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Comparison between oral azithromycin versus oral doxycycline in meibomian gland dysfunction: a 9-months randomised trial

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Session Details

Session Title: Moderated Poster Session: New and Interesting

Venue: Poster Village: Pod 1

First Author: : G.De Benedetti SPAIN

Co Author(s): :    A. Vaiano   E. Coronado Quitllet           

Abstract Details

Purpose:

Ocular surface disease is very common and multifactorial pathology, one of the most common reasons for visiting an ophthalmologist and known to affect 15% of Americans older than 65 years. The purpose of this work was to compare the efficacy and safety of orally administered azithromycin versus doxycycline in patients who experienced failure with conservative and topical treatment in Meibomian gland disease (MGD) with posterior blepharitis during one year time, in order to assess also the recurrence of the disease and to determine the possible number of pulses needed in such a period.

Setting:

Quironsalud Hospital San Sebastián, Spain

Methods:

The Authors measured, in 115 consecutive patients (18-82 years-old), 5 main symptoms, such as burning, itching, foreign body sensation, dryness and eyelid edema and 7 main signs, including type of meibomian gland secretion, number of occluded gland orifices, conjunctival hyperemia, lid margin redness, ocular surface staining with fluorescein and tear break up time (TBUT) and Schirmer I test, plus Visual Acuity (VA). Every 3 months, depending on severity of signs and symptoms, the patients were randomly assigned to azithromycin or doxycycline and recorded results were examined by χ2, Student t-test and Anova test.

Results:

Of the 115 patients, 12 were lost on follow-up, so only 103 patients were studied. Symptoms and signs significantly ameliorated in both groups since the first follow-up but only in the azithromycin group there was a significant improvement in a shorter time and maintained along the whole period. Side effects were mild but worse in the doxycycline group. At last follow-up, in the azithromycin group, 65% did not present any recurrence, 28.9% had grade 2 blepharitis, 6.1% grade 3 blepharitis. In the doxycycline group 10% had no recurrence, 67% had grade 2 blepharitis, 23% had grade 3 blepharitis.

Conclusions:

Azithromycin resulted more performing all along the study, obtaining a significant improvement in the majority of patients (65%), in a shorter time and along the whole period as well, especially improving VA, conjunctival redness and corneal staining, with lower side effects. Patients treated with Doxycycline had similar results but only in a relatively small percentage of patients (10%), the majority being switched to the azithromycin group. Considering the reduced time of administration (5-days vs 4-weeks course) of azithromycin and the chronic nature of the disease, repeating this treatment seems a safer, cheaper and logical alternative to longer pulses.

Financial Disclosure:

NONE

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