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    Potential benefits of oral antibiotics for MGD put into perspective


    Evidence base

    Serving on the American Academy of Ophthalmology Ophthalmic Technology Assessment Committee Oculoplastics and Orbit Panel, Dr. Wladis and colleagues undertook a review of the role of oral antibiotics in the management of meibomian gland-related ocular surface disease [Wladis EJ, et al. Ophthalmology. 2016;123:492-496]. The lack of scientific evidence was surprising to Dr. Wladis.

    “Considering the prevalence of the disease and the common use of oral antibiotics, I was sure this was a Herculean task that would require review of extensive literature,” he said. “Our search, however, only identified eight articles that suffered serious methodological flaws.”

    Of the eight papers, four reported on doxycycline, and only one included a control group. One uncontrolled study of 8 patients with blepharitis treated for 4 weeks found significant improvement in signs and symptoms, but not in visual acuity or keratitis. A second uncontrolled study, including 39 patients with ocular rosacea treated for 12 weeks, found improved tear breakup time (TBUT), Schirmer scores, and eyelid inflammatory signs, but no improvement in keratitis or corneal staining.

    In an uncontrolled study of 15 patients with ocular rosacea treated for 8 months, there was no improvement in keratitis or visual acuity, but 87% of patients reported resolution or significant improvements in symptoms.


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