Correlation between ocular Demodex infestation and serum immunoreactivity to Bacillus proteins in patients with Facial rosacea

Ophthalmology. 2010 May;117(5):870-877.e1. doi: 10.1016/j.ophtha.2009.09.057. Epub 2010 Jan 15.


Purpose: To investigate correlation between ocular Demodex infestation and serum.

Design: A prospective study to correlate clinical findings with laboratory data.

Participants: We consecutively enrolled 59 patients: 34 men and 25 women with a mean age of 60.4+/-17.6 years (range, 17-93).

Methods: Demodex counting was performed based on lash sampling. Serum immunoreactivity to two 62-kDa and 83-kDa proteins derived from B oleronius was determined by Western blot analysis. Facial rosacea, lid margin, and ocular surface inflammation were documented by photography and graded in a masked fashion.

Main outcome measures: Statistical significance based on correlative analyses of clinical and laboratory data.

Results: These 59 patients were age matched, but not gender matched, regarding serum immunoreactivity, ocular Demodex infestation, or facial rosacea. There was a significant correlation between serum immunoreactivity and facial rosacea (P = 0.009), lid margin inflammation (P = 0.040), and ocular Demodex infestation (P = 0.048), but not inferior bulbar conjunctival inflammation (P = 0.573). The Demodex count was significantly higher in patients with positive facial rosacea (6.6+/-9.0 vs. 1.9+/-2.2; P = 0.014). There was a significant correlation of facial rosacea with lid margin inflammation (P = 0.016), but not with inferior bulbar conjunctival inflammation (P = 0.728). Ocular Demodex infestation was less prevalent in patients with aqueous tear-deficiency dry eye than those without (7/38 vs. 12/21; P = 0.002).

Conclusions: The strong correlation provides a better understanding of comorbidity between Demodex mites and their symbiotic B oleronius in facial rosacea and blepharitis. Treatments directed to both warrant future investigation.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Animals
  • Bacillus / immunology
  • Bacillus / isolation & purification*
  • Bacterial Proteins / blood*
  • Blepharitis / blood
  • Blepharitis / microbiology
  • Blepharitis / parasitology
  • Blotting, Western
  • Comorbidity
  • Eye Infections, Parasitic / blood*
  • Eye Infections, Parasitic / microbiology
  • Eye Infections, Parasitic / parasitology
  • Eyelashes / parasitology
  • Female
  • Gram-Positive Bacterial Infections / blood*
  • Humans
  • Male
  • Middle Aged
  • Mite Infestations / blood*
  • Mite Infestations / microbiology
  • Mite Infestations / parasitology
  • Mites
  • Prospective Studies
  • Rosacea / blood*
  • Rosacea / microbiology
  • Rosacea / parasitology
  • Young Adult


  • Bacterial Proteins