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Bianka Sobolewska, Deshka Doycheva, Christoph M. Deuter, Ines Pfeffer, Martin Schaller, Manfred Zierhut; Efficacy of Systemic Treatment with Doxycycline 40 mg on Ocular Rosacea. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2758.
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To determine the efficacy of once-daily systemic treatment with doxycycline 40mg in a slow-release form (Oraycea™).
Fifteen patients with ocular rosacea were enrolled between February 2010 and November 2011 in a retrospective observational case series. A complete history and ocular examination were performed, including best-corrected visual acuity (BCVA). Patient complaints (i.e. foreign-body sensation, burning, stinging, itching, tearing, dryness, redness, light sensitivity and blurred vision) and clinical findings including lid margin erythema, telangiectasias, conjunctival redness and fluorescein staining of the cornea were evaluated. The ocular manifestations were scored as follows: 0 - absent, 1 - mild, 2 - moderate and 3 - severe, as indicated in the proposals of the National Rosacea Society Expert Committee. All measurements were repeated at the 6-week follow-up visit. The mean duration of the treatment was six months (range 3-15 months).
At the baseline visit, 73% of patients had severe complaints and blepharitis despite topical therapy with artificial tears and eyelid hygiene.After six and twelve weeks of treatment, both patient complaints and clinical findings improved significantly.After twelve weeks of therapy, absent or significant improvement of complaints showed 27% and 40% of patients, respectively (P = 0.002). Absent, mild or moderate blepharitis was observed in 73% of patients after twelve weeks of treatment (P = 0.004). Absent (40%) or mild (60%) redness of conjunctiva was seen in 100% of patients (P = 0.008).After discontinuation of treatment with doxycycline, patient complaints were absent or mild in 53% and 33% of patients, respectively (P = 0.001). In 47% of patients, blepharitis resolved and in 30% of patients it improved significantly (P = 0.001). After cessation of therapy, no conjunctival redness was found in 66.7% of patients. Only mild conjunctival redness was observed in 33.3% of patients (P = 0.004). Corneal staining showed a tendency to improvement of the grading score (grade 0 before vs. after therapy: 53.3% v. 80%). BCVA did not change significantly during the entire follow-up period. There was no side effect leading to discontinuation of therapy in any patient.
Anti-inflammatory dose of slow release doxycycline 40mg daily is an effective and safe therapy of ocular rosacea.
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