Oral Ivermectin in Patients With Refractory Chronic Blepharitis Associated With Demodex Folliculorum

Abstract

Purpose: : To evaluate the efficacy of oral ivermectin in patients with refractory chronic blepharitis, in the presence of the Demodex folliculorum.

Methods: : Prospective and experimental study involving 13 patients (26 eyes) (50.4 ± 21.0 years old) with refractory chronic blepharitis in the presence of Demodex folliculorum in the eyelash were enclosed. All the patients of this study were analyzed 1 day before and 30 days after the treatment with oral ivermectin. Lacrimal meniscus height measurement, Tear break-up-time, fluorescein and rose bengal staining score, Schirmer I test and the quantification of Demodex in the removed eyelashes were performed. Patients were treated with one dose 200µg/kg of oral ivermectin. The treatment was repeated after 7 days.

Results: : Improvement of the average lacrimal meniscus height (p=0,0397), tear break-up-time (p=0,0018) and Schirmer I test (p=0,0005) was observed after the treatment with ivermectin. Fluorescein and rose bengal staining score has not improved. Reduction of the average Demodex (eyelashes of the upper/lower eyelid margin) was observed after the treatment with ivermectin (p=0,0006).

Conclusions: : Ivermectin could be a useful tool for the reduction of the Demodex folliculorum in eyelashes of the patients with chronic refractory blepharitis. Improvement of the average number of parasites found in the eyelashes, lacrimal meniscus height, tear break-up-time and Schirmer I test was observed after 30 days of treatment with ivermectin.

Clinical Trial: : www.hcnet.usp.br/adm/dc/cappesq/ Number 0688/09

Keywords: clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • anterior segment • eyelid