Conjunctival Impression Cytology, Ocular Surface, and Tear-Film Changes in Patients Treated With Systemic Isotretinoin

Karalezlı, Aylin; Borazan, Mehmet; Altınörs, Dilek Dursun; Dursun, Recep; Kiyici, Halil; Akova, Yonca A.

doi:10.1097/ico.0b013e318183a396

Cited by 54 publications

(40 citation statements)

References 27 publications

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“…RA causes keratinization and thickening of the meibomian gland ducts (Lambert and Smith 1989), degeneration and necrosis of the acinar cells (Kremer and others 1994), fibrosis of the periacinar tissue, and reduced lipid content in meibomian gland (Lambert and Smith 1989). Further, isotretinoin exposure is associated with tear film instability and hyperosmolarity, dry eye symptoms and blepharitis (Bozkurt and others 2002; Fraunfelder 2004; Karalezli and others 2009; Santodomingo-Rubido and others 2008). In effect, RA promotes MGD and evaporative dry eye disease (Knop and others 2011).…”

Section: Anti-aging Treatment- Potential Influence On Mgd and Dry Eyementioning

confidence: 99%

Aging and dry eye disease

Ding

Sullivan

2012

Experimental Gerontology

134

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Dry eye disease is a prevalent eye disorder that in particular affects the elderly population. One of the major causes of dry eye, meibomian gland dysfunction (MGD), shows increased prevalence with aging. MGD is caused by hyperkeratinization of the ductal epithelium of meibomian gland and reduced quantity and/or quality of meibum, the holocrine product that stabilizes and prevents the evaporation of the tear film. Of note, retinoids which are used in current anti-aging cosmetics may promote the development of MGD and dry eye disease. In this review, we will discuss the possible mechanisms of age-related MGD.

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Section: Anti-aging Treatment- Potential Influence On Mgd and Dry Eyementioning

confidence: 99%

Aging and dry eye disease

Ding

Sullivan

2012

Experimental Gerontology

134

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“…Karalezli et al (14) observed blepharitis in 36 % of patients 1 month after the cessation of treatment. It was accompanied by dysfunction of meibomian glands, hyperemia and vascularization of the lid margin.…”

Section: Adverse Ocular Effectsmentioning

confidence: 99%

“…In our opinion, this might be assumed as an indirect effect of retinoid acid whereas direct action should also be taken into consideration. It is caused by the presence of the drug and its metabolites in the tear film (14), which may directly provoke its instability, hence dryness and irritation. We emphasize that both of these mechanisms are predis- .…”

Section: Adverse Ocular Effectsmentioning

confidence: 99%

“…The list of side effects is long but, in our experience, the most common ocular adverse effects are the dry eye syndrome and blepharoconjunctivitis. They occur in 20-50 % of patients taking the drug, usually 3-5 weeks after initiation of the therapy (2,14). Dry eye is caused by atrophic changes in meibomian glands (15,16) as well as modification of the tear film composition (15).…”

Section: Adverse Ocular Effectsmentioning

confidence: 99%

“…Karalezli et al (14) conducted a prospective clinical study examining 50 patients treated with isotretinoin at a daily dose of 0.8 mg kg -1 . The patients underwent a full ophthalmologic examination before treatment, during treatment (on the 30 th and 120 th day), at the end of treatment, and 30 days after the treatment.…”

Section: Adverse Ocular Effectsmentioning

confidence: 99%

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Side effects of retinoid therapy on the quality of vision

Bergler‐Czop

Bilewicz-Stebel²,

Stańkowska³

et al. 2016

Acta Pharmaceutica

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Retinoids are compounds chemically related to vitamin A, which are frequently used in dermatological practice (1). They are characterized by numerous mechanisms of action leading to normalization of keratinocyte proliferation and maturation. They have anti-seborrhoeic, immunomodulatory and anti-inflammatory effects (1, 2). A number of side effects to retinoid treatment have been recorded; one group of such side effects relates to eyes and vision. Dry eye syndrome and blepharoconjunctivitis are the most common side effects, appearing in 20-50 % of patients treated with retinoids. They often contribute to the occurrence of other side-effects such as eye discomfort and contact lens intolerance. Due to the widespread use in clinical practice, the adverse effects, including ocular side effects, should be studied. To confirm the variety of adverse effects of retinoids, several case reports of rare side-effects are presented.

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Retinoids

Dawson¹

2010

Burger's Medicinal Chemistry and Drug Discovery

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Retinoid drugs find major applications in the topical treatment of cutaneous proliferative disorders such as acne, psoriasis, and photoaging and cutaneous cancers such as cutaneous T‐cell lymphoma (CTCL) and Kaposi's sarcoma. Oral retinoids are successfully used to treat nodular/cystic acne, systemic CTCL, and acute promyelocytic leukemia. This overview of available retinoid drugs and those in the preclinical or clinical pipeline covers their development, indications, clinical trial results, adverse effects, and pharmacology/metabolism. Retinoids have been described historically and functionally in the context of interaction with their nuclear receptors—retinoic acid receptors (RARs) and retinoid X receptors (RXRs)—in inducing gene transcription. RAR‐selective retinoids or their prodrugs include first‐generation all‐ trans ‐retinoic acid (tretinoin) and its 13‐ cis isomer (isotretinoin), and second‐generation acitretin and its ethyl ester (etretinate), both having an aromatic 2,3,6‐trimethyl‐4‐methoxyphenyl terminus. Third‐generation more aromatic analogs include ethyl ester tazarotene (Tazorac®) and adapalene (Differin®), both selective for RAR subtypes β and γ, and RARα‐selective pipeline candidates Am80 and NRX 195183, which are in clinical trials. RAR and RXR transcriptional panagonist 9‐ cis ‐retinoic acid is next and is followed by RXR‐selective bexarotene (Targretin™) and two RXR‐selective clinical trial candidates, 9cUAB and NRX 194204. The fourth generation includes three compounds that may have applications in the treatment or prevention of cancer. While originally considered as retinoids, such as N ‐(4‐hydroxyphenyl) retinamide, or as retinoid‐related or derived, such as ST1926 (AHPC) and SHetA2, they subsequently were found to function independently of the RARs and RXRs in inhibiting cancer cell proliferation and inducing apoptosis.

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Conjunctival Impression Cytology, Ocular Surface, and Tear-Film Changes in Patients Treated With Systemic Isotretinoin

Abstract: Conjunctival epithelial cells, tear basal secretion, and tear quality are markedly affected in patients during systemic treatment with isotretinoin (0.8 mg/kg). Ocular adverse effects of isotretinoin are generally not serious and are reversible after discontinuation.

Cited by 54 publications

References 27 publications

Aging and dry eye disease

Aging and dry eye disease

Side effects of retinoid therapy on the quality of vision

Retinoids

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