Treatment of ocular rosacea: a systematic review

• Published in: Journal der Deutschen Dermatologischen Gesellschaft 2024-02, Vol.22 (2), p.167-174
• Main Authors: Avraham, Shani, Khaslavsky, Sophie, Kashetsky, Nadia, Starkey, Samantha Y., Zaslavsky, Kirill, Lam, Joseph M., Mukovozov, Ilya
• Format: Article
• Language: English
• Subjects: adverse events; Antibiotics; Antimicrobial agents; Cyclosporins; doxycycline; Emulsions; Hygiene; IPL; isotretinoin; ocular; Rosacea; Skin diseases; Systematic review; treatment; Vitamin A
• ISSN: 1610-0379; 1610-0387; 1610-0387
• DOI: 10.1111/ddg.15290

Summary Rosacea is a common chronic skin disease distributed primarily around the central face. Ocular manifestations of rosacea are poorly studied, and estimates of prevalence vary widely, ranging from 6% to 72% in the rosacea population. Treatment options for ocular rosacea include lid hygiene, topical and oral antibiotics, cyclosporine ophthalmic emulsion, oral vitamin A derivatives, and intense pulsed light; however, a direct comparison of treatment methods for ocular rosacea is lacking. This review aims to compare treatment efficacy and adverse events for different treatment modalities in ocular rosacea. We performed a systematic review by searching Cochrane, MEDLINE and Embase. Title, , full text screening, and data extraction were done in duplicate. Sixty‐six articles met the inclusion criteria, representing a total of 1,275 patients. The most effective treatment modalities were topical antimicrobials and oral antibiotics, which achieved complete or partial response in 91% (n = 82/90) and 89% (n = 525/580) of patients respectively, followed by intense pulsed light (89%, n = 97/109 partial response), cyclosporine ophthalmic emulsion (87% n = 40/46), and lid hygiene (65%, n = 67/105). Combination treatments achieved a complete or partial response in 90% (n = 69/77). Results suggest that topical antimicrobials, oral antibiotics, intense pulsed light. and cyclosporine were the most efficacious single modality treatments.