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J.M. Vargas, J. Aronowicz, W.E. Shine, D. Oral, J.P. McCulley; Short-Term Treatment of Chronic Blepharitis With Oral Minocycline . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2506.
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Purpose: To investigate in chronic blepharitis the effects of oral minocycline on tear film function, bacterial cultures, vital staining of ocular surface and meibography. Methods: A prospective nonrandomized study of 20 eyes of 10 patients with chronic blepharitis treated with oral minocycline was done. Routine ophthalmologic examination, evaporometry, fluorophotometry, bacterial cultures, lissamine green staining of the ocular surface, Schirmer's test without anesthetic and meibography were done before starting minocycline and after three months of treatment with minocycline. Results: Of the 10 patients, there were 8 men and 2 women with a mean age of 68.6 years, (range 32-89 years). Tear flow decreased (0.33 vs 0.23, p = 0.10) from the first visit to the second visit. Tear volume decreased (3.02 vs 2.02, p = 0.03); tear turnover increased (0.13 vs 0.16, p = 0.87), the Schirmer's test value decreased (18.75 vs 13.00, p = 0.016), and evaporation decreased (6.427 vs 5.642, p = 0.43). Meibomian gland dropout percentages remained the same (21.789 vs 21.700, p = 0.76). Staphylococcus epidermidis was present at both visits; anaerobe (normal flora) was present in 80% on the first visit, 50% on the second visit. The lissamine green staining showed no changes at the different visits. Conclusions: Oral minocycline treatment of patients with chronic blepharitis resulted in decreased tear volume and Schirmer's value suggesting an adverse effect on aqueous tears but a stabilization of the lipid layer manifest by decreased tear evaporation on therapy.
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