Comparison Of Pre- And Post-Treatment Clinical Findings, Meibography And Tbut In Pediatric Cases With Ocular Rosacea

The aim of the study was to demonstrate the changes in the ocular findings, meibography and TBUT (tear break-up time) values of 12 pediatric patients with ocular rosacea after a standard treatment. The study also aimed to create awareness about the management of this chronic inflammatory process of the disease during long-term follow-ups.

Twenty-four eyes of 12 patients who were diagnosed with ocular rosacea and referred to a tertiary hospital between 2021 and 2023 were included in the study. There was no distinction made based on gender or ethnic origin. Ocular rocasea diagnosis was made according to the criteria determined in the 2019 ROSCO panel.Patients were followed at variable intervals based on the severity of their symptoms at the time of application. Parameters were recorded at 1 month after treatment.

Biomicroscopic examination findings, non-invasive TBUT, corneal and conjunctival fluorescein staining according to Oxford scoring and meibography were recorded for each patient. Warm compress, eyelid hygiene, preservative-free sodium hyaluronate eye drops (four times a day), topical azithromycin 1.5% (twice a day for 3 days), topical steroid (loteprednol 0.5%, four times a day for 2 weeks), doxycycline 100mg/day for patients >14 years old for 14 days and oral suspension of azithromycin 5-10mg/kg for 3 days for <14 years old were administered as the standard treatment protocol. The Wilcoxon test was used to compare the means of the groups. The chi-square or Fisher’s exact tests were used in the analysis of the categorical data.

There were 7(58.3%) female and 5(41.6%) male patients with a mean age of 9.5±4.09(3-17) years. The mean follow-up period was 38.4±28.1 weeks. Although the relationship between the presence of lid margin telangiectasia, corneal melting and chalazia was not statistically significant before and after treatment, improvement was observed in these parametres.Significant changes were observed in the Oxford scores, presence of corneal neovascularization and TBUT before and after treatments (p<0.001, p=.001, p<0.001, respectively). Meibomian gland dysfunction was present in every patient before treatment and significant decrease was observed in the scoring between pre(36.47±12.75%) and post (26.7±9.02%) treatment in meibography measurements(p=.001).

This study showed that pediatric ocular rosacea patients had better meibomian gland parameters after a standard treatment protocol. Children presenting with a long history of ocular irritation, meibomian gland disease, sterile corneal infiltrates, and chalazia should alert ophthalmologists to consider ocular acne rosacea even in the absence of skin changes. The use of meibography and TBUT in the treatment follow-up of this disease is instructive.