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Clare Halleran, Leslie O'Dell, Jennifer S Harthan, Justin Timothy Kwan, Kristen Hipolito, Milton M Hom; An Evaluation of the Presence of Demodex and its influence on Meibomian Gland structure. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4389.
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The Purpose of this study was to evaluate any correlation, or lack of correlation, between the presence of Demodex mites and meibomian gland (MG) structure. The study evaluated structure in terms of both gland atrophy and tortuosity.
This was a multicenter study evaluating ocular surface symptoms with the UNC and SPEED questionnaires. Bilateral epilation of two eyelashes per eye was performed followed by microscopic evaluation counting of mites. Meibography was also performed on upper and lower eyelids. The Pult and Halleran scales were used to grade MG atrophy and tortuosity respectively. The Gao scale was used to grade cylindrical dandruff (CD). Statistical analyses included unpaired t-test
Fourteen subjects were found to have Demodex folliculorum and 7 subjects had no mites. The average age of each cohort was 54.0 and 33.9 respectively. Symptomatology measured by SPEED (p = 0.226) and UNC (p = 0.505) were not found to be different between the two groups. Neither was there a difference in MG morphology (atrophy and tortuosity). The cylindrical dandruff amount and severity reflected the presence of mites found upon epilation. When the sample was separated by ethnicity (53% Hispanic, 47% White), Hispanics were found to have more MG tortuosity in the lower eyelids than White (p = 0.005)
This study confirmed that cylindrical dandruff is pathognomonic for Demodex and that symptomology may not always be significantly higher than those without Demodex. We found that Hispanics had more MG tortuosity than Whites. Further ethnic differences MG morphology is worth exploring. The presence of mites does not affect MG physical configuration, therefore MGD related to demodex must be obstruction probably due to cylindrical dandruff
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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