AzaSite and MGD!!!!!!!!!!!!!!!!!

[Meebo]

Listen guys, I do not want to get too excited yet but I think AzaSite might be one solid treatment avenue for many people that have MGD. I recently found this information and I recommend EVERYONE on this site read it in its entirety. However, beginning on page 18 is the meat and potatoes; there is a documented study on the effects of AzaSite on patients suffering from MGD.

The only thing I am somewhat concerned about is if the inclusion group contained anyone with MGD due to ocular rosacea. Which then leads me to the question, does it matter if you have ocular rosacea or not? Is MGD just MGD but sometimes coexists with ocular rosacea? Basically, something I always wanted to know, is if the inflammation from ocular rosacea literally causes MGD and will AzaSite help me? Also, there is, I believe .003% BAK. This was prob not a concern as this medication was meant for short term in the resolution of pink eye. Maybe, hopefully, they will create this as a non-preserved product.

Anyways, I am going to beg my MD to let me try this in addition to taking some oral meds (maybe Oracea).

Here is the link:

http://www.pioneersinoptometry.org/G...%20Azasite.pdf

[NYer]

According to Dr. L, in those of use with ocular Rosacea, it's the rosacea that causes the MGD.
I tried Azasite and had to stop after two days. It was extremely irritating to my eyes.
Do a search under the word Azasite on this site. There are some long threads with lots of posts. Some people like it, some people like it and then stop liking it, and some people hate it.

[Meebo]

According to Dr. L, in those of use with ocular Rosacea, it's the rosacea that causes the MGD.
I tried Azasite and had to stop after two days. It was extremely irritating to my eyes.
Do a search under the word Azasite on this site. There are some long threads with lots of posts. Some people like it, some people like it and then stop liking it, and some people hate it.

Yes, I read most of the posts including yours. I saw that you had some success with it early on but then your eyes became red.

I mainly started this thread because of the actual documentation of a trial specifically for MGD/bleph. Supposedly, if the rumors are true about a phase 4, AzaSite may be produced specifically for MGD/bleph patients.

I wonder if the reason you had irritation was because of the BAK.

[NYer]

No, I had no success...just irritation. The first day I put it in I had no stinging or anything from instilling the drops, but there was no benefit to my eyes. Then after the second day, my eyes just got really sore and dry and burned.

It wasn't from the BAK. I don't have a reaction to that in other meds.

[Meebo]

No, I had no success...just irritation. The first day I put it in I had no stinging or anything from instilling the drops, but there was no benefit to my eyes. Then after the second day, my eyes just got really sore and dry and burned.

It wasn't from the BAK. I don't have a reaction to that in other meds.

Ahh, gotcha. I hope AzaSite isn't a solution for only those with MGD due to the global issue of blepharitis and does nothing for those with MGD due to ocular rosacea.

After reading, reading and more reading I have somewhat understood the difference and/or relationship between MGD and blepharitis. If I am wrong et me know, but it seems that posterior bleph, or lid margin disease is basically bleph/MGD combo. This would be lid margin disease.

MGD, however, can stand by itself, which i believe it does with me since I have no external symptoms associated with bleph at all (visual inflmmation, crusting.) I have redness and dryness in morning that goes away, a TBUT of 3, and barely any excretion at all when expressing, but glands appear open. I do have ocular rosacea which is suppoesdly the cause of my MGD, and in this case basically have meibomitis or MGD and not bleph.

I am gonna give AzaSite a shot and see what happens. I will definitely report back.

I am also waiting on hearing from people that saw Dr. Gilwit in Florida ("patented gland expression procedure") and I am awaiting contact from Dr. Toyos who is known for spearheading IPL treatments for rosacea induced MGD patients.

KEEP THE FAITH!

[AdrianS]

Meebo:

Did you try the Azasite? What did it do?

did you contact the practitioners of IPL and the doctor about the MGD treatments?

I would love to hear what you have learned!

Adrian

[NYer]

Adrian, if you want an idea of people's responses to Azasite, do a search on this site using the word "Azasite". There have been lots of posts on it. Personally, I had a very bad experience with it. Some people liked it for a while and then it stopped helping. I haven't heard of anyone who was helped immensely by it, nor helped for a long period of time.

[Teri]

NYer is right: there have been a lot of posts on here about Azasite.

I just wanted to throw my two cents in...I have posterior blepharitits and Azssite has helped me immensely. The first time I used it (nightly, for one month), it got my blepharitis under control. (The improvement did not occur until about three weeks in....)

I have used Azasite twice this year, about six months apart, each time for one month, and both times I have experienced a noticeable improvement in my symptoms.

And while my symptoms have fluctuated since the first time I used it, my eyes have not returned to their miserable pre-Azasite state.

It seems to help some people and not others, but my personal opinion is that it is worth a try.

Teri

[Philipp_from_Germany]

In my experience, Azasite helps with blepharitis but does nothing for the MGD itself...

One could also use other existing anti-inflammatory agents ahort term such as Lotemax to calm down the eyelids so I do not really think there's something special about Azasite at all.

Of course, now they are trying to get it approved for posterior blepharitis as well because they wanna make more cash out of it (and out of the desperate longing of dry eye folks to get a drug with an indication for that condition). What's interesting is that Azasite Plus will also have a steroid compound in it...

Note that Azasite is not indicated for MGD and probably never will be...

[Meebo]

NYer is right: there have been a lot of posts on here about Azasite.

I just wanted to throw my two cents in...I have posterior blepharitits and Azssite has helped me immensely. The first time I used it (nightly, for one month), it got my blepharitis under control. (The improvement did not occur until about three weeks in....)

I have used Azasite twice this year, about six months apart, each time for one month, and both times I have experienced a noticeable improvement in my symptoms.

And while my symptoms have fluctuated since the first time I used it, my eyes have not returned to their miserable pre-Azasite state.

It seems to help some people and not others, but my personal opinion is that it is worth a try.

Teri

Well i has almost been a month experimenting with Azasite. I must also state I am taking oracea, but I am not sure what that is doing for my condition. It is also important to specificaly state my condition. I have ocular rosacea which apparently has caused my MGD, this can also be called posterior bleph, however, I do not show clogged glands and heat treatment really doesnt do anytin for me. There is no crusting, just a lack in the production of oil.

For the first two weeks I felt as if I was cured, literally. My eyes were so white I could not believe it and they felt like a million bucks. After two weeks, my eyes began to bother me a lot. I was told to increase to 2 drops a day again. Today yesterday and today are two days I stopped taking it altogether. For some odd reason, I feel better now, not taking it, than i did after the two weeks of taking it.

I have been analyzing this very closely and did notice actual droplets of oil on my lid margins during my first two weeks. I do manual expressions every night with a qtip and it has been helping.

I supplement with lovaza fish oil, multi vitamins, two grams of vit C, and recently, l-acetylcysteine/glutithione (search about it)

Once in a while i will pop some drops of pataday in (for eye allergies) and it seems to reduce redness. It would be interesting to see if it is an extreme ongoing alergy that is causing this, a direct influence of the ocular rosacea, or an overall fluctuation of body inflammation. For those of you that have looked into alternative medicine, the chinese believe in yin and yang levels of body heat. Would be interesting if a VERY specific diet were to eliminate all conditions.

I guess we will now see what happens after stopping the azasite and i will continue with everything else. I am also very interested in laser therapy for the face, but i will not pursue this for a while.

[Meebo]

In my experience, Azasite helps with blepharitis but does nothing for the MGD itself...

One could also use other existing anti-inflammatory agents ahort term such as Lotemax to calm down the eyelids so I do not really think there's something special about Azasite at all.

Of course, now they are trying to get it approved for posterior blepharitis as well because they wanna make more cash out of it (and out of the desperate longing of dry eye folks to get a drug with an indication for that condition). What's interesting is that Azasite Plus will also have a steroid compound in it...

Note that Azasite is not indicated for MGD and probably never will be...

It has shown that Azasite directly affects the gland's ability to produce oil.

Lotemax is usually only used during and when the eye(s) are nearing a keratitis state or extreme inflammation. Also, lotemax has no direct benefit to bleph or MGD, not to mention it is not safe at all for long term use due to increase in ocular pressure and risk of cateracts. With that said i find it very interesting that you have fund some evidence that the new one may contain a steroid. If this is in fact true then that means they are not planning to have it used for more than a month or couple of weeks at a time.

[NYer]

Lotemax is usually only used during and when the eye(s) are nearing a keratitis state or extreme inflammation.

Nope. Dr. Latkany prescribes this at the drop of a hat. He prescribes it to take in conjunction with Restatis. He prescribed it to me when my eyes when I had a sty. (I didn't take it in either situation. I didn't use the Restatis either.)

ocular rosacea which apparently has caused my MGD, this can also be called posterior bleph

Nope. Ocular rosacea and bleph are two entirely different conditions, although you can certainly have them both at the same time.

...Azasite directly affects the gland's ability to produce oil.

Nope. (Sorry, Meebo, I'm not trying to jump all over you. )
Azasite is an antibiotic that has been shown to have anti-inflammatory properties for some people. It has no direct affect on oil production whatsoever. In the event that it helps inflammation, the idea is that it reduces the inflammation in the eyes, which, in turn, eases off on the glands, giving the warm compresses / expressing a chance to actually start working.

That said, NONE of the above (azasite, compresses, expressing) has done anything for me. My blepharitis is better since I am very careful about cleaning the lids/lashes all the time. But that has had no effect on the MGD or rosacea.

I, like you, do think that there is a strong allergic component somehow involved. I absolutely thing there is some sort of overall systemic issue. Don't know what yet, though.

[Meebo]

Nope. Dr. Latkany prescribes this at the drop of a hat. He prescribes it to take in conjunction with Restatis. He prescribed it to me when my eyes when I had a sty. (I didn't take it in either situation. I didn't use the Restatis either.)

I am not going to speak for Dr. Latkany, but I will assure you he does not prescribe lotemax at a "drop of a hat" unless he feels it is imperative you take it.

He is not a fan of steroids in general as long term treatment and has expresed his continual concern over the side effects of long term steroid use.

While I understand it would seem like a drop of a hat in regard to your examples, but prescribing lotemax in conjunction with restasis is common protocol when prepping a patient for restasis use.

Nope. Ocular rosacea and bleph are two entirely different conditions, although you can certainly have them both at the same time.

I will give you the benefit of the doubt that you misunderstood my comment.

MGD is very common in ocular rosacea patients, and yes, I am aware you can have both at the same time as I am an example of such.

Furthermore, my comment was to inform that MGD is also referred to as posterior blepharitis, just another name for lid margin disease.

Unfortunately, the "bleph umbrella" makes it very confusing for many describing the specific condition they have due to various symptoms that come along with such disease.

Nope. (Sorry, Meebo, I'm not trying to jump all over you. )
Azasite is an antibiotic that has been shown to have anti-inflammatory properties for some people. It has no direct affect on oil production whatsoever. In the event that it helps inflammation, the idea is that it reduces the inflammation in the eyes, which, in turn, eases off on the glands, giving the warm compresses / expressing a chance to actually start working.

Yup. I recommend doing a bit more research on this topic. I will say that the topic has been evolving so I understand how come information hasnt been digested yet.

Study's show Azasite has a DIRECT affect on the meibomian gland's ability to produce lipid and increase the quality and quantity of secretion, in addition to acting as an anti-inflammatory.

This is why there has been great success with MGD patients that show signs of rosacea.

Unfortunately, azasite may not make sense for long term use and the trials that are taking place include a steroid component.

It will be interesting to see how the azasite story pans out.

http://http://www.eyeworld.org/article.php?sid=4650

I, like you, do think that there is a strong allergic component somehow involved. I absolutely thing there is some sort of overall systemic issue. Don't know what yet, though.

While I believe there may be an allergy component, I feel that the rosacea is the most likely culprit. It would be hard to believe an allergy would cause the meibomian glands to cease working.

[NYer]

I'm a long time patient of Dr. Latkany's and I still am his patient. I stand by everything I said.

He has prescribed Lotemax for a number of things for me - not serious conditions.

Blepharitis is, indeed, not MGD but one can certainly have them concurrently.

There has not been "great success with MGD with patients that show signs of rosacea." I have both of those conditions. Even Dr. Latkany will not speak for the effacacy of Azasite for either of those conditions because it hasn't been around long enough and not enough patients have used it long enough to be able to say that.

Dr. Latkany thinks that allergy is a very important factor in dry eye. I didn't think, initially, that it was such a strong factor but I'm leaning in that direction now that some people on here have seen very positive results having to do with contact allergies (rather than inhaled allergies).

[Meebo]

I'm a long time patient of Dr. Latkany's and I still am his patient. I stand by everything I said.

I am here to discuss more to find solutions and not to argue but since you have taken the time to express your thoughts on my comments, I only feel it is fair I do the same.

I do not know if it is wise to stand by everything you initially said, because some of it is inaccurrate.

He has prescribed Lotemax for a number of things for me - not serious conditions.

Maybe not serious "conditions" but most likely inflammation that was of erious nature. This would be the only reason for lotemax to be prescribed.

Blepharitis is, indeed, not MGD but one can certainly have them concurrently.

My research is much more extensive than this, including face to face discussions as well as telephone discussions with MD's who have dedicated their practices to ocular surface disease. The links below should shed adequate light on this topic.

http://www.agingeye.net/otheragingeye/blepharitis.php

http://www.steadyhealth.com/articles..._a186_f32.html

http://www.optometric.com/article.aspx?article=102028

There has not been "great success with MGD with patients that show signs of rosacea." I have both of those conditions. Even Dr. Latkany will not speak for the effacacy of Azasite for either of those conditions because it hasn't been around long enough and not enough patients have used it long enough to be able to say that.

I have to say I agree to some point. I have shown some success, however it has been short term, so we must first define "success." I am sure you will agree, and I believe, success in our cases is a long term solution. Whether a cure or methods to control causes to consistently remain comfortable, this would be the definition of true success. I have both of those conditions as well and azasite helped only short term. Again, I will not speak for any medical professional, but there were specific comments located in the article i hyperlinked showing that azasite does sound promising to doctors, to a limited extent. However, MANY patients have expressed that there was some level of success in reducing symptoms when on azasite. This is fact.

Dr. Latkany thinks that allergy is a very important factor in dry eye. I didn't think, initially, that it was such a strong factor but I'm leaning in that direction now that some people on here have seen very positive results having to do with contact allergies (rather than inhaled allergies).

I think the rosacea plays more of a role, but I do believe allergy plays a role as well. TO what extent, I have no idea at this point. I would also bet some money on food allergies as well.

Again, I, as well, am not i any way trying to jump all over either. It;s just that this condition has been frusturating and I take it serious to the point where I dedicate many hours a week researching and learning. I am not saying you do not do the same. Please interpret my comments as dedication to a cause for not only myself, but for you as well as everyone else seeking relief.