Demodex-infected qualitative index based on meibomian gland dropout in Demodex blepharitis
- 1National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
- 2College of Mathematical Medicine, Zhejiang Normal University, Jinhua 321004, Zhejiang Province, China
Abstract
AIM: To explore a novel morphological feature of the meibomian gland (MG) and evaluate its prevalence and diagnostic utility in Demodex blepharitis. METHODS: This study included an initial cohort examined for Demodex using in vivo confocal microscopy and an additional validation cohort examined using conventional light microscopy. The new Demodex-infected qualitative (DQ) dropout was defined as the appearance of one or more fully atrophied glands among relatively healthy MG. Diagnostic efficiency was assessed using a receiver operating characteristic (ROC) curve, and diagnostic consistency was tested using Cohen’s kappa. The association between ocular surface parameters and DQ dropout was assessed. RESULTS: The initial cohort included 105 participants, comprising 70 Demodex-positive (DP; 18 males and 52 females; median age, 38y; range, 21–51y) and 35 Demodex-negative (DN; 11 males and 24 females; median age, 33y; range, 24–55y) individuals. The DQ dropout feature was 64.3% and 2.8% in the DP and DN groups, respectively (P<0.001). ROC analysis yielded an area under the curve (AUC) of 0.807. Substantial inter-rater agreement was achieved in confirming DQ dropout, with a Cohen’s kappa of 0.617. In the validation cohort of 887 patients, DQ dropout prevalence remained higher in the DP group than in the DN group (59.9% vs 28.5%, P<0.001), with strong expert agreement (kappa=0.642, P<0.001), and an AUC of 0.671. A multivariable logistic regression model incorporating tear meniscus height, MG area, and energy curve achieved an AUC of 0.969. CONCLUSION: This novel morphological feature of DQ dropout is common in Demodex infection, demonstrating good diagnostic ability and substantial inter-observer agreement.
Related
- Systematic literature review and meta-analysis of lotilaner 0.25% and tea tree oil for Demodex blepharitis.
- Demodex Folliculitis Following Anifrolumab Infusion.
- Intracrine androgen metabolism in the meibomian gland: regulation, circadian control, and implications in dry eye disease
- A study of changes in meibomian gland function before and after cataract surgery by customized meibographer using auto refractokeratometer
- Meibomian gland epithelial cells demonstrate enhanced reliance on glycolysis for energy metabolism and differentiation
BibTeX
@article{fu2026demodexinfected,
title = {{Demodex-infected qualitative index based on meibomian gland dropout in Demodex blepharitis}},
author = {Lin Fu and Xiao-Yu Chen and Sen Wang and Sheng-Lu Yao and Heng-Li Lian and Ya-Na Fu and Xin-Xin Yu and Zu-Hui Zhang and Qi Dai},
journal = {International Journal of Ophthalmology},
year = {2026},
month = nov,
doi = {10.18240/ijo.2026.11.06},
url = {https://doi.org/10.18240/ijo.2026.11.06},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Demodex-infected qualitative index based on meibomian gland dropout in Demodex blepharitis
AU - Lin Fu
AU - Xiao-Yu Chen
AU - Sen Wang
AU - Sheng-Lu Yao
AU - Heng-Li Lian
AU - Ya-Na Fu
AU - Xin-Xin Yu
AU - Zu-Hui Zhang
AU - Qi Dai
PY - 2026
DA - 2026/11/02
JO - International Journal of Ophthalmology
DO - 10.18240/ijo.2026.11.06
UR - https://doi.org/10.18240/ijo.2026.11.06
AB - AIM: To explore a novel morphological feature of the meibomian gland (MG) and evaluate its prevalence and diagnostic utility in Demodex blepharitis. METHODS: This study included an initial cohort examined for Demodex using in vivo confocal microscopy and an additional validation cohort examined using conventional light microscopy. The new Demodex-infected qualitative (DQ) dropout was defined as the appearance of one or more fully atrophied glands among relatively healthy MG. Diagnostic efficiency was assessed using a receiver operating characteristic (ROC) curve, and diagnostic consistency was tested using Cohen’s kappa. The association between ocular surface parameters and DQ dropout was assessed. RESULTS: The initial cohort included 105 participants, comprising 70 Demodex-positive (DP; 18 males and 52 females; median age, 38y; range, 21–51y) and 35 Demodex-negative (DN; 11 males and 24 females; median age, 33y; range, 24–55y) individuals. The DQ dropout feature was 64.3% and 2.8% in the DP and DN groups, respectively (P<0.001). ROC analysis yielded an area under the curve (AUC) of 0.807. Substantial inter-rater agreement was achieved in confirming DQ dropout, with a Cohen’s kappa of 0.617. In the validation cohort of 887 patients, DQ dropout prevalence remained higher in the DP group than in the DN group (59.9% vs 28.5%, P<0.001), with strong expert agreement (kappa=0.642, P<0.001), and an AUC of 0.671. A multivariable logistic regression model incorporating tear meniscus height, MG area, and energy curve achieved an AUC of 0.969. CONCLUSION: This novel morphological feature of DQ dropout is common in Demodex infection, demonstrating good diagnostic ability and substantial inter-observer agreement.
SN - 2222-3959
SN - 2227-4898
ER -