A Report by the American Academy of Ophthalmology Ophthalmic Technology Assessment Committee Oculoplastics and Orbit Panel: Edward J. Wladis, MD,1 Elizabeth A. Bradley, MD,2 Jurij R. Bilyk, MD,3 Michael T. Yen, MD,4 Louise A. Mawn, MD5
Ophthalmology, March 2016, Vol 123, 492-496 © 2016 by the American Academy of Ophthalmology. Click here for free access to the OTA.
Objective: To review the existing medical literature on the role of oral antibiotics in the management of ocular surface disease (OSD) that arises from disorders of the meibomian glands and to assess the efficacy of oral antibiotics in the management of this common ocular disease.
Methods: A literature search was last conducted on August 12, 2015, in the PubMed and the Cochrane databases for English-language original research investigations that evaluated the role of doxycycline, minocycline, and azithromycin in OSD among adult patients. The searches identified 87 articles, and 8 studies ultimately met the criteria outlined for this assessment.
Results: The 8 studies identified in the search documented an improvement in meibomian gland-related OSD after treatment with these agents, although side effects were common. This search identified only 1 randomized, controlled trial to assess the efficacy of these medications.
Conclusions: Although oral antibiotics are used commonly in the management of OSD, there is no level I evidence to support their use. There are only a few studies that have assessed the efficacy of oral antibiotics in clinically meaningful ways in the management of OSD that arises from disorders of the meibomian glands. The current level of evidence is insufficient to conclude that antibiotics are useful in managing OSD arising from disorders of the meibomian glands. The few existing studies on the topic indicate that oral antibiotics may be an effective treatment for OSD that results from meibomian gland disease.
1Ophthalmic Plastic Surgery, Department of Ophthalmology, Albany Medical Center, Albany (Slingerlands), New York
2Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
3Wills Eye Hospital, Philadelphia, Pennsylvania
4Cullen Eye Institute, Baylor College of Medicine, Houston, Texas
5Vanderbilt Eye Institute, Vanderbilt University, Nashville, Tennessee