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Common ocular findings in patients with acne rosacea



To evaluate ocular surface manifestations in patients with acne rosecea (AR) and to find out main features indicating a propensity toward an association with disease diagnosis.


Right eyes of consecutive 76 AR patients and 113 age-gender matched healthy subjects were enrolled. Ophthalmologic examinations including tear break-up time (t-BUT) and Schirmer-2 tests to analyze tear film insufficiency, optical coherence tomography (OCT)-assisted infrared meibography to analyze meibomian gland drop-out, and Ocular Surface Disease Index (OSDI) questionnaire were performed in all participants.


No statistically differences were found in visual acuity, intraocular pressure, central corneal thickness, and axial length assessments between the study and control eyes. Study eyes had more foreign body sensation, itching, dryness, hyperemia, conjunctival telangiectasia, and meibomitis (p ≤ 0.005, for all). Significantly higher t-BUT and Schirmer-2 tests; lower-eyelid and total OCT meibography; and OSDI scores were found in AR patients (p < 0.05, for all). Among all, only conjunctival telangiectasia (p = 0.001; OR:0.070, 95% CI:0.015–0.330) was found to be major independent predictor for AR diagnosis.


Detailed slit-lamp examination to detect any conjunctival telangiectasia seems to be crucial in recalcitrant dry eye cases, not to miss underlying AR. Especially, lower-eyelid OCT meibography score may be sensitively used for disease staging.

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  1. Webster GF, Durrani K, Suchecki J (2016) Ocular rosacea, psoriasis, and lichen planus. Clin Dermatol 34:146–150

    Article  Google Scholar 

  2. Vieira AC, Höfling-Lima AL, Mannis MJ (2012) Ocular rosacea—a review. Arq Bras Oftalmol 75:363–369

    Article  Google Scholar 

  3. Wladis EJ, Adam AP (2018) Treatment of ocular rosacea. Surv Ophthalmol 63:340–346

    Article  Google Scholar 

  4. Jabbehdari S, Memar OM, Caughlin B, Djalilian AR (2020) Update on the pathogenesis and management of ocular rosacea: an interdisciplinary review. Eur J Ophthalmol 31:22–33

    Article  Google Scholar 

  5. Gokcinar NB, Karabulut AA, Onaran Z, Yumusak E, BudakYildiran FA (2019) Elevated Tear Human Neutrophil Peptides 1–3, Human Beta Defensin-2 Levels and Conjunctival Cathelicidin LL-37 Gene Expression in Ocular Rosacea. Ocul Immunol Inflamm 27:1174–1183

    CAS  Article  Google Scholar 

  6. Buhl T, Sulk M, Nowak P et al (2015) Molecular and morphological characterization of inflammatory infiltrate in rosacea reveals activation of th1/th17 pathways. J Invest Dermatol 135:2198–2208

    CAS  Article  Google Scholar 

  7. Al Arfaj K, Al Zamil W (2010) Spontaneous corneal perforation in ocular rosacea. Middle East Afr J Ophthalmol 17:186–188

    Article  Google Scholar 

  8. Andrade FMX, Picosse FR, Cunha LPD et al (2020) Ocular surface changes in the treatment of rosacea: comparison between low-dose oral isotretinoin and doxycycline. Arq Bras Oftalmol 83:109–112

    Article  Google Scholar 

  9. Arita R, Itoh K, Inoue K, Amano S (2008) Noncontact infrared meibography to document age-related changes of the meibomian glands in a normal population. Ophthalmology 115:911–915

    Article  Google Scholar 

  10. Napoli PE, Coronella F, Satta GM, Iovino C, Sanna R, Fossarello M (2016) A simple novel technique of ınfrared meibography by means of spectral-domain optical coherence tomography: a cross-sectional clinical study. PLoS One 11:e0165558.

  11. Guarnieri A, Carnero E, Bleau AM, Alfonso-Bartolozzi B, Moreno-Montanes J (2020) Relationship between OSDI questionnaire and ocular surface changes in glaucomatous patients. Int Ophthalmol 40:741–751

    Article  Google Scholar 

  12. Tan J, Almeida LM, Bewley A et al (2017) Updating the diagnosis, classification and assessment of rosacea: recommendations from the global ROSacea COnsensus (ROSCO) panel. Br J Dermatol 176:431–438

    CAS  Article  Google Scholar 

  13. Redd TK, Seitzman GD (2020) Ocular rosacea. Curr Opin Ophthalmol 31:503–507

    Article  Google Scholar 

  14. Arman A, Demirseren DD, Takmaz T (2015) Treatment of ocular rosacea: comparative study of topical cyclosporine and oral doxycycline. Int J Ophthalmol 8:544–549

    PubMed  PubMed Central  Google Scholar 

  15. Palamar M, Degirmenci C, Ertam YA (2017) Ocular response analyser measurements and central corneal thickness in ocular rosacea patients. Int Ophthalmol 37:7–11

    Article  Google Scholar 

  16. Abdelfattah NS, Dastiridou A, Sadda SR, Lee OL (2015) Noninvasive imaging of tear film dynamics in eyes with ocular surface disease. Cornea 34(Suppl 10):S48-52

    Article  Google Scholar 

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All co authors have all participated sufficiently in the conception and design of this work and interpretation of the data as well as in the writing of the manuscript.

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Correspondence to Taylan Ozturk.

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The authors declared that there is no conflict of interest.

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Available upon request after fogging the names of the participants.

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The data were stored on a computerized database and analyzed using SPSS version 22.0 statistical software (IBM, Armonk, NY).

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Approval was obtained from the ethics committee of Dokuz Eylul University. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

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Ozturk, T., Kayabasi, M., Ozbagcivan, O. et al. Common ocular findings in patients with acne rosacea. Int Ophthalmol 42, 1077–1084 (2022).

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  • Acne rosacea
  • Dry eye
  • Infrared meibography
  • Meibomian gland dysfunction