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Tomo Suzuki, Kazuhiro Maeda, Chie Sotozono, Shigeru Kinoshita; Bacterial flora of the meibum in elderly patients with meibomian gland dysfunction. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3918.
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© ARVO (1962-2015); The Authors (2016-present)
Meibomian gland dysfunction (MGD) is sometimes accompanied with inflammation (meibomitis) which has an influence on the ocular surface inflammation. We previously reported the role of Propionibacterium acnes (P. acnes) in the meibomitis-related keratoconjunctivitis (MRKC) of young patients and the effectiveness of systemic antimicrobial treatment for targeting P. acnes (AJO 2005, and The Ocular Surface 2015). In this present study, we examined the bacterial flora of the meibum in elderly patients with MGD.
This study involved 19 meibomitis patients (mean age: 69.5 years) and 9 patients with obstructive MGD without obvious inflammation (mean age: 65.8 years). After a warm compress of the eyelids (40°C, 10 minutes) followed by sterilization on the lid margin by diluted povidone iodine, meibum was obtained from the eyes of each subject by use of a Daviel cataract spoon after gently squeezing the eyelid margin by use of a Yoshitomi meibomian gland compressor (T.M.I. Co. Ltd., Saitama, Japan) under a surgical microscope. All specimens were immediately placed into culture medium “ANA port BIKEN2®” (The Research Foundation of Microbial Diseases of Osaka University, Osaka, Japan), and both aerobic and anaerobic bacterial examinations were performed.
Bacterial culture of the meibum in the meibomitis patients revealed that 44.2% were positive for P. acnes, 25.6% were positive for Staphylococcus epidermidis (S. epidermidis), and that 16.6% were negative for bacterial flora, yet that of the meibum from the MGD patients without inflammation showed that 10% were positive for P. acnes, 3.3% were positive for S. epidermidis, and that 70% were negative for bacterial flora.
The findings of this study show that the causative bacterium for meibomitis may change according to age. In elderly MGD patients, not only P. acnes but also S. epidermidis might play a role in the inflammation. Using the appropriate systemic antimicrobial agents is important for the successful treatment of meibomitis.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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