Department of Ophthalmology, Bnai Zion Medical Center, Haifa, Israel.
Department of Ophthalmology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel; and.
Cornea. 2020 Jul;39(7):858-861. doi: 10.1097/ICO.0000000000002254.
To determine whether Demodex infestation in blepharitic patients can be confirmed by slit-lamp examination without the need for light microscopy.
Demodex infestation was evaluated in 16 patients presenting with blepharitis and cylindrical dandruff at a single medical center from November 2014 to February 2015. Two lashes with cylindrical dandruff were epilated from each lid (8 per patient, total 128), mounted on slides, and examined in the clinic under a slit lamp equipped with a 90D condensing lens followed by light microscopy in the pathology laboratory. All evaluations were performed by the same pathologist. Mites were identified by their characteristic morphology and movement patterns. Findings were compared between the 2 methods.
The mean total Demodex count per lash was 1.5 ± 2.1 mites by using the slit lamp and 2 ± 2.9 mites by light microscopy. Corresponding counts per patient were 11.7 ± 9.4 and 16.1 ± 12.4. The correlation between the slit lamp and microscopy results was statistically significant, per lash (r = 0.922, P < 0.01) and per patient (r = 0.976, P < 0.01). On analysis by the more clinically relevant negative (no mites detected) or positive results (at least 1 mite detected), the accuracy of the slit-lamp examination for a single lash was 91.4% and the specificity and sensitivity were 89% and 94%, respectively; the negative predictive value was 93% [χ(1) = 87.94, P < 0.01)]. All 16 patients were positive for Demodex infestation by both methods (accuracy 100%).
Demodex infestation in blepharitic patients with cylindrical dandruff can be confirmed using only a slit lamp and common eye clinic equipment.
确定在不需要显微镜的情况下，通过裂隙灯检查是否可以确认患有睑缘炎和圆柱状鳞屑的患者是否存在螨虫感染。
我们在 2014 年 11 月至 2015 年 2 月期间在一家医疗中心评估了 16 名患有睑缘炎和圆柱状鳞屑的患者的螨虫感染情况。每个眼睑从 2 根带有圆柱状鳞屑的睫毛上拔下（每位患者 8 根睫毛，总计 128 根睫毛），将其安装在载玻片上，并在配备有 90°D 聚光镜的裂隙灯下在诊所进行检查，随后在病理实验室中通过显微镜进行检查。所有评估均由同一位病理学家进行。通过其特征形态和运动模式来鉴定螨虫。比较了两种方法的结果。
使用裂隙灯时每根睫毛的螨虫总数为 1.5±2.1 只，使用显微镜时为 2±2.9 只。每位患者的相应计数分别为 11.7±9.4 和 16.1±12.4。裂隙灯和显微镜结果之间的相关性具有统计学意义，每根睫毛（r=0.922，P<0.01）和每位患者（r=0.976，P<0.01）。通过更具临床相关性的阴性（未检测到螨虫）或阳性结果（至少检测到 1 只螨虫）进行分析，单个睫毛的裂隙灯检查的准确性为 91.4%，特异性和灵敏度分别为 89%和 94%，阴性预测值为 93%[χ(1)=87.94，P<0.01)]。两种方法均显示 16 名患者均为螨虫感染阳性（准确性 100%）。
对于患有圆柱状鳞屑的睑缘炎患者，可以仅使用裂隙灯和普通眼科诊所设备来确认螨虫感染。
