Conjunctival impression cytology, ocular surface, and tear-film changes in patients treated with systemic isotretinoin.
OBJECTIVE
To evaluate the ocular surface changes and tear-film functions in patients treated with systemic isotretinoin.


METHODS
Fifty subjects treated with 0.8 mg/kg oral isotretinoin were enrolled in this prospective clinical trial. All patients underwent a full ophthalmoscopic examination before, during, and after treatment with isotretinoin. Ocular surface changes of the cell content of the surface conjunctival epithelium were evaluated by conjunctival impression cytology and tear-film functions using the Schirmer test, anesthetized Schirmer test, tear breakup time, and rose bengal staining. Subjective ocular complaints were scored with an Ocular Surface Disease Index questionnaire.


RESULTS
There were no significant differences observed in average Schirmer test scores for patients before, during, or after isotretinoin treatment. Mean anesthetized Schirmer test scores and tear breakup time decreased significantly during treatment (P < 0.001). Mean impression cytology scores, Ocular Surface Disease Index scores, and rose bengal staining scores increased significantly during treatment (P < 0.05, P < 0.001 and P < 0.001, respectively). Blepharitis was seen in 36% of patients. All abnormal findings disappeared 1 month after the cessation of treatment.


CONCLUSIONS
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.
Karalezli
Aylin
A
Department of Ophthalmology, Pathology and Dermatology, Baskent University School of Medicine, Ankara, Turkey. akaralezli@yahoo.com
Borazan
Mehmet
M
Altinors
Dilek D
DD
Dursun
Recep
R
Kiyici
Halil
H
Akova
Yonca A
YA
D000152:Acne Vulgaris / Q000188:drug therapy*; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D001762:Blepharitis / Q000139:chemically induced / Q000453:epidemiology; D003228:Conjunctiva / Q000187:drug effects / Q000473:pathology*; D003879:Dermatologic Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D004847:Epithelial Cells / Q000187:drug effects / Q000473:pathology; D005123:Eye / Q000187:drug effects / Q000473:pathology*; D005128:Eye Diseases / Q000139:chemically induced / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D015474:Isotretinoin / Q000008:administration & dosage* / Q000009:adverse effects*; D008297:Male; D013666:Tears / Q000187:drug effects / Q000378:metabolism*; D055815:Young Adult
D003879:Dermatologic Agents; D015474:Isotretinoin