Should ocular Demodex be checked and treated in refractory keratitis patients without blepharitis?  

作　　者：Ying-Ying Gao Ting Wang Yu-Ting Jiang Ming-Jun Yang Xiu-Hai Lu Ling Zheng Shu-Ting Wang Wei-Yun Shi 

机构地区：[1]Department of Ophthalmology,the Second Affiliated Hospital,Fujian Medical University,Quanzhou 362000,Fujian Province,China [2]Eye Hospital of Shandong First Medical University,Jinan 250021,Shandong Province,China [3]State Key Laboratory Cultivation Base,Shandong Provincial Key Laboratory of Ophthalmology,Shandong Eye Institute,Shandong First Medical University&Shandong Academy of Medical Sciences,Qingdao 266071,Shandong Province,China

出　　处：《International Journal of Ophthalmology(English edition)》2023年第2期201-207,共7页国际眼科杂志（英文版）

基　　金：Supported by the National Natural Science Foundation of China(No.82271052,No.82271058,No.U20A20386);the Taishan Scholar Program(No.tspd20150215,No.tsqn201909188)。

摘　　要：AIM:To evaluate the correlation between Demodex infestation and keratitis,and to assess demodicosis using a simple approach.METHODS:A modified slit lamp illumination(at 40×magnification)was used to observe Demodex tails in 40patients with refractory keratitis and 80 healthy controls.Bacterial smear and culture of the conjunctival sac and corneal lesion were performed to identify the pathogen.Tea tree oil ointment(TTOO)was added as a Demodex killing agent for lid scrubs to the treatment when Demodex infestation was confirmed.RESULTS:Demodex tails were found in all patients compared to 42/80 of the controls(P<0.01).Seventeen patients presented blepharitis,while 23 were free of scales and inflammation at the lid margin.The demodicosis was mild,moderate,and severe in 8,19,and 13 patients,respectively,compared to mild in 42 controls(P<0.01).The keratitis was mild,moderate,and severe in 13,19,and 8patients,respectively.The severity of Demodex infestation was not correlated to the severity of keratitis(P=0.126).The growth of Staphylococcus was revealed in nine patients who did not react to antibiotic eye drops prior to the TTOO treatment.Patients’signs and symptoms got resolved after the lid scrub with TTOO.CONCLUSION:Ocular Demodex needs to be checked and treated in refractory keratitis patients with or without blepharitis.A slit-lamp illumination under high magnification favors the judgment of the severity of Demodex infestation.

关 键 词：DEMODEX KERATITIS BLEPHARITIS slit-lamp microscopy 

分 类 号：R777.1[医药卫生—眼科]