Evaluation of Corneal Topography and Biomechanical Parameters after Use of Systemic Isotretinoin in Acne Vulgaris

Yıldırım, Yusuf; Olcucu, Onur; Ağca, Alper; Alagöz, Cengiz; Demircan, Ali; Basci, Abdurrahman; Demirok, Ahmet; Kutlubay, Zekayі

doi:10.1155/2014/701361

Cited by 15 publications

(9 citation statements)

References 21 publications

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“…These studies reported worsening of ocular surface parameters which support our result. 30,31 Treatment options for isotretinoin-associated MGD are limited and palliative to symptoms of OSD. Besides, there is no definitive method for restoration of the structure and function of damaged meibomian glands.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of omega-3 fatty acids and punctal plugs in the prevention of isotretinoin-associated ocular surface disease

Elhamaky

2020

European Journal of Ophthalmology

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Purpose: To investigate the effects of omega-3 fatty acids and punctal plugs on tear film and ocular surface parameters in patients receiving systemic isotretinoin therapy. Methods: This is a prospective randomized study that included 180 eyes of 90 patients who had systemic isotretinoin therapy (120–150 mg/kg for at least 4–6 months). Exclusion criteria: DED according to the diagnostic criteria of TFOS DEWS II. Patients were assigned into three groups; (1) O3FAs/PPs group: A soft preloaded silicone plug was inserted in the inferior punctum of both eyes and received oral O3FAs two capsules twice daily total daily dose of 1040 mg/day for 6 months. (2) PPs group: A soft preloaded silicone plug was inserted in the inferior punctum of both eyes and received oral placebo. (3) Isotretinoin group: No intervention was done. At baseline, 1 week, 1, 3, and 6 months of study, Ocular surface evaluation tests were done in following order: OSDI, tear osmolarity, Schirmer’s I test, TBUT, ocular surface staining score, and meibomian gland expression. Primary outcome measures: The changes in measurement of ocular surface evaluation tests including ocular surface disease index (OSDI), tear film breakup time (TFBUT), corneal staining, tear osmolarity, and meibomian gland expression at 6 months. Results: There are significant changes between all groups at 6 months follow-up. The ocular surface parameters were better for the PPs and O3FAs/PPs groups than the isotretinoin group. The isotretinoin group showed worsening of ocular surface parameters including a significant decrease of FTBUT and an increase of OSDI score, corneal staining score, tear osmolarity, and meibomian expression score. There was no significant difference in ST1 throughout the whole study in all groups. At 6 months follow-up, there were no statistically significant differences between PPs and O3FAs/PPs groups except meibomian expression score which showed a significant increase in PPs group. Conclusion: Our cohort highlights the beneficial effects of the combination of O3FAs supplementation with PPs in the prevention of isotretinoin-associated OSD in this sample study.

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Section: Discussionmentioning

confidence: 99%

Efficacy of omega-3 fatty acids and punctal plugs in the prevention of isotretinoin-associated ocular surface disease

Elhamaky

2020

European Journal of Ophthalmology

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“… 5 Yildirim et al 2014 stated that corneal biomechanics (diameter and refractive index) did not change; however, changes in the tear film had affected the corneal surface. 6 …”

Section: Introductionmentioning

confidence: 99%

“…5 Yildirim et al 2014 stated that corneal biomechanics (diameter and refractive index) did not change; however, changes in the tear film had affected the corneal surface. 6 Ruiz-Lozano et al 2020 reported photophobia, corneal opacities, keratitis, refractive visual disturbances (day/ night vision disturbances), color vision impairment, and papilledema as rare adverse reactions. 4 There is a difference between the dermatological and the ophthalmological perceptions of isotretinoin.…”

Section: Introductionmentioning

confidence: 99%

Dermatologists’ Knowledge and Attitude Toward Isotretinoin Ocular Side Effects in Egypt

ELShafie¹,

Srour²,

el-Ansarey³

et al. 2021

CCID

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Aim The FDA approved isotretinoin for moderate and severe nodulo-cystic acne, in which it proved effective. However, this misled the dermatologists into using isotretinoin for mild cases as well. This misuse increased the risk of developing adverse effects, especially on the ocular system. These adverse effects vary from mild reversible eye dryness to severe irreversible loss of night vision. Also, it causes contact lens intolerance and corneal ulcer on top. Both ophthalmologists and dermatologists have different perceptions of the drug. Purpose To evaluate dermatologists’ knowledge and attitude toward ocular adverse effects of isotretinoin in Egypt. Methods This cross-sectional study was conducted via an online questionnaire. The questionnaire had three parts: 1) demographic data, 2) knowledge about isotretinoin dry eye disorders, contact lens intolerance, and refractive surgery precautions and 3) dermatologists’ management of a case on isotretinoin therapy. We contacted 111 participants from Facebook dermatologists’ groups between March and April 2021. Results We surveyed 111 dermatologists. One hundred and five (94.6%) reported their knowledge about ocular side effects. One hundred of them (90.1%) informed their patients about the drug’s adverse effects. Eighty-three (74.8%) reported their knowledge about contact lens intolerance. Forty-one dermatologists (36.9%) screened their patients for recent refractive surgery before isotretinoin therapy. Nearly, all dermatologists routinely prescribed lubricant eye drops for the patients, and 63 (56.8%) dermatologists sometimes referred their patients to an ophthalmologist. We found an association between knowledge about contact lens intolerance and years of experience ( p =0.012). As well, we found that the academic degree of dermatologists is directly proportional with warning patients about ocular side effects ( p =0.003) and refractive surgery ( p =0.039). Conclusion Egyptian dermatologists were knowledgeable about the effects of isotretinoin on eyes with inappropriate clinical practice.

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“… 12 Isotretinoin is now widely used for the treatment of acne. 13 Acne is a common skin inflammatory condition 14 , 15 affecting approximately 9.4% of the world's population, making it the 8th most common disease worldwide. 16 Different treatments have been proposed for different severities of acne.…”

Section: Introductionmentioning

confidence: 99%

“… 23 There are reports of the effect of this medication on dry eye, 10 meibomian glands, 13 conjunctival goblet cells, 20 visual acuity, 22 retina, 24 intraocular pressure, 25 color vision, 26 and corneal topographic and biomechanical properties. 14 …”

Section: Introductionmentioning

confidence: 99%

Evaluation of the effects of isotretinoin for treatment of acne on corneal sensitivity

Fouladgar

Khabazkhoob

Hanifnia

et al. 2018

Journal of Current Ophthalmology

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PurposeTo determine the effect of isotretinoin on corneal sensitivity in acne patients.MethodsFifty patients (13 men and 37 women) with a mean age of 23.24 ± 3.4 years were selected among patients receiving isotretinoin (1.0 mg/kg) for acne according to inclusion criteria. The Cochet-Bonnet esthesiometer was used to measure corneal sensitivity (in mm filament length) two times (the measurements were done immediately before starting the medication, then 3 months after that), including 3 measurements each time, between 11 a.m. and 1 p.m. by an experienced operator. The average of the 3 measurements in each time was recorded as the final value. One-way analysis of variance and Chi square were used for quantitative and qualitative comparison of corneal sensitivity before and after isotretinoin use, respectively.ResultsThe mean corneal sensitivity was 5.54 ± 0.05 before medication consumption which decreased to 5.41 ± 0.05 after isotretinoin treatment for 3 months (P < 0.005). After controlling the effect of age and sex, the decrease of corneal sensitivity was markedly significant (P = 0.003) as decreased corneal sensitivity was more pronounced at higher ages and in female gender. In non-parametric evaluation, corneal sensitivity was categorized as substantial (5.5–6 mm), intermediate (4.5–5.5 mm), and low (3.5–4.5). About 72% of the participants had substantial corneal sensitivity before drug consumption, which decreased to 60% after 3 months of treatment.ConclusionsAccording to the results of this study, corneal sensitivity decreases after three months of treatment with isotretinoin. This decrease is more pronounced at higher ages and in women.

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Evaluation of Corneal Topography and Biomechanical Parameters after Use of Systemic Isotretinoin in Acne Vulgaris

Cited by 15 publications

References 21 publications

Efficacy of omega-3 fatty acids and punctal plugs in the prevention of isotretinoin-associated ocular surface disease

Efficacy of omega-3 fatty acids and punctal plugs in the prevention of isotretinoin-associated ocular surface disease

Dermatologists’ Knowledge and Attitude Toward Isotretinoin Ocular Side Effects in Egypt

Evaluation of the effects of isotretinoin for treatment of acne on corneal sensitivity

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