Ocular Microbiota of Severe Meibomian Gland Dysfunction (Chronic Dry Eyes) after Intense Pulsed Light (IPL)

Ocular IPL therapy has recently been widely used for MGD, especially for patients not showing improvement with traditional therapies (warm compresses and lid scrubs) to clean debris and reduce bacterial overgrowth. Insights on the ocular microbiome and quantitative microbiome in MGD after a course of IPL could provide useful data on bacterial community monitoring and associated mechanisms linked with IPL. Ocular swabs were obtained from a severe MGD patient and age-sex matched healthy for metagenomics, followed by 16S rRNA gene sequencing and qPCR. Of 10 samples, including left and right eyes (el, er) of severe MGD females before (Db) and after 2-4 IPLs (Da2, Da3, and Da4) and the matched non-MGD females (H), both of ~40 years Using 16S rRNA gene sequencing as microbiota and combined 16S rRNA gene qPCR as quantitative microbiota revealed significant disperse in the microbiome structures of Db compared with Da and H (HOMOVA, p<0.001). Bacterial Propionibacterium acnes and unclassified taxa in the family Propionibacteriaceae and order Actinomycetales represented the core Db microbiota and were reduced after 2-4 IPLs in Da, making the Da microbiome and clinical (mucocutaneous junction, corneal, and conjunctival fluorescein score) closer to H (NMDS with Pearson’s correlation, p<0.05). The recovery of the Da microbiome also allowed Da metabolic potentials to be closer to H. Our findings first demonstrated the ocular microbiome dysbiosis in severe MGD, dispersed from Da and H, in Thai subjects, correlated with bacterial quantity and clinical MGD, including the mucocutaneous junction process. The results additionally provided taxa representing Db vs. Da and H and preliminarily underlie the idea that IPL could improve dysbiosis in the MGD microbiome. Doi: 10.28991/ESJ-2023-07-05-015 Full Text: PD

Potential impact of ocular intense pulsed light on eyelash microbiome in severe meibomian gland dysfunction: report of 2 cases

Meibomian gland dysfunction (MGD) is a prevalent worldwide eye disorder that causes eye irritation, inflammation, chronic dryness, and blurred vision. Traditional therapies offer temporary improvement, but their efficacy varies in severe MGD cases. Ocular intense pulsed light (IPL) has emerged as a novel therapy, providing long-term symptom relief and shorter treatment durations compared to traditional approaches. However, the impact of IPL on the bacterial community within the eyes remains limited. To address this, we conducted a preliminary study using metagenomics and next-generation sequencing. We compared the bacterial eyelash communities of Thai females with severe MGD before and after 2-4 IPL treatments, and against a group of healthy females. Our findings revealed higher bacterial diversity in healthy individuals compared to severe MGD cases. IPL treatments increased diversity in the MGD group, making their core bacterial community more similar to that of healthy subjects. Notably, the presence of Koribacteraceae in severe MGD and Bifidobacterium in healthy individuals and post-IPL-treated MGD exemplified this shift. Clustering analysis showed a closer relationship between post-IPL-treated MGH and healthy subjects, while the pre-IPL treatment group formed a separate branch. These results suggest that IPL treatment can reshape the eyelash microbiome in MGD cases, but further research is needed to understand the implications and the microbiome’s role in MGD pathogenesis and treatment response