Randon Matthieu, Liang Hong, El Hamdaoui Mohamed, Tahiri Rachid, Batellier Laurence, Denoyer Alexandre, Labbé Antoine, Baudouin Christophe
Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU ViewMaintain, INSERM-DHOS CIC, Paris, France INSERM, U968, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 968, Institut de la Vision, Paris, France CNRS, UMR_7210, Paris, France.
Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU ViewMaintain, INSERM-DHOS CIC, Paris, France.
Br J Ophthalmol. 2015 Mar;99(3):336-41. doi: 10.1136/bjophthalmol-2014-305671. Epub 2014 Sep 24.
Demodex mites are implicated in several ocular surface diseases such as blepharitis, ocular rosacea and dry eye syndrome. Demodex eyelid infestation is classically diagnosed by analysing depilated eyelashes under the light microscope. The use of in vivo confocal microscopy (IVCM) could be an easy way to improve its diagnosis. The ability of IVCM to identify Demodex was evaluated and compared with the classic depilation method.
Eight healthy subjects, 22 patients with dry eye syndrome without anterior blepharitis and 18 patients with anterior blepharitis were examined using lower eyelid IVCM (lash follicles and meibomian glands (MGs)). Twenty-five of the 48 subjects underwent both an IVCM examination and classic depilation to compare the two methods. Ex vivo Demodex obtained from lash depilation were also analysed using the confocal microscope.
IVCM found 100% of the mite infestations among patients with anterior blepharitis, 60% among dry eye patients without blepharitis and 12% in healthy subjects, whereas the depilation technique found 100%, 50% and 0%, respectively. Demodex brevis and Demodex larvae inside the lash follicles were better detected by IVCM. In symptomatic patients, the Demodex infestation was often associated with MG dysfunction, which was better characterised using IVCM in symptomatic patients (60% and 40% of meibomianitis and gland fibrosis, respectively).
IVCM is an efficient and reliable tool for the diagnosis of eyelid mite infestation and may also provide an evaluation of MGs.
蠕形螨与多种眼表疾病有关，如睑缘炎、眼部酒渣鼻和干眼综合征。传统上，通过在光学显微镜下分析拔除的睫毛来诊断蠕形螨睑部感染。使用活体共聚焦显微镜（IVCM）可能是改善其诊断的一种简便方法。评估了IVCM识别蠕形螨的能力，并与传统的拔毛法进行了比较。
对8名健康受试者、22名无前部睑缘炎的干眼综合征患者和18名前部睑缘炎患者进行下睑IVCM检查（睫毛毛囊和睑板腺（MGs））。48名受试者中的25名接受了IVCM检查和传统拔毛法，以比较这两种方法。还使用共聚焦显微镜分析了从拔毛获得的离体蠕形螨。
IVCM在前部睑缘炎患者中发现100%的螨虫感染，在无睑缘炎的干眼患者中发现60%，在健康受试者中发现12%，而拔毛技术分别发现100%、50%和0%。IVCM能更好地检测睫毛毛囊内的短蠕形螨和蠕形螨幼虫。在有症状的患者中，蠕形螨感染常与MG功能障碍相关，IVCM能更好地对有症状患者的MG功能障碍进行特征描述（睑板腺炎和腺体纤维化分别为60%和40%）。
IVCM是诊断睑部螨虫感染的一种有效且可靠的工具，还可对睑板腺进行评估。
