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Jae Chan Kim, Koo Hyun, Doo Hawn Oh, Yeoun Sook Chun; Clinical Manifestation and Treatment of Ocular Demodex Infestation in Patients with Ocular Discomfort: A Large-sclae Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1484.
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To evaluate the clinical symptoms and the therapeutic effects of tea tree oil eyelash scrubbing in large scale of ocular Demodex infestated patients.
Three hundred and thirty five patients with ocular discomfort including dryness, itching sense, ocular pain, and visual disturbance were enrolled. Demodex were counted and subjective symptoms were checked using ocular surface disease index (OSDI). Patients were divided into three groups; blepharitis with ocular Demodex, blepharitis without ocular Demodex, and control group. Tear cytokines including IL-1β, 5, 7, 12, 13, 17, Granulocyte colony-stimulating factor (G-CSF), and macrophage inflammatory protein -1 beta (MIP-1β) were analyzed in 30 eyes of 15 patients in each group. Patients with ocular Demodex underwent tea tree oil eyelash scrubbing for 3 months. Demodex count, tear cytokine, and OSDI score were analyzed before and after the eyelash scrubbing.
Demodex were found in 84% of patients with ocular discomfort. There were no difference in prevalence of ocular Demodex infestation between male(77%) and female(82%). The number of Demodex had a significant positive correlation with aging and ocular discomfort (OSDI), and a negative correlation with BUT. Tear cytokine analysis revealed significant increase of IL-7, 12, and 17 in Demodex blepharitis group than non-Demodex blepharitis or control group. After 3months of eyelash scrubbing in Demodex blepharitis group, Demodex count and OSDI score were remarkably decreased. And tear cytokine levels of IL-1β, IL-7, IL-12 and IL-17 were significantly decreased.
The number of Demodex showed a significant positive correlation with aging, ocular discomfort, and tear film instability in the patients with ocular discomfort. The close relationship between ocular Demodex and inflammatory cytokines indicates that Demodex induces allergic and autoimmune reactions, which may exacerbate ocular surface lesions caused by immune inflammation. It is essential to treat ocular Demodex infestation in order to improve ocular hygiene.
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