Role of Topical 5-Fluorouracil in Management of Demodex-associated Blepharitis
Mona M. Amer, Joanne W Ho, Despoina Theotoka, Sarah Wall, Anat Galor, Anny Cheng, Darlene Miller, Carol L. Karp
Bascom Palmer Eye Institute, University of Miami, Miami, Florida
Purpose: To report clinical observation of topical 5-fluorouracil (5-FU) in the treatment of Demodex-associated blepharitis.
Methods: An observational retrospective review of 13 eyes from 13 individuals with ocular surface squamous neoplasia or papilloma and concomitant demodex lash infestation who received 1% topical 5-Fluorouracil (5-FU) eye drops. Patients were followed for at least two cycles of topical 5-FU application. Clinical photos and eyelid were obtained at baseline before treatment and at each follow up visit. Lashes from both eyes were epilated and microscopically analyzed in 6 patients.
Results: Mean age of the population was 68 ± 14 years (range 30-84 years) and 91% were made. In all 13 patients, a lower demodex burden blepharitis was noted in the 5-FU treated eye compared to the fellow eye by slit lamp exam. Epilated lashes were negative for demodex in the treated eye and positive in the untreated eye.
Conclusions: These observations suggest the efficacy of 5-FU, and similar cytotoxic medications, in treating demodex-associated blepharitis. Further studies are indicated to evaluate the potential use of this drug for demodex infestation.
Support: NIH Center Core Grant P30EY014801, RPB Unrestricted Award, Dr. Ronald and Alicia Lepke Grant, The Lee and Claire Hager Grant, The Robert Farr Family Grant, The Grant and Diana Stanton-Thornbrough ,The Robert Baer Family Grant, The Roberto and Antonia Menendez Grant, The Emilyn Page and Mark Feldberg Grant, The Calvin and Flavia Oak Support Fund, The Robert Farr Family Grant, The Jose Ferreira de Melo Grant, The Richard and Kathy Lesser Grant, The Honorable A. Jay Cristol Grant, The Michele and Ted Kaplan Grant, The Carol Soffer Grant, and the Richard Azar Family Grant(institutional grants). the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Clinical Sciences R&D (CSRD) I01 CX002015 (Galor), Biomedical Laboratory R&D (BLRD) Service I01 BX004893 (Galor), Rehabilitation R&D (RRD) I21 RX003883 (Felix), Department of Defense Gulf War Illness Research Program (GWIRP) W81XWH-20-1-0579 (Dr. Galor) and Vision Research Program (VRP) W81XWH-20-1-0820 (Galor), National Eye Institute R01EY026174 (Dr. Galor) and R61EY032468 (Galor), and Research to Prevent Blindness Unrestricted Grant GR004596 (institutional).