minocycline and Eyelid-Diseases

To review the special pharmacology of tetracycline antibiotics as anti-inflammatory drugs for treatment of obstructive Meibomian gland disease (MGD) METHODS: PubMed was used as principal resource for articles, regardless of language, on doxycycline and minocycline with key interests being on their serum and tissue pharmacokinetics and their use in clinical studies as part of management of MGD.. With oral dosing of between 50 and 200mg, peak blood levels of these antibiotics have been reported to be predictably dose-dependent at between 1 and 5 microgram/mL, with human tear film levels not being detectable with 100mg dosing of doxycycline but levels of 0.2 microgram/mL with 200mg minocycline. That these two tetracycline antibiotics reach the conjunctiva is indicated by conjunctival pigmentary changes due to photosensitization after very long term use. Based the reported use in a range of clinical studies on MGD, dosing with these two antibiotics for MGD is likely to be useful at relatively low doses (e.g. 100mg for doxycycline or 50mg for minocycline, either at once or twice daily depending on severity at presentation and previous history) continued for 2 to 3 months, with the expected outcome being small-to-substantial decreases in abnormal appearance of the glands (from -4 to -89%) and increases in tear film stability (from 21 to 273%).. Oral doxycycline and minocycline have predictable pharmacokinetics and have been reported to improve Meibomian gland dysfunction over a few months of use.

Topics: Anti-Bacterial Agents; Disease Management; Doxycycline; Drug Prescriptions; Eyelid Diseases; Humans; Meibomian Glands; Minocycline; Optometry; United Kingdom; Workforce

To review the existing medical literature on the role of oral antibiotics in the management of ocular surface disease (OSD) that arises from disorders of the meibomian glands and to assess the efficacy of oral antibiotics in the management of this common ocular disease.. A literature search was last conducted on August 12, 2015, in the PubMed and Cochrane databases for English-language original research investigations that evaluated the role of doxycycline, minocycline, and azithromycin in OSD among adult patients. The searches identified 87 articles, and 8 studies ultimately met the criteria outlined for this assessment.. The 8 studies identified in the search documented an improvement in meibomian gland-related OSD after treatment with these agents, although side effects were common. This search identified only 1 randomized, controlled trial to assess the efficacy of these medications.. Although oral antibiotics are used commonly in the management of OSD, there is no level I evidence to support their use. There are only a few studies that have assessed the efficacy of oral antibiotics in clinically meaningful ways in the management of OSD that arises from disorders of the meibomian glands. The current level of evidence is insufficient to conclude that antibiotics are useful in managing OSD arising from disorders of the meibomian glands. The few existing studies on the topic indicate that oral antibiotics may be an effective treatment for OSD that results from meibomian gland disease.

Topics: Academies and Institutes; Administration, Oral; Adult; Anti-Bacterial Agents; Azithromycin; Clinical Trials as Topic; Doxycycline; Eyelid Diseases; Humans; Meibomian Glands; Middle Aged; Minocycline; Ophthalmology; Technology Assessment, Biomedical; United States

To assess clinical outcomes and tear cytokine levels in patients with moderate and severe meibomian gland dysfunction (MGD) after treatment with oral minocycline and artificial tears versus artificial tears only.. Prospective, randomized clinical trial.. Sixty eyes of 60 patients with stage 3 or 4 meibomian gland dysfunction were enrolled. We evaluated the tear film break-up time, Schirmer test results, corneal and conjunctival fluorescein staining results, biomicroscopic examination results of lid margins and meibomian glands, and tear cytokine levels before and after 1 month and 2 months of oral minocycline and artificial tears (group 1) or artificial tears only (group 2). Tear samples were collected and analyzed using a BD Cytometric Bead Array (BD Bioscience, San Jose, California, USA) for detection of interleukin (IL)-1β, IL-6, IL-7, IL-8, IL-12p70, IL-17α, interferon-γ, tumor necrosis factor-α, and monocyte chemotactic protein-1. The Wilcoxon signed-rank test, Mann-Whitney U test, generalized linear model, and linear mixed model were performed.. Patients in group 1 showed statistically significant improvement in all clinical signs and symptoms after 1 month and 2 months of treatment. Patients of group 1 showed more significant improvement compared with those in group 2. Patients in group 1 also showed statistically significant reductions in IL-6, IL-1β, IL-17α, tumor necrosis factor-α, and IL-12p70 after 2 months of treatment.. Oral minocycline can provide clinical benefits in treating moderate and severe meibomian gland dysfunction by reducing inflammatory cytokine levels.

Topics: Administration, Oral; Aged; Anti-Bacterial Agents; Cytokines; Eye Proteins; Eyelid Diseases; Female; Flow Cytometry; Fluorophotometry; Humans; Luminescent Measurements; Male; Meibomian Glands; Middle Aged; Minocycline; Ophthalmic Solutions; Prospective Studies; Tears; Treatment Outcome

Topics: Aged, 80 and over; Anti-Bacterial Agents; Conjunctivitis, Bacterial; Eye Infections, Bacterial; Eyelid Diseases; Female; Humans; Methicillin-Resistant Staphylococcus aureus; Minocycline; Staphylococcal Infections; Syndrome

We present the case of a 16-year-old girl with a 2-year history of progressive development of milia en plaque of the eyelids.

Topics: Adolescent; Anti-Bacterial Agents; Caustics; Drug Therapy, Combination; Eyelid Diseases; Facial Dermatoses; Female; Humans; Minocycline; Trichloroacetic Acid

To assess the changes in ocular surface abnormalities and meibomian fatty acid composition in patients suffering from meibomian gland dysfunction (MGD) after treatment with oral minocycline associated with lid hygiene versus lid hygiene only.. We evaluated the break-up time, corneal staining and quality of meibomian excreta, and collected meibomian oil in 20 individuals suffering from MGD before and after 8 weeks of minocycline associated with lid hygiene (n = 10) or lid hygiene only (n = 10). Meibomian fatty acids were directly transmethylated and analysed by gas chromatography (GC) and GC mass spectrometry.. The meibomian fatty acid composition was slightly modified after 8 weeks in both groups. The decrease in a branched-chain fatty acid (isoC20) was greater after minocycline treatment than after lid hygiene only (-65% and -25%, respectively; p<0.05). Other fatty acids were unchanged. A significant improvement in the BUT was observed after minocycline treatment (p = 0.03).. This study showed better tear film stability after minocycline treatment and a biological effect on meibomian fatty acid composition in MGD patients. Minocycline was more effective than lid hygiene alone. Both interventions partly corrected fatty acid composition abnormalities. Among the fatty acids, isoC20 could be a biological marker of MGD.

Topics: Administration, Oral; Aged; Aged, 80 and over; Analysis of Variance; Anti-Bacterial Agents; Blepharitis; Eyelid Diseases; Fatty Acids; Female; Humans; Hygiene; Male; Meibomian Glands; Middle Aged; Minocycline; Tears; Treatment Outcome

To evaluate the clinical impact, aqueous tear parameters, and meibomian gland morphology in patients with primary meibomianitis before, during, and 3 months after a course of oral minocycline.. 16 patients were prospectively enrolled, 11 male and five female (mean age 69 years old). Each patient received routine clinical evaluations before, after 3 months therapy, and at 6 month study follow up visit. The clinical appearance, tear volume, flow and turnover, evaporation, Schirmer I test, meibomian gland dropout, lissamine green staining, and bacteriology wer evaluated.. Improvement was observed in clinical signs of meibomianitis at the second and third visits. Microbial culture findings improved. Decreased aqueous tear volume and flow, and increased evaporation rate range at 35-45% relative humidity (RH) (p < 0.05) were also detected. Other related tear parameters did not change. Meibomian gland dropout showed no improvement.. 3 months of oral minocycline resulted in clinical improvements in all meibomianitis signs that persisted for at least 3 months after discontinuation despite decreased aqueous tear volume and flow with increased evaporation (35-45% RH). However, there was improvement in the turbidity of secretions. Short term minocycline therapy probably has efficacy in the management of meibomianitis that extends beyond eradication of bacteria.

Topics: Administration, Oral; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacteria, Anaerobic; Conjunctiva; Dry Eye Syndromes; Eyelid Diseases; Female; Humans; Male; Meibomian Glands; Middle Aged; Minocycline; Prospective Studies; Staphylococcal Infections; Staphylococcus aureus; Staphylococcus epidermidis; Tears

To report a case of phthisis bulbi resulting from late congenital syphilis untreated until adulthood.. Observational case report.. We report clinical and laboratory evaluations of a 43-year-old woman who presented with a palpebral ulcer of the right eye.. The patient had a gummatous palpebral ulcer and a phthisis bulbi in the right eye and a gumma on the left eyelid. A silent interstitial keratitis of the left eye was detected. The patient had hearing loss in the right ear, her nose was missing, and her right leg had been amputated. Treponemal pallidum hemagglutination (TPHA) test was positive. Although we administered intensive oral penicillin, the clinical symptoms of the patient did not improve.. This is a rare case of phthisis bulbi resulting from late congenital syphilis. We emphasize that treatment for late congenital syphilis must be carried out early and completely.

Topics: Adult; Amoxicillin; Anti-Bacterial Agents; Drug Therapy, Combination; Eyelid Diseases; Female; Glucocorticoids; Hemagglutination Tests; Humans; Keratitis; Minocycline; Syphilis Serodiagnosis; Syphilis, Congenital; Ulcer

To present a patient with rosacea lymphoedema of one upper eyelid resulting in unilateral complete ptosis.. A 51-year-old white man presented with a 12-month history of progressive painless swelling of the left upper eyelid. An incisional biopsy of the upper eyelid was performed.. The biopsy showed dermal oedema with lymphangiectasia and telangiectasia, accompanied by a mild to moderate mixed chronic inflammatory infiltrate of lymphocytes, histiocytes, plasma cells and rare eosinophils. Stains for fungi and mycobacteria were negative. The lack of lichenoid reaction, dermal mucin or lip swelling indicated a lymphoedematous manifestation of rosacea. The patient was treated with minocycline and prednisolone with no effect.. Rosacea lymphoedema involving the eyelid, as in our case, is a rare complication and can present diagnostic and therapeutic challenges to the ophthalmologist.

Topics: Anti-Bacterial Agents; Blepharoptosis; Drug Therapy, Combination; Eyelid Diseases; Glucocorticoids; Humans; Lymphedema; Male; Middle Aged; Minocycline; Prednisolone; Rosacea

Topics: Acneiform Eruptions; Adult; Anti-Bacterial Agents; Eyelid Diseases; Humans; Male; Minocycline; Treatment Outcome

Topics: Adult; Anti-Bacterial Agents; Eyelid Diseases; Facial Dermatoses; Female; Humans; Male; Middle Aged; Minocycline; Skin Diseases, Papulosquamous