Comparison of dose-related ocular side effects during systemic isotretinoin administration.
OBJECTIVE
To compare the effects of high- (Group 1) and low-dose (Group 2) isotretinoin treatments for acne vulgaris on lacrimal functions and other ocular complications.


METHODS
Twenty-six patients receiving high-dose (>0.5 mg/kg per day) systemic isotretinoin treatment and 25 patients treated with low-dose systemic isotretinoin (<0.5 mg/kg per day) underwent complete ophthalmologic assessment of both eyes before treatment, at days 45 and 90 of treatment, and 1 month after the completion of treatment, together with a microbiologic evaluation of conjunctival flora, tear film break-up time (BUT), and anesthetized Schirmer test of the right eye of each patient.


RESULTS
When the results of the anesthetized Schirmer test for Groups 1 and 2 were compared (pretreatment, days 45 and 90 of treatment, and 1 month after treatment), there was no statistically significant difference between the groups (p > 0.05). Although BUT did not differ significantly between the two groups before treatment (p >0.05), there was a statistically significant decrease in BUT in Group 1 when compared with Group 2 at days 45 and 90 of treatment (p <0.05). One month after the completion of treatment, there was no difference in BUT between the two groups (p >0.05). No difference in Staphylococcus aureus colonization was detected between the two groups at days 45 and 90 of treatment (p >0.05).


CONCLUSIONS
During systemic isotretinoin treatment, eye dryness was related to the dose used, at least during the period of treatment. Conversely, the rate of conjunctival S aureus colonization was unrelated to the dose of isotretinoin.
Cumurcu
Tongabay
T
Department of Ophthalmology, Gaziosmanpasa University School of Medicine, Tokat - Turkey. tcumurcu@gop.edu.tr
Sezer
Engin
E
Kilic
Rasit
R
Bulut
Yunus
Y
D000152:Acne Vulgaris / Q000188:drug therapy*; D000284:Administration, Oral; D000328:Adult; D015169:Colony Count, Microbial; D003228:Conjunctiva / Q000382:microbiology; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015352:Dry Eye Syndromes / Q000503:physiopathology; D005128:Eye Diseases / Q000139:chemically induced* / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D006801:Humans; D015474:Isotretinoin / Q000008:administration & dosage / Q000009:adverse effects*; D007765:Lacrimal Apparatus / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D013211:Staphylococcus aureus / Q000502:physiology; D013666:Tears / Q000378:metabolism
D003879:Dermatologic Agents; D015474:Isotretinoin