{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:27:50Z","timestamp":1787772470986,"version":"build-2784847793"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>\n                      The background of this study was to evaluate the relationship between keratoconus (KC) occurrence and ocular\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      infestation together with the effects of\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      on the ocular surface.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      Thirty-eight eyes of 20 KC patients (KC group) and 40 eyes of 20 age- and sex-matched healthy subjects (control group) were included in this cross-sectional study.\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      species (\n                      <jats:italic toggle=\"yes\">folliculorum\/brevis<\/jats:italic>\n                      ), clinical symptoms such as eye rubbing, Ocular Surface Disease Index (OSDI), corneal topography findings, tear break-up time (TBUT), and Schirmer test scores were evaluated. KC eyes were also divided into two subgroups according to KC severity and presence of\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      .\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      was detected using conventional light microscopy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      The mean age was 25.90 \u00b1 7.01 years in the KC group, and 26.52 \u00b1 8.94 years in the control group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.731). While unexpectedly no\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      were detected in the control group,\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      were detected in the KC group, including 8 eyes (21.1%) with\n                      <jats:italic toggle=\"yes\">Demodex folliculorum<\/jats:italic>\n                      , and 10 eyes with\n                      <jats:italic toggle=\"yes\">D. folliculorum<\/jats:italic>\n                      +\n                      <jats:italic toggle=\"yes\">Demodex brevis<\/jats:italic>\n                      (26.3%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). As the KC severity worsened, the percentage of eyes with\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      mites increased (43.8% in the mild\/moderate subgroup and 66.7% in the severe subgroup,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). The number of rubbing eyes and OSDI scores were significantly higher, and TBUT levels were significantly lower in the KC\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      + and\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      \u2212 subgroups than the control group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001 for all), but there is no significant difference between the KC\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      + and\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      \u2212 subgroups regarding ocular surface parameters (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 1.0).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>\n                      Although the number of patients is relatively small and there is no follow-up data after\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      treatment, KC and ocular\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      infestation seem to be associated.\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      -related inflammation and associated eye rubbing may contribute to KC progression.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ojo.ojo_270_22","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T13:56:24Z","timestamp":1716558984000},"page":"287-292","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Is there a relationship between keratoconus and ocular Demodex mites?"],"prefix":"10.4103","volume":"16","author":[{"given":"Bengi Ece","family":"Kurtul","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Mustafa Kemal University Tayfur Ata S\u00f6kmen Faculty of Medicine, Hatay, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozlem Makbule","family":"Kaya","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Mustafa Kemal University Tayfur Ata S\u00f6kmen Faculty of Medicine, Hatay, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Kakac","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, K\u0131z\u0131ltepe State Hospital, Mardin, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasemin Fatma","family":"Cetinkaya","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, G\u00fclhane Training and Research Hospital, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,6,27]]},"reference":[{"key":"R1-20240908","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1111\/cxo.13123","article-title":"Demodex and eye disease:A review","volume":"104","author":"Bitton","year":"2021","journal-title":"Clin Exp Optom"},{"key":"R2-20240908","doi-asserted-by":"crossref","first-page":"57","DOI":"10.2147\/OPTO.S142708","article-title":"Demodex blepharitis:Clinical perspectives","volume":"10","author":"Fromstein","year":"2018","journal-title":"Clin Optom (Auckl)"},{"key":"R3-20240908","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1515\/ap-2016-0112","article-title":"Ocular symptoms reported by patients infested with Demodex mites","volume":"61","author":"S\u0119dzikowska","year":"2016","journal-title":"Acta Parasitol"},{"key":"R4-20240908","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1097\/ICL.0000000000000656","article-title":"Demodex-mite infestation in cilia and its association with ocular surface parameters in Japanese volunteers","volume":"46","author":"Mizuno","year":"2020","journal-title":"Eye Contact Lens"},{"key":"R5-20240908","doi-asserted-by":"crossref","first-page":"745","DOI":"10.4103\/ijo.IJO_1402_19","article-title":"Demodex blepharokeratoconjunctivitis affecting young patients:A case series","volume":"68","author":"Patel","year":"2020","journal-title":"Indian J Ophthalmol"},{"issue":"Suppl 1","key":"R6-20240908","doi-asserted-by":"crossref","first-page":"S9","DOI":"10.1097\/ICO.0000000000001361","article-title":"Ocular demodicosis as a potential cause of ocular surface inflammation","volume":"36","author":"Luo","year":"2017","journal-title":"Cornea"},{"key":"R7-20240908","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/ICO.0b013e31820ce56c","article-title":"Treatment of ocular itching associated with ocular demodicosis by 5% tea tree oil ointment","volume":"31","author":"Gao","year":"2012","journal-title":"Cornea"},{"key":"R8-20240908","doi-asserted-by":"crossref","first-page":"146","DOI":"10.4103\/tjo.tjo_45_20","article-title":"Clinical characteristics and topographic findings of corneal ectasia in patients with symptomatic Demodex blepharitis","volume":"11","author":"Hung","year":"2021","journal-title":"Taiwan J Ophthalmol"},{"key":"R9-20240908","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.18240\/ijo.2019.11.17","article-title":"The correlation between keratoconus and eye rubbing:A review","volume":"12","author":"Najmi","year":"2019","journal-title":"Int J Ophthalmol"},{"key":"R10-20240908","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.4103\/ijo.IJO_3011_20","article-title":"Systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio levels are associated with keratoconus","volume":"69","author":"Elbeyli","year":"2021","journal-title":"Indian J Ophthalmol"},{"key":"R11-20240908","doi-asserted-by":"crossref","first-page":"2057","DOI":"10.1007\/s00417-021-05081-8","article-title":"Eye rubbing in the aetiology of keratoconus:A systematic review and meta-analysis","volume":"259","author":"Sahebjada","year":"2021","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"R12-20240908","doi-asserted-by":"crossref","first-page":"357","DOI":"10.3928\/1081597X-20090401-07","article-title":"Circular keratotomy to reduce astigmatism and improve vision in stage I and II keratoconus","volume":"25","author":"Krumeich","year":"2009","journal-title":"J Refract Surg"},{"key":"R13-20240908","first-page":"158","article-title":"What is the importance of Demodex folliculorum in Beh\u00e7et's disease?","volume":"33","author":"Emre","year":"2009","journal-title":"Turkiye Parazitol Derg"},{"key":"R14-20240908","doi-asserted-by":"crossref","first-page":"169","DOI":"10.2307\/3278267","article-title":"Demodex folliculorum (Simon) and D. brevis akbulatova of man:Redescription and reevaluation","volume":"58","author":"Desch","year":"1972","journal-title":"J Parasitol"},{"key":"R15-20240908","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1111\/j.1444-0938.2003.tb03082.x","article-title":"Keratoconus, allergy, itch, eye-rubbing and hand-dominance","volume":"86","author":"McMonnies","year":"2003","journal-title":"Clin Exp Optom"},{"key":"R16-20240908","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1097\/ACI.0b013e32833df9f4","article-title":"Pathogenic role of Demodex mites in blepharitis","volume":"10","author":"Liu","year":"2010","journal-title":"Curr Opin Allergy Clin Immunol"},{"key":"R17-20240908","first-page":"1","article-title":"Keratoconus:Is it a non-inflammatory disease?","volume":"6","author":"Gatzioufas","year":"2017","journal-title":"Med Hypothesis Discov Innov Ophthalmol"},{"key":"R18-20240908","doi-asserted-by":"crossref","first-page":"4285268","DOI":"10.1155\/2018\/4285268","article-title":"Overexpression of tear inflammatory cytokines as additional finding in keratoconus patients and their first degree family members","volume":"2018","author":"Ionescu","year":"2018","journal-title":"Mediators Inflamm"},{"key":"R19-20240908","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.ajo.2007.01.054","article-title":"Corneal manifestations of ocular demodex infestation","volume":"143","author":"Kheirkhah","year":"2007","journal-title":"Am J Ophthalmol"},{"key":"R20-20240908","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ajo.2019.03.007","article-title":"Demodex mite infestation and its associations with tear film and ocular surface parameters in patients with ocular discomfort","volume":"204","author":"Rabensteiner","year":"2019","journal-title":"Am J Ophthalmol"},{"issue":"Suppl 1","key":"R21-20240908","doi-asserted-by":"crossref","first-page":"S39","DOI":"10.1097\/ICL.0000000000000640","article-title":"The effect of ocular Demodex colonization on Schirmer test and OSDI scores in newly diagnosed dry eye patients","volume":"46","author":"Ayyildiz","year":"2020","journal-title":"Eye Contact Lens"},{"key":"R22-20240908","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1007\/s10792-018-0826-1","article-title":"Ocular Demodex folliculorum:Prevalence and associated symptoms in an Irish population","volume":"39","author":"Murphy","year":"2019","journal-title":"Int Ophthalmol"},{"key":"R23-20240908","doi-asserted-by":"crossref","first-page":"e198","DOI":"10.1097\/OPX.0b013e3182968c77","article-title":"Demodex","volume":"90","author":"Hom","year":"2013","journal-title":"Optom Vis Sci"},{"key":"R24-20240908","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1097\/ICL.0000000000000705","article-title":"Prevalence of ocular Demodex infestation in children:An epidemiological survey in South China","volume":"47","author":"Zhang","year":"2021","journal-title":"Eye Contact Lens"},{"key":"R25-20240908","doi-asserted-by":"crossref","first-page":"e106265","DOI":"10.1371\/journal.pone.0106265","article-title":"Ubiquity and diversity of human-associated Demodex mites","volume":"9","author":"Thoemmes","year":"2014","journal-title":"PLoS One"},{"key":"R26-20240908","doi-asserted-by":"crossref","first-page":"745","DOI":"10.4103\/ijo.IJO_1402_19","article-title":"Demodex blepharokeratoconjunctivitis affecting young patients:A case series","volume":"68","author":"Patel","year":"2020","journal-title":"Indian J Ophthalmol"},{"key":"R27-20240908","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1186\/s12886-019-1074-5","article-title":"Evaluation of the ocular surface characteristics and Demodex infestation in paediatric and adult blepharokeratoconjunctivitis","volume":"19","author":"Wu","year":"2019","journal-title":"BMC Ophthalmol"}],"container-title":["Oman Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ojo.ojo_270_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:47:58Z","timestamp":1787770078000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ojo.ojo_270_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":27,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/ojo.ojo_270_22","relation":{},"ISSN":["0974-620X","0974-7842"],"issn-type":[{"value":"0974-620X","type":"print"},{"value":"0974-7842","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5]]},"assertion":[{"value":"2022-09-23","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-06","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}