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Journals / Kommagene Biyoloji Dergisi / 2026 / Cilt: 10 Sayı: 1

Prevalence of Ocular Demodex spp. in Patients with Chronic Uveitis Under Immunosuppressive Treatment

İmmünosupresif Tedavi Alan Kronik Üveitli Hastalarda Oküler Demodex spp. Prevalansı

Zarife Ekici Gök(MALATYA TURGUT ÖZAL ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0002-9250-9618
Ayten Gündüz(MALATYA TURGUT ÖZAL ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0003-2031-9978
Pages
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Publication Date
2026-09-28
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In conclusion, Demodex prevalence was not increased in patients receiving immunosuppressive or anti-TNF therapy.

📌 3 Key Takeaways

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Objective & Hypothesis:This study aimed to evaluate the prevalence of Demodex infestation in patients with chronic uveitis receiving immunosuppressive and/or anti-TNF therapy and to compare the findings with those of a healthy control group.
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Key Findings & Data:This cross-sectional study included 93 participants (34 uveitis patients and 59 controls).
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Conclusion & Impact:In conclusion, Demodex prevalence was not increased in patients receiving immunosuppressive or anti-TNF therapy.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Ectoparasites · parasite density · eyelid microbiota

Abstract

This study aimed to evaluate the prevalence of Demodex infestation in patients with chronic uveitis receiving immunosuppressive and/or anti-TNF therapy and to compare the findings with those of a healthy control group. This cross-sectional study included 93 participants (34 uveitis patients and 59 controls). Uveitis was classified according to the Standardization of Uveitis Nomenclature criteria. Demodex was assessed by eyelash epilation followed by masked light microscopic examination and parasite presence and density were recorded. Group comparisons were performed using the chi-square or Fisher’s exact test, with statistical significance set at p 0.05). The prevalence of Demodex was 11.8% in the uveitis group and 18.6% in the control group, with no significant difference (p=0.52). No association was found between Demodex positivity and the use of anti-TNF agents, methotrexate, azathioprine, or corticosteroids (all p>0.05). Parasite density in positive cases was low to moderate (mean 1.92 ± 1.16; median 2). The lower prevalence observed in the uveitis group may be related to the frequent use of topical corticosteroids, which could suppress local ocular surface inflammation and limit colonization. In conclusion, Demodex prevalence was not increased in patients receiving immunosuppressive or anti-TNF therapy. Further large-scale prospective studies are needed to clarify the relationship between immune modulation, the ocular surface microenvironment, and Demodex infestation.

Özet

Bu çalışmada, immünosupresif ve/veya anti-TNF tedavi alan kronik üveitli hastalarda Demodex infestasyonu prevalansının değerlendirilmesi ve sağlıklı kontrol grubu ile karşılaştırılması amaçlandı. Bu kesitsel çalışmaya 34 üveit hastası ve 59 sağlıklı birey olmak üzere toplam 93 katılımcı dahil edildi. Üveit tanısı Standardization of Uveitis Nomenclature (SUN) kriterlerine göre konuldu. Demodex varlığı kirpik epilasyonu sonrası maskeli ışık mikroskobisi ile değerlendirildi ve parazit varlığı ile yoğunluğu kaydedildi. Gruplar arası karşılaştırmalar ki-kare veya Fisher kesin testi ile yapıldı ve istatistiksel anlamlılık p 0.05). Demodex prevalansı üveit grubunda %11.8, kontrol grubunda %18.6 olarak saptandı ve aradaki fark istatistiksel olarak anlamlı değildi (p=0.52). Demodex pozitifliği ile anti-TNF ajanlar, metotreksat, azatioprin veya kortikosteroid kullanımı arasında anlamlı ilişki bulunmadı (tüm p>0.05). Pozitif olgularda parazit yoğunluğu düşük-orta düzeydeydi (ortalama 1.92 ± 1.16; medyan 2). Üveit grubunda gözlenen daha düşük prevalansın, topikal kortikosteroidlerin lokal oküler yüzey inflamasyonunu baskılayarak kolonizasyonu sınırlaması ile ilişkili olabileceği düşünüldü. Sonuç olarak, immünosupresif veya anti-TNF tedavi alan hastalarda Demodex prevalansında artış saptanmadı. İmmün modülasyon, oküler yüzey mikroçevresi ve Demodex infestasyonu arasındaki ilişkinin aydınlatılması için daha geniş örneklemli prospektif çalışmalara ihtiyaç vardır.

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Cite This Article

Gök, Z. E., Gündüz, A. (2026). Prevalence of Ocular Demodex spp. in Patients with Chronic Uveitis Under Immunosuppressive Treatment. Kommagene Biyoloji Dergisi, Cilt: 10 Sayı: 1. https://doi.org/10.31594/commagene.1938976

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References (27)

  1. Bernstein, J.E. (1982). Rosacea flushing. International Journal of Dermatology, 21(1), 24. https://doi.org/10.1111/j.1365-4362.1982.tb00483.x
  2. Biernat, M.M., Rusiecka-Ziółkowska, J., Piątkowska, E., Helemejko, I., Biernat, P., & Gościniak, G. (2018). Occurrence of Demodex species in patients with blepharitis and in healthy individuals: a 10-year observational study. Japanese Journal of Ophthalmology, 62(6), 628-633. https://doi.org/10.1007/s10384-018-0624-3
  3. Cheng, A.M., Galor, A., Banoub, R., & Gupta, S.K. (2023). The impact of ocular demodicosis on the eyes. Eye, 37(15), 3061–3062. https://doi.org/10.1038/s41433-023-02526-8
  4. Cheng, A.M., Hwang, J., Dermer, H., & Galor, A. (2021). Prevalence of ocular demodicosis in an older population and its association with symptoms and signs of dry eye. Cornea, 40(8), 995–1001. https://doi.org/10.1097/ico.0000000000002542
  5. Cheng, A.M., Sheha, H., & Tseng, S.C. (2016). Recent advances on ocular Demodex infestation. Current Opinion in Ophthalmology, 26(4), 295–300. https://doi.org/10.1097/ico.0000000000002542
  6. Coston, T.O. (1967). Demodex folliculorum blepharitis. Transactions of the Ophthalmological Societies of the United Kingdom, 87, 361–392.
  7. Ciftci, I.H., Dundar, U., Cetinkaya, Z., Ciftci, H., & Arslan, F. (2007). Demodex folliculorum in patients with rheumatoid arthritis. Acta Parasitologica, 52(1), 70–73. https://doi.org/10.2478/s11686-007-0002-7
  8. Foley, R., Kelly, P., Gatault, S., & Powell, F. (2021). Demodex: A skin resident in man and his best friend. Journal of the European Academy of Dermatology and Venereology, 35(1), 62–72. https://doi.org/10.1111/jdv.16461
  9. Gao, Y.Y., Di Pascuale, M.A., Li, W., Liu, D.T., Baradaran-Rafii, A., Elizondo, A., & Tseng, S.C. (2005). High prevalence of Demodex in eyelashes with cylindrical dandruff. Investigative Ophthalmology & Visual Science, 46(9), 3089–3094. https://doi.org/10.1167/iovs.05-0275
  10. Gazi, U., Ozkan, A.T., & Mumcuoglu, K.Y. (2019). Immune mechanisms in human and canine demodicosis: A review. Parasite Immunology, 41(12), e12673. https://doi.org/10.1111/pim.12673
  11. Jansen, T., Kastner, U., Kreuter, A., & Altmeyer, P. (2001). Rosacea-like demodicidosis associated with acquired immunodeficiency syndrome. British Journal of Dermatology, 144(1), 139–142. https://doi.org/10.1046/j.1365-2133.2001.03794.x
  12. Kaya, S., Selimoglu, M.A., Kaya, O.A., & Ozgen, U. (2013). Prevalence of Demodex folliculorum and Demodex brevis in childhood malnutrition and malignancy. Pediatrics International, 55(1), 85–89. https://doi.org/10.1111/j.1442-200x.2012.03740.x
  13. Keles, H., Pancar Yuksel, E., Aydin, F., & Senturk, N. (2020). Pre-treatment and post-treatment Demodex densities in patients under immunosuppressive treatments. Medicina, 56(3), 107. https://doi.org/10.3390/medicina56030107
  14. Kosik-Bogacka, D.I., Łanocha, N., Łanocha, A., Lanocha-Arendarczyk, N., & Prokopowicz, D. (2013). Demodex folliculorum and Demodex brevis in healthy and immunocompromised patients. Ophthalmic Epidemiology, 20(3), 159–163. https://doi.org/10.3109/09286586.2013.789532
  15. Lacey, N., Kavanagh, K., & Tseng, S.C. (2009). Under the lash: Demodex mites in human diseases. Biochemist, 31(4), 2–6.
  16. Li, X., Lam, N.S.K., Yang, L., Liang, A., Long, X.X., Guo, J., & Li, J. (2022). Demodex density increases after adalimumab therapy in ankylosing spondylitis: A pilot study. Parasitology, 149, 940–943. https://doi.org/10.1017/s0031182022000348
  17. Litwin, D., Chen, W., Dzika, E., & Korycińska, J. (2017). Human permanent ectoparasites: Recent advances on biology and clinical significance of Demodex mites. Iranian Journal of Parasitology, 12(1), 12–21.
  18. Liu, J., Sheha, H., & Tseng, S.C. (2010). Pathogenic role of Demodex mites in blepharitis. Current Opinion in Allergy and Clinical Immunology, 10(5), 505–510. https://doi.org/10.1097/aci.0b013e32833df9f4
  19. Luo, X., Li, J., Chen, C., Tseng, S.C., & Liang, L. (2017). Ocular demodicosis as a potential cause of ocular surface inflammation. Cornea, 36(1), 9–14. https://doi.org/10.1097/ico.0000000000001361
  20. Marquardt-Feszler, A., Cekała, K., Dębska-Ślizień, A., & Imko-Walczuk, B. (2022). Demodicosis among immunocompromised patients: A review. Advances in Dermatology and Allergology, 39(5), 829–837. https://doi.org/10.5114/ada.2022.120879
  21. Post, C.F., & Juhlin, E. (1963). Demodex folliculorum and blepharitis. Archives of Dermatology, 88(3), 298–302. https://doi.org/10.1001/archderm.1963.01590210056008
  22. Sahn, E.E., & Sheridan, D.M. (1992). Demodicidosis in a child with leukemia. Journal of the American Academy of Dermatology, 27(5), 799–801. https://doi.org/10.1016/0190-9622(92)70250-j
  23. Sędzikowska, A., Tarkowski, W., Moneta-Wielgoś, J., Grzyliński, K., Tarkowski, G., & Młocicki, D. (2021). Effect of ocular demodicosis on the stability of the tear film and the tear break-up time. Scientific Reports, 11, 24296. https://doi.org/10.1038/s41598-021-03801-y
  24. Seyhan, M.E., Karincaoglu, Y., Bayram, N., Aycan, O., & Kuku, I. (2004). Density of Demodex folliculorum in haematological malignancies. Journal of International Medical Research, 32(4), 411–415. https://doi.org/10.1177/147323000403200410
  25. Wilkin, J.K. (1981). Oral thermal-induced flushing in erythematotelangiectatic rosacea. Journal of Investigative Dermatology, 76(1), 15–18. https://doi.org/10.1111/1523-1747.ep12524458
  26. Zeytun, E., & Ölmez, H. (2017). KOAH Hastalarında Demodex (Acari: Demodicidae) Enfestasyonu ve İmmunosüpresyon ile Arasındaki İlişki. Erzincan University Journal of Science and Technology, 10(2), 220–231.
  27. Zhang, A.C., Muntz, A., Wang, M.T.M., Craig, J.P., & Downie, L.E. (2020). Ocular Demodex: A systematic review of the clinical literature. Ophthalmic and Physiological Optics, 40(4), 389–432. https://doi.org/10.1111/opo.12691