MGD - Topical Vitamin D3 Ointment

[PhoenixEyes]

The result photos and meibography images for this study look very promising!

"7 June 2017 - Clinical safety and efficacy of vitamin D3 analog ointment for treatment of obstructive meibomian gland dysfunction

The clinical scores for plugging of meibomian gland orifices and lid margin vascularity as well as BUT, meibum grade, and meibomian gland area were significantly improved after the 8-week treatment period compared with pretreatment values. Topical eyelid application of an analog of the active form of vitamin D3 was found to be safe as well as to improve the condition of patients.

Our results thus suggest that analogs of the active form of vitamin D3 may be effective for the treatment of obstructive meibomian gland dysfunction and that they warrant further investigation in clinical trials with larger numbers of patients."

https://bmcophthalmol.biomedcentral....886-017-0482-7

Patent for the vitamin D3 ointment:
https://www.google.com/patents/EP3015107A1?cl=en

[MGD1701]

Thanks! Seems it tailers to obstructive/clogged glands and does not contain oil?
Any idea when would be available in Europe?

Thanks again.

[PhoenixEyes]

Thanks! Seems it tailers to obstructive/clogged glands and does not contain oil? Any idea when would be available in Europe?

Yes blockage of glands due to hyperkeratinization. So maybe not for all forms of MGD, unless they do further testing and find it helps those who have problems with the quality of oils rather than the blockage.

Lid margin keratinization can occur with the condition I had ( Stevens Johnson Syndrome / Toxic Epidermal Necrolysis ) so this sounds promising. Though I would wanna know more about possible side effects long term. I've read in the past that taking vitamin D supplements increases calcium absorption and lead to calcification in high doses. Though this study does link to another study where they regulated calcium with Vitamin D so I guess they are aware of the correlation.

No idea regarding availability unfortunately, does it even have a brand name or marketing yet? The study was also only on a small number of people so they say it's gotta go through further studies with more people.

Some of the same researchers studied a Japanese eyelid cleanser called Eye Shampoo Long for MGD:

https://www.hindawi.com/journals/joph/2016/4292570/

That seems to be on the Japanese market and could be imported via online stores but not thrilled at the long list of ingredients.

https://global.rakuten.com/en/store/jnl/item/a0096406/

http://www.foula-store.com/After-car...l-p-15871.html

[Hokucat]

Hey PhoenixEyes, I have not had much time to post the past week or so, but wanted to tell you this research is REALLY exciting! Something applied topically and is vitamin-based I would imagine is much less expensive, invasive and uncomfortable compared to the few current options like probing (even though this did work for me), would be a major breakthrough. It could potentially help many people with plaguing blocked glands. I love the quantitative and meibography before and after images, thanks for also posting these. I am definitely going to follow the progress on this closely...probably with your help, lol!

You are so great at providing and summarizing in layman terms these potential treatments. It really gives hope that we can overcome or at least actually picture getting some material improvement in the near future. I feel like you are our resident dry eye "Siri", but we don't even have to ask, you just keep it coming :-). Sometimes I think you have a medical background, some of the write ups on research can be very technical. I know you have lots of issues related to your SJS/TENS so you do a lot of research, but thanks so much for always taking the extra time to share with and help us in this forum, it's truly invaluable! I hope we are able to help you too.

[PhoenixEyes]

Thanks Hokucat, you're so kind. I gotta credit the Facebook groups though for posting about this ointment.

Yes, I think probing isn't available on NHS here in UK and I'd be wary to do it private due to risks. So I hope this ointment will be proven to be safe and effective with further trials.

Yeah the pictures look almost too good to be true, what happened between week 4 and 8!? Of course they could have just picked out the one patient with the best results, so maybe not all will get the same level of benefit, but looks promising either way.

No medical background, I studied art and design, heh. But hoping some of these new developments will get my eyes back to clear vision without discomfort, so I can fully appreciate art and animation again. And yes the forum here is very helpful.

[PhoenixEyes]

Looking at this again, I overlooked the product brand name used was Oxarol with the main ingredient being maxacalcitol, already on the market in Japan for use on skin but don't know if the dosage is the same as the skin cream.

Earlier 2014 animal study:
http://iovs.arvojournals.org/article...icleid=2266738

[Hokucat]

That's even more promising this could be available sooner, if the Oxarol ointment product already available in Japan for other purposes was successful in this study for MGD treatment.

I suppose when they do the next study with a larger group, they could test the current Oxarol vs. different strengths, but if the current Oxarol proves effective and safe, that would be quickest to market (as another application of the product) and $$s for the pharmaceutical companies. It also looks like the maxacalcitol ingredient is available from other companies in Japan and in other countries, so that could lead to more options and availability.

Looking forward to the results of the next study, with a larger number of patients and increased observation period. This is very hopeful non-invasive treatment for those with blocked glands. Thanks for adding the Oxarol info, PhoenixEyes!

[deep_dry_eye]

My apologies if this has been linked before, but before the Japanese group published, "Clinical safety and efficacy of vitamin D3 analog ointment for treatment of obstructive meibomian gland dysfunction," 2017 [https://bmcophthalmol.biomedcentral....886-017-0482-7], a Korean group published this:

"Low Serum 25-Hydroxyvitamin D Levels Are Associated with Dry Eye Syndrome", 2016. [http://journals.plos.org/plosone/art...ype=printable]
"Vitamin D Supplementation for Patients with Dry Eye Syndrome Refractory to Conventional Treatment," 2016. [http://pubmedcentralcanada.ca/pmcc/a.../srep33083.pdf]

The first Korean paper establishes a possible link between dry eye patients and Vit D (but not zinc) -- see Table 4. If you understand the math (p-values and odds ratio) though, the correlation is very very weak. i.e., see Table 2.
The second Korean paper establishes that a shot of Vitamin D seems to help dry eye patients. However, this should not be taken too seriously as there is no control group (i.e., no placeblo group). For example, maybe the environment got better and everyone just got higher TBUTs as opposed to the Vit D did anything.

The Japanese paper also had no control group as well.

Regardless, I encourage the ppl in this forum to check their zinc, Vit D and Testosterone levels. Since Zinc + Vit D is used to make T, and T is highly correlated to dry eyes.
"Androgen deficiency, Meibomian gland dysfunction, and evaporative dry eye." [https://www.ncbi.nlm.nih.gov/pubmed/12114274]

[PhoenixEyes]

There's a home test kit you can get from an NHS lab, they also offer the service outside the UK. They send you the test kit, you post the test back and get the results via email. I tried it a long time back since Vitamin D testing was not available via my GP unless I had signs of severe deficiency (e.g. rickets).

http://vitamindtest.org.uk/

I think the Oxarol ointment used in the study is currently approved for psoriasis in Japan, which is "characterized by excessive keratin production." and they talk about hyperkeratinization, hard skin, scarring the meibomian gland ducts shut. I guess they'd have to do a study comparing the topical action of Vitamin D3 applied directly to the eyelids against a systemic Vitamin D supplement / injection for us to know which is best for obstructed meibomian glands.

I wish Oxarol was available in UK... There's a few other Vitamin D3 ointments for psoriasis but as they're not the same D3 form I'm not sure if they'll be as safe and effective for use on eyelids.
Oxarol - Maxacalcitol
Silkis - Calcitriol
Dovonex - Calcipotriol
Curatoderm - Tacalcitol

[zoso967]

Looking at this again, I overlooked the product brand name used was Oxarol with the main ingredient being maxacalcitol, already on the market in Japan for use on skin but don't know if the dosage is the same as the skin cream.

Earlier 2014 animal study:
http://iovs.arvojournals.org/article...icleid=2266738

I was able to purchase this online if you're still interested