Prevalence and treatment of Helicobacter pylori in patients with blepharitis.
OBJECTIVE
Helicobacter pylori is a major pathogen etiologically associated with gastritis, peptic ulcer disease, gastric cancer, and primary gastric lymphoma. This study was conducted to investigate a possible association between Helicobacter pylori infection and blepharitis. Two hundred fifty consecutive patients with symptomatic blepharitis and 250 control subjects without blepharitis symptoms were evaluated. After exclusions, the blepharitis group consisted of 186 patients with blepharitis and a control group of 215 patients.


METHODS
Blepharitis was diagnosed on the basis of findings in ophthalmic and dermatologic examinations. All patients underwent a 13C-urea breath test (UBT) to detect H. pylori infection, and impression cytology was performed before and after eradication therapy. The follow-up period was 4 months +/- 28 days.


RESULTS
The blepharitis group showed an H. pylori infection prevalence of approximately 76.3% (UBT-positive group with blepharitis: n = 142 patients), compared with 42.3% of the control group (UBT-positive group with blepharitis [although asymptomatic]: n = 66 patients; UBT-positive group without blepharitis: n = 25 patients). Furthermore, we observed blepharitis in 30.6% (n = 66 patients) of UBT-positive control subjects and 13.4% (n = 29 patients) of UBT-negative control subjects. Impression cytology revealed that blepharitis was more severe in UBT-positive patients than in negative ones, and a clinical improvement in blepharitis was noted in approximately 50% of patients after H. pylori eradication.


CONCLUSIONS
Even though possible sources of error in defining the association of two highly prevalent conditions must be considered, the data seem to validate an association between H. pylori infection and blepharitis, but may not be indicative of a causal association. Eradication of H. pylori improved ocular cytology results. It is possible that chronic blepharitis is an extradigestive manifestation of H. pylori infection.
Saccà
Sergio Claudio
SC
Department of Neurosciences, Ophthalmology and Genetics, Clinica Oculistica, Italy. sergio.sacca@hsanmartino.it
Pascotto
Antonio
A
Venturino
Gian Maria
GM
Prigione
Guido
G
Mastromarino
Antonio
A
Baldi
Franco
F
Bilardi
Claudio
C
Savarino
Vincenzo
V
Brusati
Carlo
C
Rebora
Alfredo
A
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001762:Blepharitis / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D001944:Breath Tests; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use; D015995:Prevalence; D013752:Tetracycline / Q000627:therapeutic use; D014011:Tinidazole / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D014011:Tinidazole; D013752:Tetracycline; D009853:Omeprazole