L'oxytétracycline, antibiotique oral contre la rosacée oculaire.

Oxytetracycline: Antibiotics in the Treatment of Ocular Rosacea.

Ocular rosacea is a form of rosacea affecting over 400 million people worldwide, causing red, dry, and teary eyes. The management of this condition often involves the use of antibiotics from the tetracycline family, such as oxytetracycline. Discover more details here about oxytetracycline and its effects on ocular rosacea.

Summary
Published September 27, 2024, updated on September 27, 2024, by Marie, Scientific Editor — 6 min read

What is ocular rosacea?

Often accompanying cutaneous rosacea, ocular rosacea is a inflammatory condition that manifests as redness, tearing, itching, and burning sensations in the eyes. The eyelids may also appear swollen, and the eyes may become particularly sensitive to light. Ocular rosacea also causes the dilation of small blood vessels in the white area of the eye, known as the sclera, making them visible. Several factors are likely to cause ocular rosacea, among which are a dysfunction of the Meibomian glands, which contribute to eye lubrication by secreting an oily substance, an increase in Demodex mites, releasing inflammation molecules, or even genetics.

The treatment of ocular rosacea primarily involves the adoption of strict ocular hygiene. The use of artificial tears and warm compresses can also help. If this is not enough or if the ocular involvement is too severe, antibiotics belonging to the tetracycline family can be prescribed in conjunction.

Evidence of the effectiveness of oxytetracycline against ocular rosacea?

Available only by prescription, oxytetracycline is an antibiotic from the tetracycline family used to combat certain forms of rosacea, including ocular rosacea. This molecule is indeed capable of acting as a bacterial translation inhibitor. Oxytetracycline prevents the attachment of aminoacyl-tRNA to the mRNA-ribosome complex by binding to the 30S subunit of the ribosomes. In doing so, it halts the elongation phase of protein synthesis. By inhibiting the production of proteins by microorganisms, oxytetracycline prevents them from growing and multiplying, a useful property in the case of colonization by Demodex.

Furthermore, oxytetracycline possesses a lipase-inhibiting action that allows it to inhibit bacterial lipases, enzymes secreted by certain bacteria that hydrolyze the triglycerides of meibum into fatty acids and glycerol. This, however, has a negative impact on the cornea of the eye. Indeed, meibum is a fatty substance composed mainly of triglycerides that helps protect and hydrate the eyes. It can be compared to the sebum of the skin. By protecting the meibum from bacterial lipases, oxytetracycline ensures better hydration for the cornea, which helps combat the eye dryness induced by ocular rosacea.

The effectiveness of cyclines in combating rosacea, and particularly ocular rosacea, has been confirmed in numerous studies. As for oxytetracycline specifically, there is also evidence of its value in the scientific literature, summarized in the table below.

StudyProcedureResults
MARMION (1969)Administration of 150 mg of oxytetracycline twice daily for six weeks to 23 patientsSignificant improvement in ocular rosacea observed in all patients
BARTHOLOMEW & al. (1982)Administration of 250 mg of oxytetracycline or a placebo twice daily for six weeks to 35 patientsComplete remission of ocular rosacea for 31% of patients treated with oxytetracycline versus 14% of patients treated with placebo
SEAL & et al. (1995)Administration of 250 mg of oxytetracycline twice daily for six weeks to 22 patientsSignificant improvement of ocular rosacea for 50% of treated patients
Revue des études cliniques sur l'efficacité de l'oxytétracycline dans le traitement de la rosacée oculaire.

However, it's important to know that this antibiotic is contraindicated during pregnancy and in cases of hypersensitivity to cyclines. Additionally, some people report temporary vision disturbances related to the use of oxytetracycline. In the event of adverse effects following the use of this antibiotic or any other medication, it's crucial to inform your doctor, so they can guide you on the next steps.

While the use of oxytetracycline appears to be relevant in the case of ocular rosacea, it is important to note that its administration is strictly subject to medical advice.

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