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Efficacy of treatments for demodex blepharitis: A systematic review and meta-analysis
Navel, Valentin Mulliez, Aurélien D'Azy, Cédric Benoist Baker, Julien S. Malecaze, Jean Chiambaretta, Frédéric Dutheil, Frederic
Navel, Valentin
Mulliez, Aurélien
D'Azy, Cédric Benoist
Baker, Julien S.
Malecaze, Jean
Chiambaretta, Frédéric
Dutheil, Frederic
Abstract
Purpose We conducted a systematic review and meta-analysis to evaluate the efficacy of different treatment for Demodex blepharitis. Parameters studied were mites count, improvement of symptoms and mites’ eradication, stratified on type of treatments and mode of delivery of treatments (local or systemic). Method The PubMed, Cochrane Library, Embase, ClinicalTrials.gov, Google scholar and Science Direct databases were searched for studies reporting an efficacy of treatments for Demodex blepharitis. Results We included 19 studies (14 observational and 5 randomized clinical trials), for a total of 934 patients, 1741 eyes, and 13 different treatments. For mites count, eradication rate, and symptoms improvement, meta-analysis included fifteen, fourteen and thirteen studies, respectively. The overall effect sizes for efficiency of all treatments, globally, were 1.68 (95CI 1.25 to 2.12), 0.45 (0.26–0.64), and 0.76 (0.59–0.90), respectively. Except usual lid hygiene for mites count, Children's Hospital of Eastern Ontario ointment (CHEO) for both eradication rate and symptoms, and CHEO, 2% metronidazole ointment, and systemic metronidazole for eradication rate, all treatments were efficient. Stratified meta-analysis did not show significant differences between local and systemic treatments (1.22, 0.83 to 1.60 vs 2.24, 1.30 to 3.18 for mites count; 0.37, 0.21 to 0.54 vs 0.56, 0.06 to 0.99 for eradication rate; and 0.77, 0.58 to 0.92 vs 0.67, 0.25 to 0.98 for symptoms improvement). Conclusion We reported the efficiency of the different treatments of Demodex blepharitis. Because of less systemic side effects, local treatments seem promising molecules in the treatment of Demodex blepharitis.
Keywords
Demodex, Blepharitis, Infection, Immunology, Inflammation, Tea tree oil, Ivermectin, Pilocarpine, Metronidazole
Date
2019
Type
Journal article
Journal
The Ocular Surface
Book
Volume
17
Issue
4
Page Range
655-669
Article Number
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
Open access
License
CC BY-NC-ND 4.0
File Access
Open