Evaluating Role of Topical Azithromycin in Meibomian Gland Dysfunction – An Interventional Study
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 2734-2745
Abstract
Background:Meibomian gland dysfunction (MGD) is a common ocular disorder, often underdiagnosed, and is a major contributory factor causing dry eye disease and ocular discomfort due to compromised quality of tears. A variety of physical measures, lubricants and antibiotics have been tried to alleviate the condition. Topical Azithromycin has been observed to provide relief in MGD. Interest has been generated in this drug due to its anti- inflammatory properties in addition to its antibiotic effect.Materials and Methods: The present study was undertaken to study the clinical efficacy of topical Azithromycin in MGD. 70 patients randomly detected with MGD were given Azithromycin 1% topically. In half of the patients; n═35, (Group A), the mode of administration was aqueous as 1% eye drops, twice a day for 30 days while in remaining half (Group B), it was delivered as an ointment, applied daily at night for same duration. This was combined with physical measures of lid massage and lid hygiene. Primary outcome measures of evaluation were Fluorescein tear breakup time, (FTBUT)’, Tear quantification (Schirmer’s test), Corneal staining score, Meibomian gland score and a subjective clinical score. Measurements were recorded prior to drug usage and at subsequent follow up visits at Day 30, 60 & 90. Statistical analysis: Considering the small sample size, the outcome measures for the two groups were statistically analysed employing the Fischer’s exact test and the Mann Whitney test. P values (two sided) less than 0.05 were considered statistically significant.
Results: Azithromycin in aqueous form, showed significantly higher clinical efficacy at day 30, whereas noted efficacy of ointment was higher at day 60 and 90. The symptom score showed significant improvement among both the groups receiving azithromycin. The effect was however less significant for users of eye drops at day 90, compared to ointment. Values of Schirmer’s test echoed similar results.
Conclusion: Azithromycin 1% ophthalmic solution is effective in reducing the signs and symptoms associated with meibomian gland dysfunction in both, drop and ointment form. These effects persist in ocular tissues beyond the last application. However, long term effect of azithromycin seems better when used in the ointment form.
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