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Martínez Díaz, F. González López, N. Puerto Amorós, A. Moreno Valladares" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Martínez Díaz" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "González López" ] 2 => array:2 [ "nombre" => "N." "apellidos" => "Puerto Amorós" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Moreno Valladares" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669120300332" "doi" => "10.1016/j.oftal.2020.01.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669120300332?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579420300384?idApp=UINPBA00004N" "url" => "/21735794/0000009500000004/v1_202004240656/S2173579420300384/v1_202004240656/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173579420300499" "issn" => "21735794" "doi" => "10.1016/j.oftale.2020.02.002" "estado" => "S300" "fechaPublicacion" => "2020-04-01" "aid" => "1656" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Soc Esp Oftalmol. 2020;95:157-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Phakic intraocular lenses: Adapting to change" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "157" "paginaFinal" => "158" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lentes intraoculares fáquicas: adaptándose a los cambios" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "F. Gonzalez-Lopez, R. Bilbao-Calabuig" "autores" => array:2 [ 0 => array:2 [ "nombre" => "F." "apellidos" => "Gonzalez-Lopez" ] 1 => array:2 [ "nombre" => "R." 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Correa Fontt, M. Mena Oliva, C. Pérez Campos, C. Alburquenque Ossandón" "autores" => array:4 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Correa Fontt" "email" => array:1 [ 0 => "javiera.correa@umayor.cl" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Mena Oliva" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Pérez Campos" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "Alburquenque Ossandón" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Escuela de Tecnología Médica, Facultad de Ciencias, Universidad Mayor, Huechuraba, Santiago, Chile" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Prevalencia de <span class="elsevierStyleItalic">Demodex</span> spp. en pestañas de una población universitaria en Santiago, Chile" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 775 "Ancho" => 1348 "Tamanyo" => 56050 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0090" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Presence of signs and/or symptoms of volunteers who tested positive for <span class="elsevierStyleItalic">Demodex</span> spp.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Blepharitis is an acute or chronic inflammatory process that develops in the eyelashes and specifically on the edges thereof, and is frequently bilateral and symmetrical.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> This pathology expresses as a common condition that could exhibit ocular and palpebral irritation, itching and burning feeling in the eyes.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">From the etiological viewpoint, several causes are associated to blepharitis including immunological, microbiological (predominantly bacterial origin, particularly <span class="elsevierStyleItalic">Staphylococcus</span> spp.) and also associated to viral, fungal and parasitic causes.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4–6</span></a> Blepharitis is frequently observed in ophthalmological examinations with the most frequently treatment being palpebral hygiene commonly focused on the bacterian cause which not always has the expected result due to originating in other causes such as <span class="elsevierStyleItalic">Demodex</span> spp.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7–9</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Demodex</span> comes from the Greek word <span class="elsevierStyleItalic">demos</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>fat; dex<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span> woodworm, and insects that lives in and feeds off wood. It belongs to the <span class="elsevierStyleItalic">Artrópoda</span> phylum, the <span class="elsevierStyleItalic">Arachnida class,</span> the <span class="elsevierStyleItalic">Acari</span> order and the <span class="elsevierStyleItalic">Demodicodoidea</span> super-family.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,6</span></a> Infestation of <span class="elsevierStyleItalic">Demodex</span> spp. In humans is known as demodicidosis or demodecosis. These are mites not visible to human eyes with a length between 200 and 400<span class="elsevierStyleHsp" style=""></span>μm, colorless and with 4 pairs of short legs in the anterior third of their bodies.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,10</span></a> The lifecycle of these parasites is between 14 and 18 days starting from the egg, through the larvae phase, protonymph, deutonympth and finally the adult mite.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,11,12</span></a> Two species have been identified on the skin of humans: <span class="elsevierStyleItalic">Demodex folliculorum</span> and <span class="elsevierStyleItalic">Demodex brevis</span>.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The latter is the smallest species, measuring between 200 and 300<span class="elsevierStyleHsp" style=""></span>μm long, spindle-shaped, present only in the sebaceous glands or Meibomium glands, i.e. modified sebaceous glands in the eyelashes, for which reason it is difficult to remove.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> It generally presents as a single specimen.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a><span class="elsevierStyleItalic">D. folliculorum</span> measures 300–400<span class="elsevierStyleHsp" style=""></span>μm, has elongated shape and resides in the hair follicles, generally in groups.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,11</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The classification of parasitic blepharitis includes blepharitis caused by <span class="elsevierStyleItalic">Demodex</span> spp., an organism that resides in the sebaceous glands or hair follicles with a preference for areas with high production of sebum.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> It can be found on the scalp, the upper part of the chest, pubis and buttocks. Lastly it is found in parts of the face of such as the forehead, cheeks, nose and nasolabial groove; specifically, in some patients it is found in the Meibomium glands and follicles of eyelashes.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Even though the role of <span class="elsevierStyleItalic">Demodex</span> spp. in the microbiota has not been determined, its pathogenic role is controversial.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,13</span></a><span class="elsevierStyleItalic">D. folliculorum</span> and <span class="elsevierStyleItalic">D. brevis</span> have been related to diseases such as rosaceae due to its potential capacity to induce follicular hyper-keratinization and an inflammatory reaction similar to that caused by a foreign body or due to delayed hyper-sensitivity. In addition, they can act as a vector for some bacteria that could also give rise to an inflammatory response.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In the facial region, specifically in the eyelashes, it is possible to find <span class="elsevierStyleItalic">Demodex</span> spp. that produces acridid blepharitis which could remain asymptomatic or produce clinical expressions, generally associated in direct proportion to the degree of infestation.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> It is believed that this condition is due to an obstruction of hair follicles and sebaceous ducts caused by said mite, giving rise to an inflammatory response followed by clinic signs such as chronic palpebral inflammation, follicular inflammation producing edema on the palpebral edge, cylinder-shaped descaling on the base of the eyelids, palpebral reddening and symptoms such as foreign body or sand-like feeling, sensitivity to light and loss of eyelashes.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11,12</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Studies conducted in Spain, Belgium and Turkey found a prevalence of 18%,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> 25%<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> and 26.7%<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> respectively. An additional study of the same type, carried out in Colombia, found a prevalence of 42.1%<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> and 72% in Brazil.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> In Chile, 2 studies on the prevalence of <span class="elsevierStyleItalic">Demodex</span> spp. have been conducted although the samples of both comprised patients diagnosed with blepharitis.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,18</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The objective of the present study is to assess the presence of <span class="elsevierStyleItalic">Demodex</span> spp. in hair follicles and sebaceous ducts of eyelids in volunteers of the <span class="elsevierStyleItalic">Universidad Mayor</span> and to determine the presence of signs indicating blepharitis.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0045" class="elsevierStylePara elsevierViewall">The present study and analysis of samples was conducted in the Medical Technology School of the <span class="elsevierStyleItalic">Universidad Mayor</span>. The study was approved by ethics committee of said University.</p><p id="par0050" class="elsevierStylePara elsevierViewall">The community of said University was invited to participate in the study by means of information posters. The Huechuraba campus of said University hosts a population of 5147 students and 478 employees and professors, totaling 5625 individuals. The sample comprised 200 volunteers who responded the survey and subsequently signed an informed consent. The study established the following exclusion criteria: ocular trauma history, diagnostic with any ocular pathology and being in topical treatment with the exception of artificial tears, and utilization of cosmetic eyelashes. After signing the informed consents, none of the volunteers withdrew from the study.</p><p id="par0055" class="elsevierStylePara elsevierViewall">A biomicroscopic assessment was conducted with slit lamp utilizing the diffuse lighting technique at a 45° angle and low magnification (10×) for detecting characteristic signs produced by the mite in eyelashes and eyelids. For obtaining samples, a topical anesthetic (proparacaine hydrochloride) was instilled on the palpebral edge and at the ocular level before extracting 8 eyelashes, 2 from each eyelid, one from the nasal zone and the other randomly from the temporal zone with ordinary tweezers. Subsequently the upper and lower eyelashes were sequentially placed according to the order of extraction (nasal-temporal) on adhesive tape over a previously labeled slide. After that, the samples were analyzed by 2 observers under lit microscope with a magnification of 10× and 40× to determine the presence and amount of mites.</p><p id="par0060" class="elsevierStylePara elsevierViewall">The proportion of positive samples was conducted utilizing Excel 2010 version 14®. Subsequently, the infestation index was determined, defined as the numerical amount of an infectious agent that invades a specific area (eyelids), facilitating the detection of invasion of a living organism by parasites. To this end, the following formula was applied:<elsevierMultimedia ident="eq0005"></elsevierMultimedia></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">The study included 200 volunteers between March and June 2017, 38 of which (19%) were employees and 162 (81%) were students, 118 (59%) females and 82 (41%) males, with an age range between 18 and 67 and a mean of 26 years of age.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Out of the 400 eyes analyzed for <span class="elsevierStyleItalic">Demodex</span> spp., 54 volunteers (27%) were positive, with at least one eyelash showing the presence of a mite.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Out of the 54 cases with <span class="elsevierStyleItalic">Demodex</span> spp., 42 (77.8%) exhibited the mite unilaterally (in only one eye) and 12 (22.2%) had bilateral presence of mites. In addition, 20 (37%) were found on females and 34 (63%) on males.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Volunteers with positive presence of <span class="elsevierStyleItalic">Demodex</span> spp. were classified on the basis of the biomicroscopic evaluation and clinic record in 4 categories. It was determined that 24 volunteers (44%) only had signs, while 3 (6%) only had symptoms, 13 (24%) had signs and symptoms, and 14 (26%) did not refer irritation and no signs were detected under slit lamp examination (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">The mean infestation index was 0.65<span class="elsevierStyleHsp" style=""></span>m/e (mites per eyelash), in a range of 0.25–2.50<span class="elsevierStyleHsp" style=""></span>m/e, where 34 (51.5%) eyes exhibited and infestation index of 0.25<span class="elsevierStyleHsp" style=""></span>m/e, 12 (18.2%) and infestation index of 0.5, and 2 (3%) and infestation index of 2.50<span class="elsevierStyleHsp" style=""></span>m/e (<a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Mean infestation index for volunteers who did not exhibit signs or symptoms was 0.44<span class="elsevierStyleHsp" style=""></span>m/e; for those who exhibited only signs was 0.67<span class="elsevierStyleHsp" style=""></span>m/e; with signs and symptoms, 0.74<span class="elsevierStyleHsp" style=""></span>m/e, and for the volunteers who exhibited only symptoms the index was 0.94<span class="elsevierStyleHsp" style=""></span>m/e. The Mann–Whitney test (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.0372) (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>) showed a statistically significant difference between the group of volunteers without signs or symptoms and the group with the signs and symptoms.</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Out of the positive samples for the mite, 35 (53%) eyes exhibited mites only on the lower eyelid, followed by 18 (27.3%) with infestation in the upper eyelid and 13 (19.7%) eyes and both eyelids (upper and lower).</p><p id="par0100" class="elsevierStylePara elsevierViewall">None of the positive samples showed the presence of <span class="elsevierStyleItalic">D. brevis</span> (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>B).</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0105" class="elsevierStylePara elsevierViewall">The research suggested different perspectives about the pathogenesis of <span class="elsevierStyleItalic">Demodex</span> spp. One of them would indicate that it could be part of the microbiota without potential pathogenicity, because 26% of volunteers who had the mite did not show neither signs nor symptoms of blepharitis. On the other hand, <span class="elsevierStyleItalic">Demodex</span> spp. could be an agent capable of invading eyelashes, giving rise to signs and symptoms at the palpebral level<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> which was the case in 24% of volunteers.</p><p id="par0110" class="elsevierStylePara elsevierViewall">The prevalence found in healthy volunteers does not match the prevalence found in other Latin American countries. In Santander, Colombia, it was reported that 42.1% of patients who visited the general ophthalmological practice exhibited the presence of <span class="elsevierStyleItalic">D. folliculorum</span><a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> while in Botucatu, Brazil, the percentage was 72% of volunteers who attended an aesthetic clinic,<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> Both of these percentages are higher than those reported in the present study. In addition, a similar study conducted in Breslau, Poland, found a prevalence of 41% in a population without blepharitis diagnostic.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> On the other hand, a study conducted in Oaxaca, Mexico, found that 20% of health patients were positive for the presence of the mite,<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> and an additional study carried out in Smyrna, Turkey, reported 4.16% in healthy subjects.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> The latter percentage is lower than that of the present study.</p><p id="par0115" class="elsevierStylePara elsevierViewall">In studies conducted on healthy patients in Spain, the prevalence of said mite was 18%,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> In Belgium, 25%<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> and in a further study in Turkey the prevalence was 26.7%,<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> These values are very similar to those found in the present study.</p><p id="par0120" class="elsevierStylePara elsevierViewall">It was determined that the presence of this mite was predominantly unilateral, probably because eyelashes were extracted in only 2 areas, i.e., the temporal and nasal areas of the eyelids, leaving areas without examination, which constitutes a limitation of this study.</p><p id="par0125" class="elsevierStylePara elsevierViewall">Higher prevalence was found in males (63%) than in females, which could be due to the fact that males have a greater production of sebum induced by masculine androgens.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">The data of this research evidence that <span class="elsevierStyleItalic">Demodex</span> spp. Is found both in patients who exhibited signs in greater prevalence, symptoms in lower proportion as well as in those who did not exhibit signs or symptoms of mite blepharitis. It is interesting to note that 26% of volunteers who had the mite did not show symptoms or signs, which could indicate that in some patients the low level of infestation might not be clinically significant.</p><p id="par0135" class="elsevierStylePara elsevierViewall">The presence of the mite was more prevalent in the lower eyelid lashes, which could be explained by the topographic distribution of the mite in the follicle-sebaceous units. This demonstrates that the most frequent location for said mites is above the nose, followed by the external auditory meatus, the eyelids and cheeks. The shortest migration route is from the nose towards the lower eyelids.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">The studied samples did not find <span class="elsevierStyleItalic">D. brevisin</span> any of the volunteers, only <span class="elsevierStyleItalic">D. folliculorum</span> was exhibited by 100% of them. This matches the location of the mite, the obtained samples, considering that <span class="elsevierStyleItalic">D. brevis</span> inhabits the Meibomium, sebaceous glands, its detection does not require the extraction of eyelashes, a fact that is confirmed by other authors.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">The larger sample size of young volunteers might have generated a limitation in the study because it cannot be confirmed that the presence of the mite occurs in elderly individuals, as in the present study the limited participation of employees. Accordingly, the present study exposes the prevalence of <span class="elsevierStyleItalic">Demodex</span> spp. In a population with various age ranges in order to determine the presence of mites and the alterations it produces.</p><p id="par0150" class="elsevierStylePara elsevierViewall">It is important to educate individuals who present with <span class="elsevierStyleItalic">Demodex</span>, both in what concerns treatment as well as hygiene, to avoid direct contagion which is a considerably important cause of chronic blepharitis<span class="elsevierStyleSup">20</span>, taking into account that its presence in eyelashes involves multiple relapses due to being a perpetuating agent if undetected and untreated.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusions</span><p id="par0155" class="elsevierStylePara elsevierViewall">The prevalence of <span class="elsevierStyleItalic">Demodex</span> spp. found in the present study was 27%, and higher in males than in females. Overall, 74% of volunteers who gave positive for the presence of the mites exhibited signs and/or symptoms of blepharitis, with the lower eyelid being the most frequent location. A significant difference was observed between volunteers who exhibited signs and symptoms against those who did not exhibit signs or symptoms in what concerns the infestation index.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Funding</span><p id="par0160" class="elsevierStylePara elsevierViewall">The present study has not received any specific grant from agencies of the public, private or nonprofit sectors.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflict of interests</span><p id="par0165" class="elsevierStylePara elsevierViewall">None.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1328687" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1224519" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1328686" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Materiales y Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1224518" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Funding" ] 10 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflict of interests" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-12-10" "fechaAceptado" => "2020-01-27" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1224519" "palabras" => array:3 [ 0 => "<span class="elsevierStyleItalic">Demodex</span> spp." 1 => "Blepharitis" 2 => "Infestation rate" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1224518" "palabras" => array:3 [ 0 => "<span class="elsevierStyleItalic">Demodex</span> spp." 1 => "Blefaritis" 2 => "Indice de infestación" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To determine the presence of <span class="elsevierStyleItalic">Demodex</span> spp. in the eyelashes’ pilosebaceous unit in volunteers of one campus of a private university.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The volunteers underwent anamnesis, biomicroscopic study and samples were taken of 8 eyelashes, 2 of each eyelid of both eyes. The eyelashes were mounted on a slide and observed under a light microscope to determine the presence and quantity of mites.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">200 volunteers were recruited, determining the prevalence of <span class="elsevierStyleItalic">Demodex</span> spp. in 54 (27%) of them. Of the positive cases, 40 (74.1%) presented signs and/or symptoms of blepharitis, 43 (79.7%) presented the mite in one eye and an average infestation rate of 0.65 <span class="elsevierStyleItalic">Demodex</span> spp. per eyelash was obtained.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Approximately one in four of the volunteers studied without a diagnosis of blepharitis was a carrier of the parasite, of which a significant percentage presented some type of sign and/or symptom of this pathology which was related to a higher rate of infestation (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,05).</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Determinar la presencia de <span class="elsevierStyleItalic">Demodex</span> spp. en la unidad pilosebácea de las pestañas en voluntarios de una sede de una universidad privada.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materiales y Métodos</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">A los voluntarios se les realizó anamnesis, estudio biomicroscópico y se tomaron muestras de 8 pestañas, 2 de cada párpado de ambos ojos. Las pestañas fueron montadas en un portaobjeto y observadas bajo un microscopio de luz para determinar la presencia y cantidad de ácaros.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Se reclutaron 200 voluntarios, determinando en 54 (27%) de ellos la prevalencia de <span class="elsevierStyleItalic">Demodex</span> spp. De los casos positivos, 40 (74,1%) presentó signos y/o síntomas de blefaritis, 43 (79,7%) presentó el ácaro en un solo ojo y se obtuvo un índice de infestación promedio de 0,65 <span class="elsevierStyleItalic">Demodex</span> spp. por pestaña.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Aproximadamente uno de cada 4 de los voluntarios estudiados sin diagnóstico de blefaritis fue portador del parásito, de los cuales un importante porcentaje presentó algún tipo de signo y/o síntoma de esta patología la cual se relacionaba con un mayor índice de infestación (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,05).</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Materiales y Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Correa Fontt J, Mena Oliva M, Pérez Campos C, Alburquenque Ossandón C. Prevalencia de <span class="elsevierStyleItalic">Demodex</span> spp. en pestañas de una población universitaria en Santiago, Chile. Arch Soc Esp Oftalmol. 2020;95:159–163.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">This study was conducted as part of the degree research for the Medical Technology study, with mention of Ophthalmology and Optometrics, of Micsi Mena Oliva and Cynthia Pérez Campos.</p>" ] ] "multimedia" => array:5 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 775 "Ancho" => 1348 "Tamanyo" => 56050 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0090" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Presence of signs and/or symptoms of volunteers who tested positive for <span class="elsevierStyleItalic">Demodex</span> spp.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1008 "Ancho" => 2133 "Tamanyo" => 72178 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0095" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">infestation index.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1228 "Ancho" => 2167 "Tamanyo" => 251939 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0100" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Demodex folliculorum</span> in eyelash hair follicle. (A) Observation of 3 parasites with 10× enlargement. (B) Observation of 2 parasites with 40× enlargement.</p>" ] ] 3 => array:8 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1255 "Ancho" => 1536 "Tamanyo" => 69968 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0105" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Infestation index versus signs and/or symptoms.</p>" ] ] 4 => array:5 [ "identificador" => "eq0005" "tipo" => "MULTIMEDIAFORMULA" "mostrarFloat" => false "mostrarDisplay" => true "Formula" => array:5 [ "Matematica" => "Number of Demodex ssp. Per eyeTotal number of extracted eyelashes" "Fichero" => "STRIPIN_si1.jpeg" "Tamanyo" => 5026 "Alto" => 36 "Ancho" => 253 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Demodex</span> spp en pacientes con blefaritis crónica" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. 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