July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Demodex folliculorum mite density is associated with reduced cornea subbasal nerve density in patients with Dry Eye Disease
Author Affiliations & Notes
  • Nicholas Pondelis
    Cornea Service, New England Eye Center, Boston, Massachusetts, United States
    Center for Translational Ocular Immunology, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, United States
  • Milton M Hom
    Private Practice, Azusa, California, United States
  • Leslie O'Dell
    Dry Eye Center of PA, Manchester, Pennsylvania, United States
  • Arsia Jamali
    Center for Translational Ocular Immunology, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, United States
  • Rodrigo Mueller
    Ocular Surface Imaging Center, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
    Cornea and Refractive Surgery Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Chareenun Chirapapaisan
    Department of Ophthalmology, Faculty of Medicine Siriraj Hostpital, Mahidol University, Bangkok, Thailand
  • Bernardo Cavalcanti
    Ocular Surface Imaging Center, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
    Cornea and Refractive Surgery Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Ahmad Kheirkhah
    Ocular Surface Imaging Center, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
    Cornea and Refractive Surgery Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Farshad Abedi
    Ocular Surface Imaging Center, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
    Cornea and Refractive Surgery Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Pedram Hamrah
    Cornea Service, New England Eye Center, Boston, Massachusetts, United States
    Center for Translational Ocular Immunology, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Nicholas Pondelis, None; Milton Hom, None; Leslie O'Dell, None; Arsia Jamali, None; Rodrigo Mueller, None; Chareenun Chirapapaisan, None; Bernardo Cavalcanti, None; Ahmad Kheirkhah, None; Farshad Abedi, None; Pedram Hamrah, Heidelberg Engineering (C)
  • Footnotes
    Support  Tufts Medical Center Institutional Support and the Massachusetts Lions Club
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 2758. doi:https://doi.org/
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      Nicholas Pondelis, Milton M Hom, Leslie O'Dell, Arsia Jamali, Rodrigo Mueller, Chareenun Chirapapaisan, Bernardo Cavalcanti, Ahmad Kheirkhah, Farshad Abedi, Pedram Hamrah; Demodex folliculorum mite density is associated with reduced cornea subbasal nerve density in patients with Dry Eye Disease. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2758. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Demodex folliculorum are intradermal ectoparasites that are associated with dry eye disease (DED) and Blepharitis. In Vivo Confocal Microscopy (IVCM) been used clinically to evaluate anterior segment health, visualize abnormalities in corneal nerves, and identify the presence and extent of D. folliculorum infestation. This study sought to assess corneal nerve alterations in patients with D. folliculorum.

Methods : This retrospective study included 57 patients in three groups: Both DED and D. folliculorum blepharitis (n=12; 6M:6F; mean 52.085.34 years), DED alone (n=19; 7M:12F; mean 44.322.48 years), and normal controls (n=26; 10M:16F; mean 48.81 years).Patients received laser IVCM (Heidelberg Retinal Tomograph 3/Rostock Cornea Module) of the central corneal subbasal nerve plexus, as well as a D. folliculorum examination of the eyelid margin at the lash follicles. Subbasal nerve density was compared among the groups using ANOVA post hoc LSD. Association between density of mites and nerves was analyzed using Pearson’s correlation coefficient. Data reported as meanSEM in mm/mm2.

Results : No significant differences were observed in gender (p=0.741) and age (p=0.248) of the participants among the groups. Patients with both DED and D. folliculorum blepharitis had a reduced total central corneal nerve density (15.69±1.49) compared to both DED alone (19.63±1.25; p=0.0001) and normal controls (22.60±0.77; p=0.042). Additionally, there was a negative correlation between mite density and subbasal nerve density, with a higher density of mite per lash follicle correlating to a reduced subbasal nerve density (R=-4.86; p<0.0001). A similar relationship was found in subbasal nerve branch density, with a decreased density in patients with DED and D. folliculorum (7.07±1.01) compared to DED alone (11.15±1.08; p=0.006), and normal controls (12.62±0.65; p=0.0001) and an inverse relationship between mites and branch density (R=-0.493; p<0.0001).

Conclusions : Patients experiencing both DED and D. folliculorum have decreased subbasal nerve density compared to healthy patients, and DED alone. IVCM analysis reveals that D. folliculorum may play a larger role in ocular surface damage and DED than previously estimated.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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