Role of Topical 5-Fluorouracil in Demodex-Associated Blepharitis.
Journal
Cornea
ISSN: 1536-4798
Titre abrégé: Cornea
Pays: United States
ID NLM: 8216186
Informations de publication
Date de publication:
18 Jan 2024
18 Jan 2024
Historique:
received:
27
05
2023
accepted:
03
12
2023
medline:
18
1
2024
pubmed:
18
1
2024
entrez:
18
1
2024
Statut:
aheadofprint
Résumé
The aim of this study was to report clinical observations suggesting the efficacy of topical 1% 5-fluorouracil (5-FU) in treating Demodex-associated blepharitis. An observational retrospective review of 13 eyes from 13 individuals with conjunctival neoplastic lesions and concomitant Demodex lash infestation that received topical 1% 5-FU eye drops. Patients underwent slit-lamp examination at each follow-up visit. Clinical photographs of the lash line were obtained after treatment initiation. In a subset of patients, lashes were epilated bilaterally and microscopically analyzed for presence of Demodex mites before and after treatment initiation. The mean age of the population was 68 ± 14 years (range: 30-84 years) and 92% were male. In all 13 patients, a marked reduction in cylindrical dandruff was noted in the treated eye by slit-lamp examination after 2 cycles of 5-FU. There was complete resolution of cylindrical dandruff in 10 of 13 treated eyes compared with 0 resolution of cylindrical dandruff in untreated eyes (P = 0.0001). In the 6 patients who received epilation, the lashes from the treated eye showed no Demodex, whereas lashes from the fellow untreated eye revealed persistent Demodex. Topical 1% 5-FU shows efficacy in treating Demodex-associated blepharitis. Further studies are indicated to reproduce our findings and evaluate the potential use of 5-FU as a treatment ingredient.
Identifiants
pubmed: 38236070
doi: 10.1097/ICO.0000000000003470
pii: 00003226-990000000-00453
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : BLRD VA
ID : I01 BX004893
Pays : United States
Organisme : RRD VA
ID : I21 RX003883
Pays : United States
Organisme : NEI NIH HHS
ID : R01EY026174
Pays : United States
Organisme : NEI NIH HHS
ID : R61EY032468
Pays : United States
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors have no funding or conflicts of interest to disclose.
Références
Zhang AC, Muntz A, Wang MTM, et al. Ocular Demodex: a systematic review of the clinical literature. Ophthalmic Physiol Opt. 2020;40:389–432.
Rufli T, Mumcuoglu Y. The hair follicle mites Demodex folliculorum and Demodex brevis: biology and medical importance: a review. Dermatologica. 1981;162:1–11.
English FP, Nutting WB. Demodicosis of ophthalmic concern. Am J Ophthalmol. 1981;91:362–372.
Lacey N, Kavanagh K, Tseng SC. Under the lash: Demodex mites in human diseases. Biochem (Lond). 2009;31:2–6.
Gao YY, Di Pascuale MA, Li W, et al. High prevalence of Demodex in eyelashes with cylindrical dandruff. Invest Ophthalmol Vis Sci. 2005;46:3089–3094.
Szkaradkiewicz A, Chudzicka-Strugala I, Karpinski TM, et al. Bacillus oleronius and Demodex mite infestation in patients with chronic blepharitis. Clin Microbiol Infect. 2012;18:1020–1025.
Jacobi C, Doan S, Pavel V, et al. Different approach to manage Demodex blepharitis - initial and maintenance treatment. Curr Eye Res. 2022;47:352–360.
Savla K, Le JT, Pucker AD. Tea tree oil for Demodex blepharitis. Cochrane Database Syst Rev. 2020;6:CD013333.
Capasso L, Abbinante G, Coppola A, et al. Recent evidence of tea tree oil effectiveness in blepharitis treatment. Biomed Res Int. 2022;2022:9204251.
Gao YY, Di Pascuale MA, Li W, et al. In vitro and in vivo killing of ocular Demodex by tea tree oil. Br J Ophthalmol. 2005;89:1468–1473.
Avila MY, Martínez-Pulgarín DF, Rizo Madrid C. Topical ivermectin-metronidazole gel therapy in the treatment of blepharitis caused by Demodex spp.: a randomized clinical trial. Cont Lens Anterior Eye. 2021;44:101326.
Choi Y, Eom Y, Yoon EG, et al. Efficacy of topical ivermectin 1% in the treatment of demodex blepharitis. Cornea. 2022;41:427–434.
Helm CJ. Treatment of ocular Demodex infestation with topical ivermectin cream. Am J Ophthalmol Case Rep. 2022;26:101551.
Holzchuh FG, Hida RY, Moscovici BK, et al. Clinical treatment of ocular Demodex folliculorum by systemic ivermectin. Am J Ophthalmol. 2011;151:1030–1034.e1.
Muntz A, Sandford E, Claassen M, et al. Randomized trial of topical periocular castor oil treatment for blepharitis. Ocul Surf. 2021;19:145–150.
Gonzalez-Salinas R, Yeu E, Holdbrook M, et al. Safety and efficacy of topical lotilaner ophthalmic solution 0.25% for the treatment of demodex blepharitis: a pilot study. J Ophthalmol. 2021;2021:3862684.
Fulk GW, Murphy B, Robins MD. Pilocarpine gel for the treatment of demodicosis—a case series. Optom Vis Sci. 1996;73:742–745.
Zhang X, Song N, Gong L. Therapeutic effect of intense pulsed light on ocular demodicosis. Curr Eye Res. 2019;44:250–256.
Syed YY. Lotilaner ophthalmic solution 0.25%: first approval. Drugs. 2023;83:1537–1541.
Yeu E, Wirta DL, Karpecki P, et al. Lotilaner ophthalmic solution, 0.25%, for the treatment of demodex blepharitis: results of a prospective, randomized, vehicle-controlled, double-masked, pivotal trial (Saturn-1). Cornea. 2023;42:435–443.
Gaddie IB, Donnenfeld ED, Karpecki P, et al. Lotilaner ophthalmic solution, 0.25% for demodex blepharitis: randomized, vehicle-controlled, multicenter, phase 3 trial (Saturn-2). Ophthalmology. 2023;130:1015–1023.
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;27:1574–1579.
Su CW, Tighe S, Sheha H, et al. Safety and efficacy of 4-terpineol against microorganisms associated with blepharitis and common ocular diseases. BMJ Open Ophthalmol. 2018;3():e000094.
Thomas DM, Zalcberg JR. 5-fluorouracil: a pharmacological paradigm in the use of cytotoxics. Clin Exp Pharmacol Physiol. 1998;25:887–895.
Wylegala A, Sripawadkul W, Zein M, et al. Topical 1% 5-fluorouracil eye drops as primary treatment for ocular surface squamous neoplasia: long-term follow-up study. Ocul Surf. 2023;27:67–74.
Parrozzani R, Frizziero L, Trainiti S, et al. Topical 1% 5-fluoruracil as a sole treatment of corneoconjunctival ocular surface squamous neoplasia: long-term study. Br J Ophthalmol. 2017;101:1094–1099.
Yeatts RP, Engelbrecht NE, Curry CD, et al. 5-Fluorouracil for the treatment of intraepithelial neoplasia of the conjunctiva and cornea. Ophthalmology. 2000;107:2190–2195.
Al Bayyat G, Arreaza-Kaufman D, Venkateswaran N, et al. Update on pharmacotherapy for ocular surface squamous neoplasia. Eye Vis (Lond). 2019;6:24.
Evren Kemer O, Karaca EE, Ozek D. Efficacy of cyclic therapy with terpinen-4-ol in Demodex blepharitis: is treatment possible by considering Demodex's life cycle? Eur J Ophthalmol. 2021;31:1361–1366.
Karakurt Y, Zeytun E. Evaluation of the efficacy of tea tree oil on the density of demodex mites (Acari: demodicidae) and ocular symptoms in patients with demodectic blepharitis. J Parasitol. 2018;104:473–478.
Liu W, Gong L. Anti-demodectic effects of okra eyelid patch in Demodex blepharitis compared with tea tree oil. Exp Ther Med. 2021;21:338.
Murphy O, O'Dwyer V, Lloyd-McKernan A. The efficacy of tea tree face wash, 1, 2-Octanediol and microblepharoexfoliation in treating Demodex folliculorum blepharitis. Cont Lens Anterior Eye. 2018;41:77–82.
Liang L, Safran S, Gao Y, et al. Ocular demodicosis as a potential cause of pediatric blepharoconjunctivitis. Cornea. 2010;29:1386–1391.
Kim JH, Chun YS, Kim JC. Clinical and immunological responses in ocular demodecosis. J Korean Med Sci. 2011;26:1231–1237.
Dingsdag SA, Hunter N. Metronidazole: an update on metabolism, structure-cytotoxicity and resistance mechanisms. J Antimicrob Chemother. 2018;73:265–279.