EVALUATION OF THE DEMODEX BLEPHARITIS SPECIFIC SYMPTOMS: THE JANUS STUDY
Published 2025 - 29th ESCRS Winter Meeting
Reference: FP04.08 | Type: Free Paper | DOI: 10.82333/qd3w-8e56
Authors: Ruth Lapid-Gortzak* 1 , 1. Preeya K. Gupta Gupta 2 , 1. Preeya K. Gupta Gupta 2 , 2. Aimee RP Edell 3 , 3. Julio Echegoyen 4 , 4. Kavita Dhamdhere 5 , Elisabeth Yue 6
1Ophthalmology,Amsterdam UMC,Amsterdam,Netherlands, 2Ophthalmology,Triangle Eye Consultants,Raleigh,United States, 3Ophthalmology,East Bay Eye Center,San Ramon,United States, 4Ophthalmology,Gordon Schanzlin New Vision Institute,San Diego,United States, 5Ophthalmology,Tarsus Rx,Irving,United States, 6Ophthalmology,Virginia Eye Consultants,Norfolk,United States
Purpose
The Janus study explored the relationships between the clinical outcomes and patient reported outcomes (PROs) in Demodex blepharitis (DB) patients compared to patients without DB.
Setting
Adult patients from across the United States were enrolled from private eyecare practices and clinics.
Methods
This was an observational, multicenter, cross-sectional, prospective parallel cohort study. Patients were enrolled if they were ≥18 years old, had a corrected distance visual acuity (CDVA) better or equal to 20/100 in each eye, and met both of the following criteria in at least one eye: an average tear breakup time (TBUT) of >7 seconds, and a Schirmer 1 test (without anesthesia) of ≥10 mm. Patients were assigned into control cohort (0 collarettes) and DB cohort (≥1 collarettes). Key clinical outcomes and PROs using visual analog scale (VAS, 0-100, ranging from no discomfort to maximal discomfort) assessing ocular itching, fluctuating vision, irritation, and redness, and most bothersome ocular PROs were collected.
Results
A total of 147 patients were enrolled (control cohort: 47 patients; DB cohort: 100 patients). The mean VAS score for itching (24.5 vs 15.1, p=0.02), fluctuating vision (24.2 vs 9.8, p<0.001), irritation (27.6 vs 17.3, p=0.02), and redness (19.8 vs 9.9, p=0.01) were significantly worse in the DB group compared to the control cohort, respectively. Moreover, DB patients reported clinically meaningfully [7-point difference (Δ) in VAS score] worse itching (Δ=9.5), fluctuating vision (Δ=14.4), irritation (Δ=10.3), and redness (Δ=9.9) compared to the control cohort. Itching was the most frequently reported and most bothersome symptom in DB patients, with the lid/lash margin being the most commonly reported location for itching in DB patients with >10 collarettes. In patients without DB, dryness was the leading symptom.
Conclusion
Patients with DB, based on the presence of the pathognomonic sign of collarettes, exhibited significantly worse symptoms than those without. DB patients reported itching as the most frequently bothersome symptom, with the lid margin being the most common location of itching in patients with moderate or severe DB.