Purpose: To assess clinical outcomes and tear cytokine levels in patients with moderate and severe meibomian gland dysfunction (MGD) after treatment with oral minocycline and artificial tears versus artificial tears only. Design: Prospective, randomized clinical trial. Methods: Sixty eyes of 60 patients with stage 3 or 4 meibomian gland dysfunction were enrolled. We evaluated the tear film break-up time, Schirmer test results, corneal and conjunctival fluorescein staining results, biomicroscopic examination results of lid margins and meibomian glands, and tear cytokine levels before and after 1 month and 2 months of oral minocycline and artificial tears (group 1) or artificial tears only (group 2). Tear samples were collected and analyzed using a BD Cytometric Bead Array (BD Bioscience, San Jose, California, USA) for detection of interleukin (IL)-1β, IL-6, IL-7, IL-8, IL-12p70, IL-17α, interferon-γ, tumor necrosis factor-α, and monocyte chemotactic protein-1. The Wilcoxon signed-rank test, Mann-Whitney U test, generalized linear model, and linear mixed model were performed. Results: Patients in group 1 showed statistically significant improvement in all clinical signs and symptoms after 1 month and 2 months of treatment. Patients of group 1 showed more significant improvement compared with those in group 2. Patients in group 1 also showed statistically significant reductions in IL-6, IL-1β, IL-17α, tumor necrosis factor-α, and IL-12p70 after 2 months of treatment. Conclusions: Oral minocycline can provide clinical benefits in treating moderate and severe meibomian gland dysfunction by reducing inflammatory cytokine levels.
Bibliographical noteFunding Information:
All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest and none were reported. Publication of this article was partially supported by a National Research Foundation of Korea grant (MEST no. 2010-0022006 ) funded by the government of Korea , Seoul, Korea; and by the Converging Research Center Program funded by the Ministry of Education, Science and Technology (no. 2011K000680 ), Seoul, Korea. Involved in design of study (H.L., T.-I.K.); Conduct of study (H.L., K.M., T.-I.K.); Collection, management, analysis, and interpretation of data (H.L., K.M., E.K.K., T.-I.K.); Preparation of manuscript (H.L., T.-I.K.); and Review or approval of manuscript (H.L., E.K.K., T.-I.K.). This study was approved prospectively by the Institutional Review Board of Severance Hospital and was conducted according to the Declaration of Helsinki and Good Clinical Practices. All patients gave informed consent for participation in research. This study is registered at http://www.clinicaltrials.gov (identification no. NCT01600625 ).
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