title: Clinical treatment of ocular Demodex folliculorum by systemic ivermectin.
abstract: OBJECTIVE
  To report clinical outcomes of the treatment of ocular Demodex folliculorum with oral ivermectin.
  
  
  METHODS
  Noncomparative, interventional case series.
  
  
  METHODS
  Setting. Institutional. Study Population. Twenty-four eyes of 12 patients (3 male and 9 female; mean age ± standard deviation, 50.4 ± 21.0 years) with refractory posterior blepharitis with the presence of D. folliculorum in lash samples were enrolled in this study. Intervention. Patients were instructed to take 1 dose of oral ivermectin (200 μg/kg). All patients were instructed to repeat the treatment after 7 days. Main outcome measures. Tear meniscus height, Schirmer I test results, noninvasive tear film break-up time (BUT), quantification of the absolute number of D. folliculorum found in the lashes, and corneal fluorescein and rose bengal staining scores were obtained from all patients 1 day before and 28 days after treatment.
  
  
  RESULTS
  Statistical improvement was observed in the absolute number of D. folliculorum found in the lashes after the treatment with oral ivermectin. Average values of Schirmer I test results and tear film break-up time improved statistically after the treatment of oral ivermectin. No statistical improvement was observed in average lacrimal meniscus height or value of corneal fluorescein and rose bengal staining after treatment with oral ivermectin.
  
  
  CONCLUSIONS
  Ivermectin successfully reduced the number of D. folliculorum found in the lashes of patients with refractory blepharitis. Oral ivermectin may be very useful as a complement in the treatment of D. folliculorum infestation with ocular manifestation, especially in cases of unsuccessful treatment related to patient compliance.
authors.affiliation: Department of Ophthalmology, School of Medicine, Hospital das Clínicas of University of São Paulo, São Paulo, Brazil.
authors.forename: Flávio Gaieta
authors.initials: FG
authors.lastname: Holzchuh
authors.forename: Richard Yudi
authors.initials: RY
authors.lastname: Hida
authors.forename: Bernardo Kaplan
authors.initials: BK
authors.lastname: Moscovici
authors.forename: Marcos Bottene
authors.initials: MB
authors.lastname: Villa Albers
authors.forename: Ruth Miyuki
authors.initials: RM
authors.lastname: Santo
authors.forename: Newton
authors.initials: N
authors.lastname: Kara-José
authors.forename: Ricardo
authors.initials: R
authors.lastname: Holzchuh
mesh_terms: D000284:Administration, Oral; D000818:Animals; D000977:Antiparasitic Agents / Q000008:administration & dosage*; D001762:Blepharitis / Q000188:drug therapy* / Q000469:parasitology; D015822:Eye Infections, Parasitic / Q000188:drug therapy* / Q000469:parasitology; D005140:Eyelashes / Q000469:parasitology*; D005260:Female; D006801:Humans; D007559:Ivermectin / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D008924:Mite Infestations / Q000188:drug therapy* / Q000469:parasitology; D008925:Mites; D013666:Tears / Q000737:chemistry
chemical_list: D000977:Antiparasitic Agents; D007559:Ivermectin