Ocular rosacea is a form of rosacea affecting over 400 million people worldwide, causing red, dry, and teary eyes. The management of this condition often involves the use of antibiotics from the tetracycline family, such as oxytetracycline. Discover more details here about oxytetracycline and its effects on ocular rosacea.
Oxytetracycline: Antibiotics in the Treatment of Ocular Rosacea.
Summary
Published on September 27, 2024, by Marie, Scientific Editor — 6 min of reading
Themes:
What is ocular rosacea?
Often accompanying cutaneous rosacea, ocular rosacea is a inflammatory condition that manifests as redness, tearing, itching, and burning sensations in the eyes. The eyelids may also appear swollen and the eyes may become particularly sensitive to light. Ocular rosacea also causes the dilation of small blood vessels in the white area of the eye, known as the sclera, making them visible. Several factors are likely to cause ocular rosacea, among which a dysfunction of the Meibomian glands, contributing to the lubrication of the eyes by secreting an oily substance, an increase in Demodex mites, releasing inflammation molecules, or even genetics.
The treatment of ocular rosacea primarily involves the adoption of strict ocular hygiene. The use of artificial tears and warm compresses can also help. If this is not sufficient or if the ocular involvement is too severe, antibiotics from the tetracycline family may be prescribed in conjunction.
Evidence of the effectiveness of oxytetracycline against ocular rosacea?
Available only on prescription, oxytetracycline is an antibiotic from the tetracycline family used to combat certain forms of rosacea, including ocular rosacea. This molecule is indeed capable of acting as a bacterial translation inhibitor. Oxytetracycline prevents the attachment of aminoacyl-tRNA to the mRNA-ribosome complex by binding to the 30S subunit of the ribosomes. In doing so, it halts the elongation phase of protein synthesis. By inhibiting the production of proteins by microorganisms, oxytetracycline prevents them from growing and multiplying, a useful property in the case of colonisation by Demodex.
Furthermore, oxytetracycline possesses a lipase-inhibiting action that allows it to inhibit bacterial lipases, enzymes secreted by certain bacteria that hydrolyse the triglycerides of meibum into fatty acids and glycerol. This, however, has a negative impact on the cornea of the eye. Indeed, meibum is a fatty substance composed mainly of triglycerides that serves to protect and hydrate the eyes. It can be compared to the sebum of the skin. By protecting the meibum from bacterial lipases, oxytetracycline ensures better hydration for the cornea, which helps to combat the dryness of the eyes induced by ocular rosacea.
The efficacy of cyclines in combating rosacea, and particularly ocular rosacea, has been attested in numerous studies. With regard to oxytetracycline specifically, there is also evidence of its value in the scientific literature, summarised in the table below.
| Study | Procedure | Results |
|---|---|---|
| MARMION (1969) | Administration of 150 mg of oxytetracycline twice daily for six weeks to 23 patients | Significant improvement in ocular rosacea observed in all patients |
| BARTHOLOMEW & al. (1982) | Administration of 250 mg of oxytetracycline or a placebo twice daily for six weeks to 35 patients | Complete remission of ocular rosacea for 31% of patients treated with oxytetracycline compared to 14% of patients treated with a placebo |
| SEAL & et al. (1995) | Administration of 250 mg of oxytetracycline twice daily for six weeks to 22 patients | Significant improvement in ocular rosacea for 50% of treated patients |
Revue des études cliniques sur l'efficacité de l'oxytétracycline dans le traitement de la rosacée oculaire.
However, it is important to know that this antibiotic is contraindicated during pregnancy and in cases of hypersensitivity to cyclines. Furthermore, some individuals report temporary vision disturbances associated with the use of oxytetracycline. In the event of adverse effects following the use of this antibiotic or any other medication, it is crucial to inform your doctor, so that they can advise you on the next steps.
If the use of oxytetracycline appears to be relevant in the case of ocular rosacea, it is important to emphasise that its administration is strictly subject to medical advice.
Sources
MARMION D. Tetracyclines in the treatment of ocular rosacea. Proceedings of the Royal Society of Medicine (1969).
BARTHOLOMEW R. & al. Oxytetracycline in the treatment of ocular rosacea: a double-blind trial. The British Journal of Ophtalmology (1982).
SEAL D. & al. Placebo controlled trial of fusidic acid gel and oxytetracycline for recurrent blepharitis and rosacea. The British Journal of Ophtalmology (1995).
CHODOSCH J. & al. Oral tetracyclines for ocular rosacea: an evidence-based review of the literature. Cornea (2004).
VIDAL. Substance active : Oxytétracycline (2013).
DOAN S. Dysfonctionnements des glandes de Meibomius. Les cahiers d'ophtalmologie (2015).
