-Hai Lu
- Eye Hospital of Shandong First Medical University, Jinan 250021, Shandong Province, China
| | - Ling Zheng
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Shu-Ting Wang
- Eye Hospital of Shandong First Medical University, Jinan 250021, Shandong Province, China
| | - Wei-Yun Shi
- Eye Hospital of Shandong First Medical University, Jinan 250021, Shandong Province, China,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
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