Published in Clinical Ophthalmology, a recent study assessed tear film transforming growth factor beta (TGF-β) and ocular microbiome changes after intense pulsed light with meibomian gland expression (IPL-MGX) vs only MGX in treating ocular rosacea with dry eye symptoms.
It consisted of 20 patients who were randomly assigned to IPL-MGX or MGX. In 4 total treatments, patients were examined, treated, and administered the ocular surface disease index (OSDI) survey every 4 to 6 weeks. Tear film and conjunctival samples were collected during the first and last visits in addition to being analyzed for TGF-β concentration and 16s rRNA amplicon sequencing of ocular microbiome. Wilcoxon rank sum and sign-rank were used to examine changes from the baseline.
The study reports that the OSDI revealed significantly greater improvement in symptoms after IPL-MGX (P=.030) compared to MGX. Additionally, there was no significant difference in mean TGF-β1, 2, or 3 concentration after IPL-MGX (P=.385, .709, and .948). The study noted that quantities of Clostridium, Klebsiella, Brevibacterium, Lactobacillus, Neisseria, Streptococcus, Corynebacterium, Butyricicoccus, and Actinomyces were significantly reduced from baseline in both groups but showed no significant difference between the two treatment groups.
At its conclusion, the study found that IPL-MGX improved dry eye symptoms more than MGX alone. In fact, the IPL treatment offered no additional benefit to MGX in decreasing virulent bacteria present on the ocular surface and did not influence TGF-β levels in tears. The authors added that prospective studies on IPL-MGX with larger sample sizes are needed to further investigate cytokines and IPL in patients with ocular rosacea with dry eye symptoms. —Jessica Garlewicz
Sagaser S, Butterfield R, Kosiorek H, et al. Effects of intense pulsed light on tear film TGF-β and microbiome in ocular rosacea with dry eye. Clin Ophthalmol. Published online January 27, 2021. doi:10.2147/OPTH.S280707