Ocular Microbiota of Severe Meibomian Gland Dysfunction (Chronic Dry Eyes) after Intense Pulsed Light (IPL)

Ocular IPL therapy has recently been widely used for MGD, especially for patients not showing improvement with traditional therapies (warm compresses and lid scrubs) to clean debris and reduce bacterial overgrowth. Insights on the ocular microbiome and quantitative microbiome in MGD after a course of IPL could provide useful data on bacterial community monitoring and associated mechanisms linked with IPL. Ocular swabs were obtained from a severe MGD patient and age-sex matched healthy for metagenomics, followed by 16S rRNA gene sequencing and qPCR. Of 10 samples, including left and right eyes (el, er) of severe MGD females before (Db) and after 2-4 IPLs (Da2, Da3, and Da4) and the matched non-MGD females (H), both of ~40 years Using 16S rRNA gene sequencing as microbiota and combined 16S rRNA gene qPCR as quantitative microbiota revealed significant disperse in the microbiome structures of Db compared with Da and H (HOMOVA, p<0.001). Bacterial Propionibacterium acnes and unclassified taxa in the family Propionibacteriaceae and order Actinomycetales represented the core Db microbiota and were reduced after 2-4 IPLs in Da, making the Da microbiome and clinical (mucocutaneous junction, corneal, and conjunctival fluorescein score) closer to H (NMDS with Pearson’s correlation, p<0.05). The recovery of the Da microbiome also allowed Da metabolic potentials to be closer to H. Our findings first demonstrated the ocular microbiome dysbiosis in severe MGD, dispersed from Da and H, in Thai subjects, correlated with bacterial quantity and clinical MGD, including the mucocutaneous junction process. The results additionally provided taxa representing Db vs. Da and H and preliminarily underlie the idea that IPL could improve dysbiosis in the MGD microbiome. Doi: 10.28991/ESJ-2023-07-05-015 Full Text: PDF