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| Analysis of Relevant Factors in Demodex Folliculorum Infection in Sjögren's Syndrome Patients |
| Qin Zhang, Ziting Huang, Fangting Li, Gong Cheng, Yaobin Cheng, Yuebo Jin, Jing He, Mingwei Zhao |
| Department of Ophthalmology, Peking University People's Hospital, Beijing 100044, China |
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Abstract Objective: To investigate the infection of demodex folliculorum in patients with Sjögren's syndrome (SS), and to determine the correlative relationship between demodexin eyelashes and the ocular surface characteristics. Methods: In this case control study, 22 patients (44 eyes) with SS (SS group, study group) and 21 dry eye patients (42 eyes) without SS (non-SS group, control group) were recruited from Peking University People's Hospital from January to June 2019. The 5-item dry eye questionnaire (DEQ-5), ocular surface disease index, non-invasive tear meniscus height, non-invasive break up time, corneal staining score, the drop out of the upper meibomian gland and the number of demodex in eyelashes were examined in both groups. A t test was used to compare the continuous variables differences between the two groups, a Chi-square test and Fisher's exact test were used to compare the categorical variables between the two groups, and Spearman correlation analysis was used to determine the correlation between the continuous variables of the 2 different groups. Results: The number of mites in the non-SS group was significantly higher than that of the SS group (Z=-2.41, P=0.021). The number of mites in the SS group was correlated with the score on the DEQ-5 scale (r=0.40, P=0.02) and the drop out of the upper meibomian gland (r= -0.70, P=0.02), while the number of mites in the non-SS group was only correlated with the score on the DEQ-5 scale (r=0.63, P=0.04). There was a significant difference in the drop out of the upper meibomian gland between the Demodex positive group and Demodex negative group (Z=3.214, P=0.002). Conclusions: The number of demodex in the SS group is lower than that in the non-SS group. The score on the DEQ-5 scale and the drop out of the upper meibomian gland are correlated with demodex in the eyelashes.
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Received: 23 December 2019
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Corresponding Authors:
Mingwei Zhao, Department of Ophthalmology, Peking University People's Hospital, Beijing 100044, China (Email: zhaomingwei64@163.com)
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| [1] |
Kheirkhah A, Casas V, Li W, et al. Corneal manifestations of ocular demodex infestation. Am J Ophthalmol, 2007, 143(5): 743-749. DOI: 10.1016/j.ajo.2007.01.054.
|
| [2] |
S?dzikowska A, Os?ka M, Skopiński P. The impact of age, sex, blepharitis, rosacea and rheumatoid arthritis on Demodex mite infection. Arch Med Sci, 2018, 14(2): 353-356. DOI: 10.5114/ aoms.2016.60663.
|
| [3] |
Biernat MM, Rusiecka-Zió?kowska J, Pi?tkowska E, et al. Occurrence of Demodex species in patients with blepharitis and in healthy individuals: a 10-year observational study. Jpn J Ophthalmol, 2018, 62(6): 628-633. DOI: 10.1007/s10384-018- 0624-3.
|
| [4] |
Zeytun E, Karakurt Y. Prevalence and load of Demodex folliculorum and Demodex brevis (Acari: Demodicidae) in Patients with chronic blepharitis in the province of Erzincan, Turkey. J Med Entomol, 2019, 56(1): 2-9. DOI: 10.1093/jme/ tjy143.
|
| [5] |
Rabensteiner DF, Aminfar H, Boldin I, et al. Demodex mite infestation and its associations with tear film and ocular surface parameters in patients with ocular discomfort. Am J Ophthalmol, 2019, 204: 7-12. DOI: 10.1016/j/ajo.2019.03.007.
|
| [6] |
Zhang XB, Ding YH, He W. The association between demodex infestation and ocular surface manifestations in meibomian gland dysfunction. Int J Ophthalmol, 2018, 11(4): 589-592. DOI: 10.18240/ijo.2018.04.08.
|
| [7] |
Sullivan DA, Dana R, Sullivan RM, et al. Meibomian Gland Dysfunction in Primary and Secondary Sjögren Syndrome. Ophthalmic Res, 2018, 59(4): 193-205. DOI: 10.1159/000487487.
|
| [8] |
Shiboski CH, Shiboski SC, Seror R, et al. International Sjögren's Syndrome Criteria Working Group. 2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Primary Sjögren's Syndrome: A Consensus and Data-Driven Methodology Involving Three International Patient Cohorts. Arthritis Rheumatol, 2017, 69(1): 35-45. DOI: 10.1002/art.39859.
|
| [9] |
Tsubota K, Yokoi N, Shimazaki J, et al. New perspectives on dry eye definition and diagnosis: A consensus report by the Asia Dry Eye Society. Ocul Surf, 2017, 15(1): 65-76. DOI: 10.1016/ j.jtos.2016.09.003.
|
| [10] |
Wolffsohn JS, Arita R, Chalmers R, et al. TFOS DEWS II diagnostic methodology report. Ocul Surf, 2017, 15(3): 539- 574. DOI: 10.1016/j.jtos.2017.05.001.
|
| [11] |
Lemp MA. Report of the National Eye Institute/Industry Workshop on Clinical Trials in Dry Eyes. CLAO J, 1995, 21(4): 221-232.
|
| [12] |
亚洲干眼协会中国分会. 海峡两岸医药交流协会眼科专业委 员会眼表与泪液病学组. 我国蠕形螨睑缘炎诊断和治疗专 家共识(2018年). 中华眼科杂志, 2018, 54(7): 491-495. DOI: 10.3760/cma.j.issn.0412-4081.2018.07.004.
|
| [13] |
Post CF, Juhlin E. Demodexfolliculorum and blepharitis. Arch Dermatol, 1963, 88: 298-302. DOI: 10.1001/archderm.1963. 01590210056008.
|
| [14] |
Gao YY, Di Pascuale MA, Elizondo A, et al. Clinical treatment of ocular demodecosis by lid scrub with tea tree oil. Cornea, 2007, 26(2): 136-143. DOI: 10.1097/01.ico.0000244870.62384. 79.
|
| [15] |
Forton F, Seys B. Density of Demodexfolliculorum in rosacea: A case control study using standardized skin-surface biopsy. Br J Dermatol, 1993, 128(6): 650-659. DOI: 10.1111/j.1365- 2133.1993.tb00261.x.
|
| [16] |
Abd-El-Al AM, Bayoumy AM, Abou Salem EA. A study on Demodexfolliculorum in rosacea. J Egypt SocParasitol, 1997, 27(1): 183-195.
|
| [17] |
Liu J, Sheha H, Tseng SC. Pathogenic role of Demodex mites in blepharitis. Curr Opin Allergy Clin Immunol, 2010, 10(5): 505- 510. DOI: 10.1097/ACI.0b013e32833df9f4.
|
| [18] |
柯兰, 杨燕宁, 黄林英, 等. 妥布霉素地塞米松眼膏联合茶 树油治疗蠕形螨性睑缘炎的观察. 中华眼视光学与视觉科 学杂志, 2017, 19(3): 176-181. DOI: 10.3760/cma.j.issn.1674- 845X.2017.03.011.
|
| [19] |
Kulac M, Ciftci IH, Karaca S, et al. Clinical importance of Demodexfolliculorum in patients receiving phototherapy. Int J Dermatol, 2008, 47(1): 72-77. DOI: 10.1111/j.1365-4632. 2007.03336.x.
|
| [20] |
Sarro RA, Hong JJ, Elgart ML. An unusual demodicidosis manifestation in a patient with AIDS. J Am Acad Dermatol, 1998, 38(1): 120-121. DOI: 10.1016/s0190-9622(98)70554-7.
|
| [21] |
Gutierrez Y. Diagnostic pathology of parasitic infections with clinical correlations, 2nd ed. New York. NY: Oxford University Press, 2000.
|
| [22] |
Cheng AM, Sheha H, Tseng SC. Recent advances on ocular Demodex infestation. Curr Opin Ophthalmol, 2015, 26(4): 295- 300. DOI: 10.1097/ICU.0000000000000168.
|
| [23] |
Gao YY, Di Pascuale MA, Li W, et al. High prevalence of Demodex in eyelashes with cylindrical dandruff. Invest Ophthalmol Vis Sci, 2005, 46(9): 3089-3094. DOI: 10.1167/ iovs.05-0275.
|
| [24] |
Zang S, Cui Y, Cui Y, et al. Meibomian gland dropout in Sjögren's syndrome and non-Sjögren's dry eye patients. Eye (Lond), 2018, 32(11): 1681-1687. DOI: 10.1038/s41433-018- 0149-5.
|
| [25] |
Lindsley K, Matsumura S, Hatef E, et al. Interventions for chronic blepharitis. Cochrane Database Syst Rev, 2012, 16(5): CD005556. DOI: 10.1002/14651858.CD005556.pub2.
|
| [26] |
Ho WE, Peh HY, Chan TK, et al. Artemisinins: pharmacological actions beyond anti-malarial. Pharmacol Ther, 2014, 142(1): 126-139. DOI: 10.1016/j.pharmthera.2013.12.001.
|
| [27] |
王梦格, 谌丹, 李丽平, 等. 强脉冲光联合睑板腺按摩治疗 睑板腺功能障碍的短期疗效. 中华眼视光学与视觉科学 杂志, 2019, 21(10): 769-775. DOI: 10.3670/cma.j.issn.1674- 845X.2019.10.008.
|
| [28] |
Koo H, Kim TH, Kim KW, et al. Ocular surface discomfort and Demodex: effect of tea tree oil eyelid scrub in Demodex blepharitis. J Korean Med Sci, 2012, 27(12): 1574-1579. DOI: 10.3346/jkms.2012.27.12.1574.
|
| [29] |
Liang L, Liu Y, Ding X, et al. Significant correlation between meibomian gland dysfunction and keratitis in young patients with Demodex brevis infestation. Br J Ophthalmol, 2018, 102(8): 1098-1102. DOI: 10.1136/bjophthalmol-2017-310302.
|
| [1] |
. [J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2023, 25(8): 0-. |
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