Oral Azithromycin For The Treatment Of Moderate To Severe Meibomian Gland Dysfunction-a Clinical Study

Objective: To observe the clinical efficacy of oral azithromycin in patients with moderate to severe meibomian gland dysfunction(MGD),and to explore its mechanism.Methods: Eighty eyes of 40 patients with moderate to severe MGD diagnosed by Slit lamp examination and Oculus Keratograph were enrolled in this study.They were observed from April2016 to January2017.They were randomly divided into 2 groups: 21 patients who were chosen as the experimental group were treated by oral azithromycin combined artificial tears,the other 19 patients were sorted as control group and treated with artificial tears only.All patients accepted lid hygiene and warm compress at the same time.Patients in experimental group were instructed to use oral azithromycin 500 mg per day for3 days in 3 cycles with 7-day intervals per cycle and use artificial tears four times every day.The control group only used artificial tears four times a day.Then an ocular check-up was performed,includingthe following aspects: Ocular surface disease index(OSDI),Noninvasive first break-uptime(NIF-BUT),Noninvasive average break-uptime(NIAvg-BUT),Tear meniscus height(TMH),R-scan,Loss rate of meibomian gland,Assessment of meibomian gland orifices,Meibum quality score,Meibum expression score,Fluorescein stain test(FL),Tear break-up time(BUT),Schirmer ?test(S?T)between pretherapy and post-treatment.Result: There were significant difference in OSDI,NIAvg-BUT,loss rate of meibomian gland,assessment of meibomian gland orifices,meibum quality score,meibum expression score,FL,as well as BUTbefore and after the treatment(P<0.05),whereas NIF-BUT,TMH,R-scan,and S ? T showed no significant difference in experimental group(P>0.05).There were significant difference in assessment of meibomian gland orifices,meibum quality score,meibum expression score as well as FL in control group(P<0.05).However,OSDI,NIF-BUT,NIAvg-BUT,TMH,R-scan,loss rate of meibomian gland,BUT,and S?T showed no significant difference in the control group(P>0.05).We can observe statistically significant differences in OSDI,NIAvg-BUT,Loss rate of meibomian gland,Assessment of meibomian gland orifices,Meibum quality score,Meibum expression score,BUT,and S?T after treatment between the two groups(P<0.05).There were no statistically significant difference in NIF-BUT,TMH,R-scan,or FL after treatment between the two groups(P>0.05).Conclusion: Oral azithromycin can be used to treat patients with moderate to severe MGD and significantly improve symptoms and signs of MGD.