RESUMO
INTRODUCTION: Demodex mites are microscopic arthropods that have been shown to be responsible for chronic blepharitis. Although many reports have demonstrated positive effects of lid hygiene on demodicosis, some have produced conflicting results. We retrospectively evaluated the effect of lid margin cleansing with a novel lid hygiene detergent, Eye Shampoo, in patients with ocular demodicosis. METHODS: Outpatient clinic notes recorded over a 24-month period between June 30, 2016, and June 29, 2018, at Keio University Hospital in Japan were reviewed to identify patients diagnosed with ocular demodicosis who started cleansing their lid margins with Eye Shampoo at least once daily as a lid hygiene therapy. RESULTS: Five patients diagnosed with ocular demodicosis who started cleansing their lid margins using Eye Shampoo for lid hygiene were identified. In four cases, Demodex mites were successfully eliminated, and ocular conditions were ultimately improved with no recurrence. Active Demodex mites were still noted after 3 months of lid hygiene therapy in one case; further observation of this case was not available. There were no adverse effects of Eye Shampoo in any of these cases. CONCLUSION: Lid hygiene therapy using Eye Shampoo successfully eliminated Demodex mites, a common pathogen of refractory obstructive meibomian gland dysfunction.
Assuntos
Detergentes/farmacologia , Higiene , Disfunção da Glândula Tarsal/prevenção & controle , Glândulas Tarsais/parasitologia , Ácaros/efeitos dos fármacos , Adulto , Idoso , Animais , Feminino , Humanos , MasculinoRESUMO
INTRODUCTION: Demodex mite is an external parasite which is implicated in various ocular conditions like anterior blepharitis, posterior blepharitis, meibomian gland dysfunction, chalazia and others. Although demodex has been shown to be a causative agent of chalazia, occurrence of a solitary inflammatory nodule due to demodex infestation has not been reported in literature. CASE: Our case describes the occurrence of an upper eyelid mass in a 62-year-old female which was found to have an associated demodex infestation. CONCLUSION: This is the first report of demodex infestation presenting as a nodular eyelid mass. This parasite needs to be considered in the differential diagnosis of eyelid masses as this condition requires specific management.
Assuntos
Blefarite , Calázio , Infecções Oculares Parasitárias , Pestanas , Infestações por Ácaros , Ácaros , Animais , Blefarite/diagnóstico , Blefarite/etiologia , Calázio/complicações , Calázio/diagnóstico , Infecções Oculares Parasitárias/diagnóstico , Infecções Oculares Parasitárias/parasitologia , Pestanas/parasitologia , Feminino , Humanos , Glândulas Tarsais/parasitologia , Pessoa de Meia-Idade , Infestações por Ácaros/complicações , Infestações por Ácaros/diagnóstico , Infestações por Ácaros/epidemiologiaRESUMO
Demodex is a saprophytic mite of the ocular adnexa, which can in certain circumstances proliferate on the skin of the face and on the eyelid margins. It is involved in facial rosacea (especially in the papulopustular form) and in the development or aggravation of anterior and/or posterior blepharitis or even keratoconjunctivitis, often in association with cutaneous lesions ; the pathophysiology is often multifactorial. Symptoms are non-specific, but the presence of cylindrical sleeves on the eyelashes is very suggestive of infestation, and certain techniques of biomicroscopic examination or imaging, such as confocal microscopy in vivo, allow direct visualization of the parasite. Parasitological examination of the eyelashes can confirm the diagnosis and can be improved by good sampling technique. Eyelid hygiene and oil-based ointments are the cornerstone of treatment. New specific treatments, in particular topical treatments based on tea tree oil, ivermectin, as well as pulsed light therapy and micro-exfoliation of the eyelid margin, can help to reduce the parasitic load and improve symptoms.
Assuntos
Infecções Oculares Parasitárias , Ácaros/fisiologia , Animais , Blefarite/diagnóstico , Blefarite/tratamento farmacológico , Blefarite/epidemiologia , Infecções Oculares Parasitárias/diagnóstico , Infecções Oculares Parasitárias/tratamento farmacológico , Infecções Oculares Parasitárias/epidemiologia , Infecções Oculares Parasitárias/parasitologia , Pestanas/diagnóstico por imagem , Pestanas/parasitologia , Pestanas/patologia , Humanos , Higiene , Ivermectina/uso terapêutico , Ceratoconjuntivite/diagnóstico , Ceratoconjuntivite/tratamento farmacológico , Ceratoconjuntivite/epidemiologia , Ceratoconjuntivite/parasitologia , Glândulas Tarsais/diagnóstico por imagem , Glândulas Tarsais/parasitologia , Glândulas Tarsais/patologia , Microscopia Confocal , Óleo de Melaleuca/uso terapêuticoRESUMO
Objective: Demodicosis is a Skin disease in humans caused by Demodex folliculorum (D. folliculorum) and Demodex brevis (D.brevis) mites. Demodex infestation is mostly located in sebaceous and meibomian glands in the hair follicles. The aim of this study was to determine the age and sex distribution of Demodex infestation in patients with blepharitis. Methods: Between 2011-2018, eyelashes from 335 patients with blepharitis, visual impairment or conjunctivitis attached to the cellophane tape were sent to the laboratory of Department of Medical Parasitology in Çukurova University Medical Faculty and were examined within 1 hour. Results: D. folliculorum was detected in 143 (42.6%) of the 335 patients. Of the patients in whom D. folliculorum was detected, 50 (35%) were female and 93 (65%) were male. The mean age of patients with D. folliculorum was 64.1 years and the mean age of patients without D. folliculorum was 52.7 years. Conclusion: In patients with blepharitis, the incidence of Demodex increases with age.
Assuntos
Blefarite/parasitologia , Infestações por Ácaros/complicações , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Animais , Blefarite/epidemiologia , Criança , Pré-Escolar , Pestanas/parasitologia , Feminino , Humanos , Incidência , Masculino , Glândulas Tarsais/parasitologia , Pessoa de Meia-Idade , Infestações por Ácaros/epidemiologia , Ácaros/classificação , Glândulas Sebáceas/parasitologia , Distribuição por Sexo , Adulto JovemRESUMO
PURPOSE: To evaluate terpinen-4-ol lid scrubs (Cliradex) with Microblepharoexfoliation (MBE) (BlephEx) in the treatment of Demodex blepharitis. METHODS: An Institutional Review Board (IRB) approved the randomized prospective double-masked trial of 50 patients with Demodex positive blepharitis. All subjects were given an in-office MBE treatment and randomized to masked lid scrubs (terpinen-4-ol or sham) twice daily for 1 month. All subjects then returned for an additional MBE treatment and received open-label terpinen-4-ol scrubs twice daily for 1 month. OUTCOMES: Demodex levels, Ocular Surface Disease Index, tear osmolarity, MMP-9, Schirmer 1 and grading of the lid margin appearance, meibomian gland dropout, and meibomian gland secretions. RESULTS: Forty-six subjects (23 per group) were included for the analysis; 4 lost to follow up. Total Demodex folliculorum levels in the Cliradex group improved: 4.7 to 3.6 (first month interval P = 0.266) to 2.6 (second month interval P = 0.279), overall P < 0.05 over 2 months. Total levels in the sham group improved: 5.1 to 3.0 (first month interval P < 0.05) to 2.5 (second month interval P = 0.496), overall P < 0.05 over 2 months. No clear statistically meaningful improvements in other dry eye and blepharitis data metrics were observed. CONCLUSIONS: In-office MBE treatments combined with either Cliradex terpinen-4-ol medicated lid scrubs or sham scrubs showed a statistically significant reduction in D. folliculorum infestation levels; however, conclusions on clinical significance could not be made. In-office MBE with terpinen-4-ol lid scrubs showed no significant improvement over sham scrubs.
Assuntos
Blefarite/terapia , Infecções Oculares Parasitárias/terapia , Pálpebras/parasitologia , Glândulas Tarsais/parasitologia , Infestações por Ácaros , Ácaros , Terpenos/farmacologia , Idoso , Animais , Blefarite/diagnóstico , Blefarite/parasitologia , Método Duplo-Cego , Infecções Oculares Parasitárias/diagnóstico , Infecções Oculares Parasitárias/parasitologia , Pestanas , Feminino , Seguimentos , Humanos , Masculino , Glândulas Tarsais/diagnóstico por imagem , Estudos ProspectivosRESUMO
To observe the clinical changes of meibomian gland dysfunctipn (MGD) and ocular Demodex infestation after intense pulsed light (IPL) treatment to further examine the mechanism of IPL treating patients with MGD and ocular Demodex infestation. The medical records of 25 patients (49 eyes) with MGD treated with IPL, were retrospectively examined to determine outcomes. Associated ocular-surface parameters (ocular surface disease index, OSDI; lipid layer thickness, LLT; noninvasive first breakup time, NIF-BUT; noninvasive average breakup time, NIAvg-BUT; tear film breakup area, TBUA; Schirmer I Test, SIT; corneal fluorescein staining, CFS), eyelid margin abnormalities, meibum quality and expressibility, MG morphological parameters (macrostructure and microstructure), and the number of Demodex infestation were examined before and after treatment. The MG microstructure and the Demodex infestation were examined via in vivo confocal microscopy (IVCM). The results showed that there were statistically significant differences in associated ocular-surface parameters (all P<0.05) before and after IPL treatment, except SIT (P=0.065). Eyelid margin abnormalities, meibum quality and expressibility obviously improved in upper and lower eyelid after IPL treatment (all P<0.0001). MG macrostructure (MG dropouts) decreased in upper (P=0.002) and lower eyelid (P=0.001) after IPL treatment. The nine parameters of MG microstructure in upper and lower eyelid all distinctly improved after IPL treatment (all P<0.0001). The mean number of Demodex mites on the upper lid margin (6.59±7.16 to 3.12±3.81/9 eyelashes) and lower lid margin (2.55±2.11 to 1.29±1.53/9 eyelashes) significantly reduced after IPL treatment (all P<0.0001). The Demodex eradication rate was 20% (8/40) in upper lid margin and 34.15% (14/41) in lower lid margin. These findings indicate that IPL shows great therapeutic potential for patients of MGD and ocular Demodex infestation.
Assuntos
Terapia de Luz Pulsada Intensa/métodos , Disfunção da Glândula Tarsal/terapia , Glândulas Tarsais/efeitos da radiação , Infestações por Ácaros/terapia , Lágrimas/efeitos da radiação , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Pálpebras/parasitologia , Pálpebras/patologia , Pálpebras/efeitos da radiação , Feminino , Humanos , Masculino , Disfunção da Glândula Tarsal/parasitologia , Disfunção da Glândula Tarsal/patologia , Glândulas Tarsais/parasitologia , Glândulas Tarsais/patologia , Pessoa de Meia-Idade , Infestações por Ácaros/parasitologia , Infestações por Ácaros/patologia , Ácaros/patogenicidade , Ácaros/fisiologia , Ácaros/efeitos da radiação , Estudos Retrospectivos , Lágrimas/parasitologiaRESUMO
Meibomian gland dysfunction (MGD) is a common disease in ophthalmic clinic. This study aimed to explore ocular Demodex infestation on the microstructure changes of the meibomian glands (MGs) in patients with MGD by in vivo confocal microscopy (IVCM).We retrospectively reviewed 103 eyes of 52 patients with MGD and 62 eyes of 31 non-MGD patients. All enrolled patients underwent IVCM examination. The following IVCM parameters were recorded: the MG acinar density (MAD), MG acinar longest diameter (MALD), MG acinar shortest diameter (MASD), MG orifice area (MOA), severity of MG fibrosis (MF), MG acinar irregularity (MAI), meibum secretion reflectivity (MSR), inhomogeneous appearance of walls of acinar units (AWI) and periglandular interstices of acinar units (API), and the number of Demodex.The positive rate of Demodex infestation in MGDs was 89.32%, and statistically higher than control group (controls; Pâ<â.001). All parameters showed statistically significant differences between MGDs and controls (Pâ<â.001), and Demodex-negative group and Demodex-positive group (Pâ<â.05) in both MGDs and controls, except MAD (Pâ=â.826) in controls. The number of Demodex was positively correlated with MALD, MASD, MF, MAI, MSR, AWI, and API in MGDs and controls (Pâ<â.05), and negatively correlated with MAD and MOA in MGDs (Pâ<â.05). MOA showed a strong significant correlation with the number of Demodex in controls (Pâ<â.001), whereas there was no significant difference between the number of Demodex and the MAD in controls (Pâ=â.448).Demodex can cause microstructural changes of MGs, which can cause or aggravate MGD, and the more the number of Demodex infestation, the more serious the structural damage.
Assuntos
Infecções Oculares Parasitárias/patologia , Doenças Palpebrais/patologia , Doenças Palpebrais/parasitologia , Glândulas Tarsais/patologia , Glândulas Tarsais/parasitologia , Infestações por Ácaros/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , China , Infecções Oculares Parasitárias/parasitologia , Feminino , Humanos , Masculino , Microscopia Confocal , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
AIMS: To report the clinical characteristics and correlation between meibomian gland dysfunction (MGD) and keratitis in young patients with ocular demodicosis. METHODS: Observational case series of 60 patients younger than 35 years with ocular demodicosis, of which the diagnosis was based on microscopic counting of Demodex folliculorum and D. brevis of epilated lashes. Severity of keratitis and MGD was graded by photography and meibography, respectively, in a masked fashion. RESULTS: MGD was detected in 54/60 (90%) patients with the loss of meibomian gland in the upper lid more than the lower lid (p<0.001). Blepharoconjunctivitis and a variety of corneal pathologies were noted in 47/60 (78.3%) and 39/60 (65%) patients, respectively. For a total of 120 eyes, normal cornea was noted in 53 (44.2%) eyes, superficial punctate keratitis or limbitis was noted in 17 (14.2%), while corneal stromal infiltration was found in 50 (41.7%) eyes. Both univariate and multivariate analyses showed that the severity of meibomian gland loss was significantly correlated with higher D. brevis count and more severe keratitis (all p<0.05). Rapid resolution of keratitis and blepharoconjunctivitis was accompanied by significant reduction of the Demodex count in 48 patients receiving lid scrub directed to kill mites. CONCLUSIONS: There is a significant correlation between MGD and keratitis in young patients with ocular demodicosis especially inflicted by D. brevis.
Assuntos
Infecções Oculares Parasitárias/diagnóstico , Doenças Palpebrais/diagnóstico , Ceratite/diagnóstico , Glândulas Tarsais/patologia , Infestações por Ácaros/diagnóstico , Ácaros , Adolescente , Adulto , Animais , Antiprotozoários/uso terapêutico , Criança , Infecções Oculares Parasitárias/tratamento farmacológico , Infecções Oculares Parasitárias/parasitologia , Doenças Palpebrais/tratamento farmacológico , Doenças Palpebrais/parasitologia , Feminino , Humanos , Ceratite/tratamento farmacológico , Ceratite/parasitologia , Masculino , Glândulas Tarsais/parasitologia , Infestações por Ácaros/tratamento farmacológico , Infestações por Ácaros/parasitologia , Adulto JovemRESUMO
Objective: To investigate the prevalence and treatment effects of Demodex species in eyelash follicles in patients with meibomian gland dysfunction (MGD). Methods: The MGD patients (MGD group) and normal subjects (control group) were collected from the Ophthalmology Clinic in PUMCH from July 2015 to December 2015. The symptom score of MGD patients was recorded. Eyelash sampling, Demodex counting, tear film break-up time (BUT), cornea fluorescein staining (Fl) and Schirmer test Ia (S â aT) were measured for both groups. All the measurements were repeated after 4 weeks of meibomian function treatment for the MGD group. Symptom score, BUT, Fl and S â aT were normally distributed and displayed as mean± standard deviation. Demodex counting was not normally distributed and displayed as median (interquartile range P25, P75). Results: Forty-four MGD patients (88 eyes) and 48 controls (96 eyes) were recruited. For the MGD and control groups, the number of Demodex was 3.5 (2, 7) and 0 (0, 7), respectively (Z =-4.912,P= 0.000). The percentage of Demodex infestation was 86.4% and 39.6%, respectively (χ(2)=35.957, P=0.000). The BUT was (3.57±2.09) s and (10.17±3.25) s, respectively (t=-5.154, P=0.000). The Fl was 2.73±1.23 and 0.85± 0.33, respectively (t=4.583, P=0.000). The Sâ aT was (8.75±5.61) s and (14.51±5.29) s, respectively (t=-2.278, P=0.028). The symptom score of the MGD group before and after treatment was 4.77 ± 3.01 and 2.79 ± 2.01, respectively (t=6.224, P=0.000). The BUT, Fl and number of Demodex of the MGD group after the treatment were (5.43±2.37)s, (1.91±0.66) and 2 (0, 3), respectively, and all had significant difference with the data before the treatment (BUT, t=-4.705, P=0.000. Fl, t =3.902, P =0.000. number of Demodex, Z=-4.623, P =0.000). The S â aT of the MGD group after the treatment was 8.86 ± 6.76, with no significant difference with the data before the treatment (t=-0.277, P=0.833). Conclusions: The Demodex infestation has some effects on the pathogenesis of MGD. The treatment of MGD may help to decrease the number of Demodex and thus relieve the ocular discomfort.(Chin J Ophthalmol, 2017, 53:193-197).
Assuntos
Infecções Oculares Parasitárias/parasitologia , Doenças Palpebrais/epidemiologia , Glândulas Tarsais/parasitologia , Infestações por Ácaros/parasitologia , Animais , China/epidemiologia , Infecções Oculares Parasitárias/diagnóstico , Infecções Oculares Parasitárias/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infestações por Ácaros/diagnóstico , Infestações por Ácaros/epidemiologia , Ácaros , Prevalência , LágrimasRESUMO
UNLABELLED: Meibomian gland dysfunction (MGD) is a common cause of dry eye disease. Demodex mites can cause MGD with symptoms like itching, dryness and general ocular discomfort. It is important to consider infestation with Demodex mites in individuals who are non responsive to traditional MGD treatment but also equally important when cylindrical dandruff is seen at the base of the eye lashes.. We report two individuals who had not responded to ocular and systemic treatment for MGD and were then diagnosed with Demodex mites. Treatment with BlephEx and Tea tree oil was successful. This is the first report on Demodex folliculorum in Iceland where a genetic analysis was done. KEY WORDS: Demodex, blepharitis, debris, tea tree oil, dry eye. Correspondence: Sigurlaug Guðrún Gunnarsdóttir sigurlaug@sjonlag.is.
Assuntos
Blefarite/parasitologia , Infecções Oculares Parasitárias/parasitologia , Glândulas Tarsais/parasitologia , Infestações por Ácaros/parasitologia , Ácaros , Animais , Blefarite/diagnóstico , Blefarite/tratamento farmacológico , Infecções Oculares Parasitárias/diagnóstico , Infecções Oculares Parasitárias/tratamento farmacológico , Humanos , Glândulas Tarsais/efeitos dos fármacos , Infestações por Ácaros/diagnóstico , Infestações por Ácaros/tratamento farmacológico , Ácaros/efeitos dos fármacos , Óleo de Melaleuca/uso terapêuticoRESUMO
Demodex species (spp.) have previously been implicated in the pathogenesis of blepharitis. This study aims to correlate improvement in symptoms of external ocular disease with treatment of underlying Demodex spp. This is a prospective, observational case series of patients with chronic external ocular disease. Demodicosis was confirmed by microscopic examination of epilated eyelashes. The main outcome measure was response to the treatment (5 % tee tree oil) in regard to change in subjective symptoms utilising a symptom-based patient questionnaire assessment. Overall patients had a good response to the treatment in terms of improvement or resolution of symptoms, with 91 % of patients reporting at least some improvement in symptoms. The treatment of underlying Demodex spp. appears to result in improvement of symptoms in patients with long standing external ocular disease and underlying Demodex spp. infestation.
Assuntos
Conjuntivite/tratamento farmacológico , Síndromes do Olho Seco/tratamento farmacológico , Infecções Oculares Parasitárias/tratamento farmacológico , Doenças Palpebrais/tratamento farmacológico , Infestações por Ácaros/tratamento farmacológico , Ácaros , Óleo de Melaleuca/uso terapêutico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Anti-Infecciosos Locais/administração & dosagem , Anti-Infecciosos Locais/uso terapêutico , Criança , Conjuntivite/parasitologia , Síndromes do Olho Seco/parasitologia , Infecções Oculares Parasitárias/parasitologia , Pestanas/parasitologia , Doenças Palpebrais/parasitologia , Feminino , Humanos , Masculino , Glândulas Tarsais/efeitos dos fármacos , Glândulas Tarsais/parasitologia , Pessoa de Meia-Idade , Infestações por Ácaros/parasitologia , Estudos Prospectivos , Inquéritos e Questionários , Óleo de Melaleuca/administração & dosagemRESUMO
PURPOSE OF REVIEW: To summarize recent advances on ocular Demodex infestation. RECENT FINDINGS: Demodex infestation is a potential cause of ocular surface inflammation. The pathogenesis of Demodex in eliciting ocular surface inflammation has been further clarified. Cliradex is currently the treatment of choice, it comprises the most active ingredient of tea tree oil, that is terpinen-4-ol, which helps eradicate Demodex mites and reduce ocular surface inflammation. SUMMARY: Ocular demodicosis is a common but overlooked eye disease that manifests a number of morbidities. Demodex folliculorum causes chronic anterior blepharitis whereas Demodex brevis causes posterior blepharitis, meibomian gland dysfunction, recurrent chalazia, and refractory keratoconjunctivitis. The lash sampling and microscopic counting method and in-vivo confocal microscopy are key diagnostic methods. Cliradex shows promising potential to reduce Demodex counts with additional antibacterial, antifungal, and anti-inflammatory actions.
Assuntos
Blefarite/diagnóstico , Infecções Oculares Parasitárias/diagnóstico , Glândulas Tarsais/parasitologia , Infestações por Ácaros/diagnóstico , Animais , Anti-Infecciosos Locais/uso terapêutico , Blefarite/parasitologia , Blefarite/terapia , Infecções Oculares Parasitárias/parasitologia , Infecções Oculares Parasitárias/terapia , Humanos , Higiene , Infestações por Ácaros/parasitologia , Infestações por Ácaros/terapia , Ácaros , Óleo de Melaleuca/uso terapêuticoRESUMO
AIMS: Demodex mites are implicated in several ocular surface diseases such as blepharitis, ocular rosacea and dry eye syndrome. Demodex eyelid infestation is classically diagnosed by analysing depilated eyelashes under the light microscope. The use of in vivo confocal microscopy (IVCM) could be an easy way to improve its diagnosis. The ability of IVCM to identify Demodex was evaluated and compared with the classic depilation method. METHODS: Eight healthy subjects, 22 patients with dry eye syndrome without anterior blepharitis and 18 patients with anterior blepharitis were examined using lower eyelid IVCM (lash follicles and meibomian glands (MGs)). Twenty-five of the 48 subjects underwent both an IVCM examination and classic depilation to compare the two methods. Ex vivo Demodex obtained from lash depilation were also analysed using the confocal microscope. RESULTS: IVCM found 100% of the mite infestations among patients with anterior blepharitis, 60% among dry eye patients without blepharitis and 12% in healthy subjects, whereas the depilation technique found 100%, 50% and 0%, respectively. Demodex brevis and Demodex larvae inside the lash follicles were better detected by IVCM. In symptomatic patients, the Demodex infestation was often associated with MG dysfunction, which was better characterised using IVCM in symptomatic patients (60% and 40% of meibomianitis and gland fibrosis, respectively). CONCLUSIONS: IVCM is an efficient and reliable tool for the diagnosis of eyelid mite infestation and may also provide an evaluation of MGs.
Assuntos
Blefarite/diagnóstico , Síndromes do Olho Seco/diagnóstico , Infecções Oculares Parasitárias/diagnóstico , Microscopia Confocal , Infestações por Ácaros/diagnóstico , Ácaros , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Blefarite/parasitologia , Síndromes do Olho Seco/parasitologia , Pestanas/parasitologia , Feminino , Remoção de Cabelo , Humanos , Masculino , Glândulas Tarsais/parasitologia , Pessoa de Meia-Idade , Infestações por Ácaros/parasitologiaRESUMO
PURPOSE: To determine the incidence and density of Demodex species on the eyelashes of subjects with normal eyelids, anterior blepharitis (AB), meibomian-gland dysfunction (MGD), and mixed blepharitis (MB). MATERIALS AND METHODS: One hundred and fifty consecutive patients diagnosed with AB, MGD, and MB were recruited. An additional 50 individuals were recruited who were free of lid and margin disease to serve as a control group. All patients underwent a standard eye examination. Data on ocular symptomatology were gathered. Digital photography was performed of the lid margins. Lash sampling was performed by epilating the lashes and the lashes were checked for Demodex based on morphology using light microscopy. The total number of mites were tabulated for each eye. Comparison between the affected eyes and the control eyes was performed. Data were analyzed using the Chi-square test. RESULTS: A total of 200 patients were included. Twenty percenth had AB, 40% had MGD, and 40% had MB. The incidence of Demodex infestation was 90% in cases of AB, 60% in MGD cases, and 90% in MB cases. The incidence of Demodex in control subjects was 18%. CONCLUSIONS: The incidence and density of Demodex infestation was highest in patients with AB and MB. Lid irritation and presence of cylindrical dandruff were indicative of a high-density infestation. These signs should alert the clinician to treat concomitant Demodex infestation.
Assuntos
Blefarite/parasitologia , Infecções Oculares Parasitárias/parasitologia , Pestanas/parasitologia , Glândulas Tarsais/parasitologia , Infestações por Ácaros/parasitologia , Ácaros , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Blefarite/diagnóstico , Blefarite/epidemiologia , Infecções Oculares Parasitárias/diagnóstico , Infecções Oculares Parasitárias/epidemiologia , Feminino , Humanos , Incidência , Índia/epidemiologia , Masculino , Glândulas Tarsais/patologia , Pessoa de Meia-Idade , Infestações por Ácaros/diagnóstico , Infestações por Ácaros/epidemiologiaRESUMO
PURPOSE: Demodex folliculorum and Demodex brevis are ectoparasites with an astounding prevalence of 100% in patients aged 70 years and older. Every person in this age group is estimated to carry a colony of 1000 to 2000 mites. With such a high prevalence, little attention has been paid to the mite among eye care practitioners. We demonstrate a clinical sequence in a set of case reports to identify the mite. The clinical sequence includes a clinical history of blepharitis, dry eyes, and/or ocular allergy; slit lamp examination of cylindrical dandruff; and confirmation using light microscope evaluation of epilated lashes. CASE REPORTS: Patient 1 was a 68-year-old woman who demonstrates associations with dry eyes and diabetes. Patient 2 was a 44-year-old man with uncommonly seen D. brevis present. Patient 3 was a 40-year-old woman with dry eyes and allergy, showing mite tails protruding from base of lashes. Patient 4 was a 60-year-old woman who demonstrates the association with rosacea. Patient 5 was a 53-year-old woman intermittently taking topical steroid and antibiotic combination medications, with an actual mite photographed on the surface. CONCLUSIONS: Following a clinical sequence helps identify Demodex, the underdiagnosed, undertreated, and underappreciated ocular surface disease.
Assuntos
Blefarite/diagnóstico , Síndromes do Olho Seco/diagnóstico , Infecções Oculares Parasitárias/diagnóstico , Pestanas/parasitologia , Infestações por Ácaros/diagnóstico , Ácaros , Adulto , Idoso , Animais , Blefarite/parasitologia , Síndromes do Olho Seco/parasitologia , Infecções Oculares Parasitárias/parasitologia , Feminino , Folículo Piloso/parasitologia , Humanos , Masculino , Glândulas Tarsais/parasitologia , Glândulas Tarsais/patologia , Pessoa de Meia-Idade , Infestações por Ácaros/parasitologiaRESUMO
Leishmania infantum infection is highly prevalent in endemic areas. Dogs with leishmaniosis may develop keratoconjunctivitis sicca (KCS). The goals of this study were (1) to quantify Leishmania amastigotes in the Meibomian glands (MG), main lacrimal gland (MLG) and nictitating membrane gland (NMG) from dogs with leishmaniosis; (2) to compare these results to immunohistochemistry (IHC), and (3) to explore the association between the Leishmania parasite load and the presence of ocular clinical signs. Twenty-five dogs diagnosed with leishmaniosis were included. MG, MLG and NMG from both eyes were collected. Histopathology, IHC and real-time PCR were performed. All specimens yielded positive real-time PCR results. For all three glands, samples from dogs with ocular clinical signs had mean ΔCt (cycle threshold) values significantly lower (higher parasite loads) than those from dogs without signs. Cut-off values of ΔCt<0, ΔCt<4 and ΔCt<4.9 for MG, MLG and NMG, resulted in a likelihood ratio of positives of 5.9, 6.38 and 6.38, respectively. Samples with ΔCt values below the reported cut-off were significantly more likely to display clinical signs related to KCS than those with results above the cut-off, for all three glands. Similarly, ΔCt values below the cut-off were significantly associated with positive IHC. In this study real-time PCR has been standardised for use in MG, MLG and NMG. A cut-off value established for each of these tissues may aid the clinician in the discrimination between ocular signs related to Leishmania from those associated with other causes of KCS.
Assuntos
DNA de Protozoário/isolamento & purificação , Doenças do Cão/diagnóstico , Leishmania infantum/isolamento & purificação , Leishmaniose/veterinária , Carga Parasitária/métodos , Animais , DNA de Protozoário/genética , Doenças do Cão/parasitologia , Cães , Doenças Palpebrais/diagnóstico , Doenças Palpebrais/parasitologia , Doenças Palpebrais/veterinária , Imuno-Histoquímica/métodos , Imuno-Histoquímica/veterinária , Ceratoconjuntivite Seca/diagnóstico , Ceratoconjuntivite Seca/parasitologia , Ceratoconjuntivite Seca/veterinária , Aparelho Lacrimal/parasitologia , Leishmania infantum/genética , Leishmaniose/diagnóstico , Leishmaniose/parasitologia , Glândulas Tarsais/parasitologia , Membrana Nictitante/parasitologia , Carga Parasitária/veterinária , Reação em Cadeia da Polimerase/veterinária , Curva ROC , Reação em Cadeia da Polimerase em Tempo Real/métodos , Reação em Cadeia da Polimerase em Tempo Real/veterináriaRESUMO
In a previous study, it was found that 2.8% of dogs with leishmaniosis had keratoconjunctivitis sicca (KCS). The aim of this study was to characterize the lesions present in the lacrimal glands of dogs with leishmaniosis and to determine the presence of the parasite by means of immunohistochemistry. The inflammatory infiltrate was described as granulomatous or pyogranulomatous and was located around the ductal component of the glands. Immunoperoxidase staining localized the parasites following the same pattern. Samples from eyes that had clinical signs compatible with KCS presented inflammatory infiltrate and parasite more commonly than those from eyes without clinical signs. One of the mechanisms of KCS in dogs with leishmaniosis may be the inflammatory infiltrate located around the ducts of lacrimal glands, producing retrograde accumulation and retention of secretion. Meibomian gland was the most commonly affected by the infiltrate, highlighting the possibility of a qualitative KCS in these dogs.
Assuntos
Doenças do Cão/parasitologia , Ceratoconjuntivite Seca/veterinária , Aparelho Lacrimal/parasitologia , Leishmania infantum/crescimento & desenvolvimento , Leishmaniose/veterinária , Animais , Doenças do Cão/patologia , Cães , Imuno-Histoquímica/veterinária , Ceratoconjuntivite Seca/complicações , Ceratoconjuntivite Seca/parasitologia , Ceratoconjuntivite Seca/patologia , Aparelho Lacrimal/patologia , Leishmaniose/complicações , Leishmaniose/parasitologia , Leishmaniose/patologia , Glândulas Tarsais/parasitologia , Glândulas Tarsais/patologiaRESUMO
La etiología de las blefaritis crónicas es diversa. Demodex folliculorum es un ácaro que habita en las glándulas de Meibomio y en los folículos de las pestañas. Objetivo. Conocer la prevalencia y características clínicas de la infestación por Demodex folliculorum en pacientes con blefaritis crónica. Materiales y métodos. Realizamos un estudio prospectivo, transversal, comparativo y observacional. Se incluyeron pacientes con blefaritis crónica realizando cultivo, antibiograma y búsqueda de Demodex folliculorum en folículos de pestañas, comparándose este último parámetro con un grupo de sujetos sanos. Resultados. Evaluamos 100 pacientes por grupo. Encontramos positividad para Demodex folliculorum en 35 por ciento de los casos con blefaritis y en 7 por ciento de los controles sanos. La prevalencia más alta se encontró después de los 60 años (51 por ciento), el sexo femenino fue el mas afectado (85 por ciento). Los collaretes en la base de las pestañas, alteraciones en su dirección, madarosis y obstrucción de glándulas de Meibomio sugieren la presencia del parásito. Conclusiones. Demodex folliculorum muestra mayor prevalencia en pacientes con blefaritis crónica comparada con sujetos sanos siendo más abundante después de los 60 años y predomina en mujeres. Debe considerarse su búsqueda y tratamiento en blefaritis crónicas resistentes al tratamiento.
Assuntos
Humanos , Masculino , Pré-Escolar , Criança , Adolescente , Adulto , Feminino , Pessoa de Meia-Idade , Blefarite , Glândulas Tarsais/parasitologia , Pestanas/parasitologia , Ácaros/patogenicidadeRESUMO
An undescribed species of Demodex (Acari: Demodecidae) was observed in hair follicles and ducts of sebaceous glands in the ear canals of seven California ground squirrels (Spermophilus beecheyi) from Santa Clara County, California (USA). The animals had died of unrelated causes and were submitted for necropsy between September 1994 and February 1996. Similar mites were observed in the lumens of hair follicles and ducts of Meibomian glands in the eyelids of two of these squirrels. Microscopic changes in the epithelium and surrounding dermis, when present, were minimal. No associated clinical signs of disease or macroscopic lesions were observed. To our knowledge, this is the first report of Demodex sp. in a ground squirrel.
Assuntos
Infestações por Ácaros/veterinária , Doenças dos Roedores/parasitologia , Sciuridae/parasitologia , Animais , California/epidemiologia , Meato Acústico Externo/parasitologia , Pálpebras/parasitologia , Cabelo/parasitologia , Glândulas Tarsais/parasitologia , Infestações por Ácaros/epidemiologia , Infestações por Ácaros/parasitologia , Ácaros , Doenças dos Roedores/epidemiologia , Glândulas Sebáceas/parasitologia , Pele/parasitologiaRESUMO
Demodex bisonianus sp. nov. (Acari, Demodicidae) and its stages of development has been described. It was found in the Meibomian glands of the Bison bonasus L. from the Puszcza Bialowieska (Poland).