Department of Ophthalmology, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia; Basic and Clinic Ophthalmology Research Group, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia.
Department of Ophthalmology, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia; Basic and Clinic Ophthalmology Research Group, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia.
Cont Lens Anterior Eye. 2021 Dec;44(6):101453. doi: 10.1016/j.clae.2021.101453. Epub 2021 May 7.
A systematic review and meta-analysis was performed to evaluate the effectiveness of interventions in the treatment ofDemodex blepharitis in adult patients.
A systematic review and meta-analysis of studies reporting the efficacy of treatments forDemodex blepharitis in the main databases (PubMed / Scopus / Cochrane / EMBASE / Science Direct / WOS / Scielo / Google Scholar / metaRegister of Controlled Trials / ClinicalTrials.gov/ WHO ICTRP) until November 24, 2020 was performed according to the PRISMA statement for meta-analysis.
Overall, 18 studies were included for 29 different interventions in 1195 participants with 1574 eyes that were positive for Demodex Spp. Demodex counts, total eradication, clinical improvement, Ocular Surface Disease Index, Tear Break-Up Time, cylindrical dandruff, Schirmer test, osmolarity and adverse reactions were analysed, and stratified sub-analyses conducted. The overall effects for Demodex count (mean difference), total eradication (risk ratio) and adverse reactions (risk difference) were -2.07 (95 % CI -3.99 to -0.15) p = 0.03, 1.84 (95 % CI 1.27-2.66) p = 0.001 and 0.24 (95 % CI 0.08 to 0.41) p = 0.005, respectively. The most frequent interventions evaluated in the included studies were tea tree oil (TTO) and its derivatives, such as terpinen 4-ol.
Multiple therapeutic choices were evaluated in this meta-analysis. Pharmacological interventions were superior to non-pharmacological (mechanical, thermal and pulsed light) interventions. It was not possible to establish significant differences between TTO and non-TTO-derived treatments. Adverse reactions were more frequent in TTO-derived treatments, however all were mild. It is necessary to execute studies with longer follow-up times to determine whether re-infestation occurs after the administration of different treatments.
系统评价和荟萃分析评估了干预措施治疗成人蠕形螨性睑缘炎的疗效。
根据荟萃分析的 PRISMA 声明，对主要数据库（PubMed / Scopus / Cochrane / EMBASE / Science Direct / WOS / Scielo / Google Scholar / metaRegister of Controlled Trials / ClinicalTrials.gov/ WHO ICTRP）中截至 2020 年 11 月 24 日报告治疗蠕形螨性睑缘炎疗效的研究进行了系统评价和荟萃分析。
共有 18 项研究纳入 29 种不同干预措施，共 1195 名参与者，1574 只眼被诊断为蠕形螨属阳性。分析了蠕形螨计数、总清除率、临床改善、眼表面疾病指数、泪膜破裂时间、圆柱状头皮屑、泪液分泌试验、渗透压和不良反应，并进行了分层亚分析。蠕形螨计数（均数差）、总清除率（风险比）和不良反应（风险差）的总体效应分别为-2.07（95%CI-3.99 至-0.15），p=0.03、1.84（95%CI1.27-2.66），p=0.001 和 0.24（95%CI0.08 至 0.41），p=0.005。纳入研究中评估最多的干预措施是茶树油（TTO）及其衍生物，如萜品-4-醇。
本荟萃分析评估了多种治疗选择。与非药物（机械、热和脉冲光）干预相比，药物干预更有效。TTO 和非 TTO 衍生治疗之间的差异没有统计学意义。TTO 衍生治疗的不良反应更为常见，但均为轻度。需要进行随访时间更长的研究，以确定在使用不同治疗后是否会再次感染。
