Posters

Topical azithromycin and oral doxycycline in the management of meibomian gland dysfunction

Poster Details

First Author: V.Chow HONG KONG

Co Author(s):    J. Lam   V. Jhanji                 

Abstract Details

Purpose:

To determine the role of topical Azithromycin and oral Doxycycline in the Management of Meibomian Gland Dysfunction (MGD).

Setting:

Double-blinded randomized controlled trial at a tertiary referral center.

Methods:

52 subjects were randomly allocated to Group 1 (topical azithromycin 1.5% twice daily for the first 3 days then daily for 25 days, and oral placebo tablet for 28 days) and Group 2 (similar topical azithromycin regimen, plus oral doxycycline 100mg daily for 28 days). Subjects were assessed with Ocular Surface Disease Index (OSDI) questionnaire, slit lamp and Keratograph at baseline, week 2, month 1 and month 3.

Results:

OSDI scores significantly improved from baseline in both groups at all time points. At week 2, Group 1 improved by 7.7±13.3 (p=0.009) and Group 2 by 5.8±10.9 (p=0.018); at month 1, Group 1 by 14.4±16.8 (p=0.000), Group 2 by 6.4±13.0 (p=0.028); at month 3, Group 1 by 13.0±15.3 (p=0.000), Group 2 by 10.7±15.4 (p=0.004). However, the differences between the two groups were not statistically significant. Clinical scores and Keratograph indices were all not significantly different from baseline for Group 1 at all time points. For Group 2, meibum quality improved by 0.4±0.8 (p=0.022) at month 1 but not at month 3; Keratograph indices all improved at month 3 (first NIBUT lengthened by 4.2s±6.6s, p=0.007; average NIBUT by 4.1s±5.7s, p=0.003; duration of eye opening by 3.1s±6.6s, p=0.039; R-score improved by 0.2±0.4s, p=0.013) but not at month 1.

Conclusions:

Topical azithromycin 1.5% significantly improved symptoms of MGD. Effect can be seen at 2 weeks and sustained at 3 months with only 1 month of therapy. Addition of oral doxycycline did not confer additional symptomatic improvement, but seemed to produce a longer-lasting effect with improved objective parameters on Keratograph at month 3.

Financial Disclosure:

None