Ocular Side Effects Associated with Systemic Isotretinoin

Öner, Ayşe; Ferahbaş, Ayten; Karaküçük, Sarper; Utaş, Serap; Karaman, Berrin; Kutlugun, Caner; Somdas, Mehmet Akıf; Mirza, Ertugrul

doi:10.1081/cus-200035368

Cited by 12 publications

(9 citation statements)

References 10 publications

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“…Önceki çalışmalara bakıldığında bu GKZ'ndaki azalmanın 1-1.5 ay civarında başladığı, 3-4. aylarda da sürdüğü, anormal GKZ saptanan hasta oranının ise %28,5 ile %69 arasında değiştiği görülmektedir. 10,11,13,14 Bizim çalışmamızda tedavinin 3. ayında hastaların %90'ında GKZ 10sn'nin altında ölçülmüştür. Tedavi öncesi GKZ değerlerine bakıldığında, hastalarımızın %86'sında GKZ'nın 10 sn'nin altında olduğu ve isotretinoin tedavisi başlanmadan önce de kuru göz tablosunun bulunduğu görülmektedir.…”

Section: Discussionunclassified

Sistemik İsotretinoin Tedavisi Alan Hastalarda Gözyaşı ve Oküler Yüzey Değişiklikleri

Çetin¹,

Şanlı²,

Bir³

et al. 2013

tjo

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Bu çalışmadaki amacımız sistemik isotretinoin tedavisi alan akne vulgaris hastalarında gözyaşı tabakası ve oküler yüzey değişikliklerinin araştırılmasıdır. Ge reç ve Yön tem: Prospektif olarak gerçekleştirilen bu çalışmaya oral isotretinoin (roaccutane ® , 0,7 mg/kg/gün) tedavisi başlanan 22 nodüler akne vulgaris hastasının 22 gözü dahil edildi. Tedavi öncesinde, tedavinin 3. ve 6. ayında, gözyaşı filmi kırılma zamanı (GKZ), anestezili Schirmer 1 testi, oküler yüzey hastalık indeksi (OYHI) ve konjonktival impresyon sitolojisi skorları kaydedildi. Sonuçlar: Tedavinin 3. ayında GKZ değerlerinde azalma ve OYHI skorlarında artış saptandı (p=0,007 ve p=0,018, eşleştirilmiş t testi). Schirmer skorlarında ise anlamlı bir değişiklik görülmedi. İmpresyon sitoloji örneği bulunan 9 hastanın 4'ünde tedavi öncesinde normal konjonktiva bulguları saptandı. Tedavinin 3. ayında, Goblet hücrelerinde azalmayı gösteren skor artışı izlendi ve 6. ayda hiçbir hastada normal konjonktiva bulgularının bulunmadığı görüldü (p=0,004, Friedman testi). Tar t›fl ma: Sistemik isotretinoin tedavisi gözyaşı filminde değişikliklere ve kuru göz semptomlarına yol açmaktadır.

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Section: Discussionunclassified

Sistemik İsotretinoin Tedavisi Alan Hastalarda Gözyaşı ve Oküler Yüzey Değişiklikleri

Çetin¹,

Şanlı²,

Bir³

et al. 2013

tjo

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“…After 1 month of discontinuing isotretinoin, conjunctival flora went back to normal levels. 18 Oner et al 20 also found an increase in Staphylococcus in subjects on isotretinoin. Staphylococcus was cultured in 22% of subjects before isotretinoin therapy and this increased to 36% during therapy.…”

Section: Clinical Studies Demonstrating Isotretinoin's Effects On Thementioning

confidence: 90%

“…15,17,19 However, there are several reports of keratoconjunctivitis sicca that persists for several years after isotretinoin therapy. 20,21 For example, in a retrospective study, Fraunfelder et al 22 found 16 cases among 1741 subjects (1%) with irreversible keratoconjunctivitis sicca. Prospective studies that delineate the prevalence of long-term damage to meibomian glands after isotretinoin therapy and potential predictors or risk factors are unavailable.…”

Section: Clinical Studies Demonstrating Isotretinoin's Effects On Thementioning

confidence: 99%

Effects of Isotretinoin on Meibomian Glands

Moy¹,

McNamara²,

Lin³

2015

Optometry and Vision Science

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The authors have reviewed the potential etiology and long-standing consequences of isotretinoin use in the development of dry eye symptoms in the absence of significant clinical findings. Despite the normal appearance of meibomian gland structure on meibography and minimal signs of eyelid margin inflammation, the secretory function of these glands is reduced and symptoms of dryness can greatly impact a patient's quality of life. The available literature indicates that isotretinoin's effect on the meibomian glands likely mimics its effects on the sebaceous glands of the skin in the treatment of acne. Several representative cases seen at the University of California Berkeley School of Optometry Dry Eye Clinic provide a clinical paradigm with the goal of raising awareness of the potential prevalence of this disease in patients who experience symptoms of dry eye. These cases highlight the importance of meibomian gland expression in determining whether there is poor quality and/or quantity of meibum secondary to reduced gland function. Currently, there is no definitive method to restore the structure and function of damaged meibomian glands; thus, treatment options for isotretinoin-associated meibomian gland dysfunction are primarily palliative to manage patient symptoms.

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“…The few prospective studies [7][8][9][10] on AEs of isotretinoin use in patients with acne were based on small cohorts (Ͻ55). The most frequent AEs in these studies were blepharitis and conjunctivitis, and the primary associated finding was marked pathologic decrease in the breakup time.…”

mentioning

confidence: 99%

Ocular Adverse Effects of Systemic Treatment With Isotretinoin

Neudorfer¹,

Goldshtein²,

Shamai‐Lubovitz³

et al. 2012

Arch Dermatol

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The study was conducted using the electronic medical databases of a large health maintenance organization in Israel. Patients: The study population consisted of 14 682 adolescents and young adults who were new users of isotretinoin for acne and 2 age-and sex-matched comparison groups (isotretinoin-naive patients with acne and acnefree patients). Main Outcome Measures: Ocular adverse effects (AEs) or purchases of ophthalmic medications within 1 year after the first dispensed isotretinoin prescription. Results: In total, 13.8% of the isotretinoin group experienced ocular AEs vs 9.6% of the isotretinoin-naive group and 7.1% of the acne-free group. During a 1-year follow-up period, the isotretinoin group had significantly higher risk for any ocular AEs (hazard ratio, 1.70; P Ͻ .001) compared with the acne-free group. No such increased risk was observed for the isotretinoin-naive group. The isotretinoin group had higher relative risks for inflammatory and structural AEs. Conclusion: Isotretinoin use may be associated with short-term ocular events, especially conjunctivitis, underscoring the importance of educating patients and caregivers about these potentially important AEs of the therapy.

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Ocular Side Effects Associated with Systemic Isotretinoin

Cited by 12 publications

References 10 publications

Sistemik İsotretinoin Tedavisi Alan Hastalarda Gözyaşı ve Oküler Yüzey Değişiklikleri

Sistemik İsotretinoin Tedavisi Alan Hastalarda Gözyaşı ve Oküler Yüzey Değişiklikleri

Effects of Isotretinoin on Meibomian Glands

Ocular Adverse Effects of Systemic Treatment With Isotretinoin

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