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Manfred Zierhut, Bianka Sobolewska, Deshka Doycheva, Christoph M E Deuter, Martin Schaller; Efficacy of Ivermectin for the Treatment of cutaneous and ocular Rosacea. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4864. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the efficacy of once-daily topical treatment of cutaneous and ocular rosacea with Soolantra (ivermectin) cream in a retrospective case series.
Ten patients (six female and four male) with cutaneous and ocular rosacea were enrolled between Mai 2016 and November 2017 in a prospective study. All ten patients suffered from ocular rosacea and cutaneous manifestation. Patients were instructed to use ivermectin (10 mg/g for 6 months) for the skin and also for the lid margins. Subjective symptoms like severity (measured with the Ocular Surface Disease Index (OSDI) questionnaire), visual acuity (VA), intraocular pressure (IOP) and clinical findings including skin and ocular changes (blepharitis with telangiectasia and meibomian gland dysfunction (MGD), conjunctival redness, tear break-up time (TBUT), and fluorescein staining of the cornea were evaluated. Skin involvement, was scored as follows: 0: clear, 1: almost clear, 2: mild, and 3: moderate, and 4: severe and ocular involvement (blepharitis, conjunctival redness, and fluorescein staining of the cornea) as: 0: absent, 1: mild, 2: moderate, and 3: severe, respectively. Dermatological and ophthalmological examinations were performed every 6 weeks. The follow-up was 8 months (range, 5–12 months).
At the baseline visit, 30% patients had mild, 20% moderate skin involvement while 80% had severe dry eye (OSDI: 52.9±19.7) with blepharitis grade 1 in 90% of the participants. The OSDI score had already significantly decreased at the 1st follow-up visit (38.5±21.7, P = 0.004). After 12 weeks cutaneous manifestation, blepharitis (MGD, lid margin telangiectasia: P =0.004), and conjunctival redness (P = 0.008) had strongly improved, and the grade 0 was seen in 100% of the patients up to the last follow-up visit. Fluorescein staining of the cornea (grade 0 in 78% of the patients, P = 0.001) and TBUT (median: 3 seconds in 78% of the patients, P = 0.016) showed significant improvement at the last follow-up visit. The VA and IOP had not significantly changed during the follow-up. Seven of the ten patients with cutaneous involvement reached clear or almost clear. No side effects were observed.
Conclusions: Soolantra (ivermectin) cream given daily is an effective and safe therapy against cutaneous and ocular rosacea.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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