Sagaser Samantha, Butterfield Richard, Kosiorek Heidi, Kusne Yael, Maldonado Juan, Fautsch Michael P, Patel Dharmendra, Shen Joanne F
Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA.
Research Biostatistics, Mayo Clinic, Scottsdale, AZ, USA.
Clin Ophthalmol. 2021 Jan 27;15:323-330. doi: 10.2147/OPTH.S280707. eCollection 2021.
To assess tear film transforming growth factor-beta (TGF-β) and ocular microbiome changes after intense pulsed light with meibomian gland expression (IPL-MGX) vs only MGX in treating ocular rosacea with dry eye symptoms.
Twenty patients were randomly assigned to IPL-MGX or MGX. Patients were examined, treated, and administered the ocular surface disease index (OSDI) survey every 4-6 weeks for four total treatments. Tear film and conjunctival samples were collected at first and last visits, and analyzed for TGF-β concentration and 16s rRNA amplicon sequencing of ocular microbiome. Wilcoxon Rank Sum and Sign-Rank were used to examine changes from baseline.
OSDI revealed significantly greater improvement in symptoms after IPL-MGX (p=0.030) compared to MGX. There was no significant difference in mean TGF-β1, 2, or 3 concentration after IPL-MGX (p=0.385, 0.709, 0.948, respectively). Quantities of , , , , , , , , and were significantly reduced from baseline in both groups but without a significant difference between the two treatment groups.
IPL-MGX improved dry eye symptoms more than MGX alone. IPL treatment offered no additional benefit to MGX in decreasing virulent bacteria present on the ocular surface and did not influence TGF-β levels in tears. Prospective studies on IPL-MGX with larger sample sizes are needed to further investigate cytokines and IPL in patients suffering from ocular rosacea with dry eye symptoms.
NCT03194698.
评估在治疗伴有干眼症状的眼部酒渣鼻时，强脉冲光联合睑板腺按摩（IPL-MGX）与单纯睑板腺按摩（MGX）后泪膜转化生长因子-β（TGF-β）和眼部微生物群的变化。
20例患者被随机分配至IPL-MGX组或MGX组。每4-6周对患者进行检查、治疗，并进行眼表疾病指数（OSDI）调查，共进行4次治疗。在首次和末次就诊时收集泪膜和结膜样本，分析TGF-β浓度以及眼部微生物群的16s rRNA扩增子测序。采用Wilcoxon秩和检验和符号秩检验来检查与基线相比的变化。
与MGX相比，IPL-MGX治疗后OSDI显示症状改善更显著（p=0.030）。IPL-MGX后TGF-β1、2或3的平均浓度无显著差异（分别为p=0.385、0.709、0.948）。两组中 、 、 、 、 、 、 、 和 的数量均较基线显著减少，但两个治疗组之间无显著差异。
IPL-MGX比单纯MGX更能改善干眼症状。IPL治疗在减少眼表存在的有害细菌方面对MGX没有额外益处，且不影响泪液中TGF-β水平。需要对IPL-MGX进行更大样本量的前瞻性研究，以进一步调查伴有干眼症状的眼部酒渣鼻患者的细胞因子和IPL情况。
NCT03194698。
