Tear secretion and lacrimal gland function of rabbits treated with isotretinoin

Rismondo, Vivian; Ubels, John L.; Osgood, Thomas B.

doi:10.1016/s0190-9622(88)70172-3

Cited by 17 publications

(8 citation statements)

References 7 publications

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“…However, they concluded that it is not toxic to the lacrimal gland per se, but its presence in the tear fluid may be related in part to its adverse ocular side effects. 15,16 The decrease in mean Schirmer I value during oral isotretinoin therapy in this study and in the study by Karalezli A et al 11 could be due to the alteration in basal tear secretion by the presence of isotretinoin and its metabolites in the tear film.…”

Section: Discussionsupporting

confidence: 54%

Association of dry eye syndrome with oral Isotretinoin therapy for severe nodulocystic acne and recalcitrant acne vulgaris

Amatya

Sharma

Karn

et al. 2015

J Patan Acad Health Sci

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Introduction: Oral isotretinoin was registered in Nepal almost three decades later its first introduction in USA. It remains the most clinically effective medication for acne. Dry eye syndrome is a ‘certain’ adverse effect of oral isotretinoin therapy which can be validated by tear film break up time and Schirmer I tests.Methods: Fifty patients aged above 12 years presenting to dermatology outpatient department of Dhulikhel Hospital with severe nodulocystic acne or recalcitrant acne vulgaris not responding to three months of systemic antibiotics along with topical agents were included. Tear film break up time and Schirmer I tests before, at 45 and 90 days, and one month after taking oral isotretinoin were performed to study association of dry eye syndrome due to oral isotretinoin.Results: Both eyes of fifty selected patients were sampled. Baseline mean tear film break up time of 12.37±4.17 sec decreased to 9.69±3.70 sec, 9.09±3.77 sec and 10.67±3.50 sec at 45 and 90 days and on follow up, respectively. Likewise, baseline mean Schirmer I value of 16.68±8.73 mm decreased to 12.26±7.64 mm, 11.49±8.07 mm and 11.76±8.11 mm respectively at 45 and 90 days and on follow up. The differences between the mean values were analyzed using paired samples T test and all were statistically significant except between the mean Schirmer values at 90 days and on follow up.Conclusions: Abnormal mean tear break up time at 45 and 90 days in this study suggests that dry eye syndrome was caused by oral isotretinoin during acne therapy but tends to revert to normal on cessation.Journal of Patan Academy of Health Sciences, Vol. 2, No. 1, 2015. page:12-16

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Section: Discussionsupporting

confidence: 54%

Association of dry eye syndrome with oral Isotretinoin therapy for severe nodulocystic acne and recalcitrant acne vulgaris

Amatya

Sharma

Karn

et al. 2015

J Patan Acad Health Sci

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“…In addition to denervation methodology described in the preceding sections, the effect of muscarinic antagonists suggests a major role for parasympathetic nerves in stimulation of lacrimal gland secretion as systemic administration of the muscarinic cholinergic antagonist scopolamine produces dry eye in mice that is exacerbated by a dessicating environment (Dursun, Wang et al 2002). Intraarterial or intraperitoneal systemic administration of acetylcholine, pilocarpine, or other cholinergic agonists stimulates lacrimal gland protein and fluid secretion measured from the cannulated lacrimal gland excretory duct of anesthetized rabbits (Dartt and Botelho 1979; Dartt, Knox et al 1980; Dartt, Moller et al 1981; Ubels, Foley et al 1986; Rismondo and Ubels 1987; Rismondo, Ubels et al 1988; Ubels, Rismondo et al 1989). Incubation of lacrimal gland pieces or acini with the cholinergic agonist carbachol stimulates protein secretion measured by peroxidase secretion from rat and mouse (Herzog, Sies et al 1976; Dartt, Baker et al 1984; Dartt, Donowitz et al 1984), and β-hexosaminidase secretion from rabbit (Andersson Exp Eye Res 1081-1088-2006).…”

Section: Neural Stimulation Of Lacrimal Gland Secretion- Cholinergmentioning

confidence: 99%

Neural regulation of lacrimal gland secretory processes: Relevance in dry eye diseases

Dartt

2009

Progress in Retinal and Eye Research

399

370

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The lacrimal gland is the major contributor to the aqueous layer of the tear film which consists of water, electrolytes and proteins. The amount and composition of this layer is critical for the health, maintenance, and protection of the cells of the cornea and conjunctiva (the ocular surface). Small changes in the concentration of tear electrolytes have been correlated with dry eye syndrome. While the mechanisms of secretion of water, electrolytes and proteins from the lacrimal gland differ, all three are under tight neural control. This allows for a rapid response to meet the needs of the cells of the ocular surface in response to environmental conditions. The neural response consists of the activation of the afferent sensory nerves in the cornea and conjunctiva to stimulate efferent parasympathetic and sympathetic nerves that innervate the lacrimal gland. Neurotransmitters are released from the stimulated parasympathetic and sympathetic nerves that cause secretion of water, electrolytes, and proteins from the lacrimal gland and onto the ocular surface. This review focuses on the neural regulation of lacrimal gland secretion under normal and dry eye conditions.

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“…When administered to rabbits over 5 months using a dosage 5 to 10 times higher than that used clinically, there was no significant change in tear secretion measured using the Schirmer test compared with the untreated control group. 13 Additionally, histologic analysis showed no significant alterations in morphology of the lacrimal gland in treated and untreated rabbits. This further indicates that ocular dryness associated with isotretinoin use is dependent on pathologic changes of the meibomian glands, rather than reduced lacrimal gland function.…”

Section: Animal Studies Demonstrating Isotretinoin's Effects On Tear mentioning

confidence: 88%

“…This further indicates that ocular dryness associated with isotretinoin use is dependent on pathologic changes of the meibomian glands, rather than reduced lacrimal gland function. 13…”

Section: Animal Studies Demonstrating Isotretinoin's Effects On Tear mentioning

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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Tear secretion and lacrimal gland function of rabbits treated with isotretinoin

Cited by 17 publications

References 7 publications

Association of dry eye syndrome with oral Isotretinoin therapy for severe nodulocystic acne and recalcitrant acne vulgaris

Association of dry eye syndrome with oral Isotretinoin therapy for severe nodulocystic acne and recalcitrant acne vulgaris

Neural regulation of lacrimal gland secretory processes: Relevance in dry eye diseases

Effects of Isotretinoin on Meibomian Glands

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