title: Conjunctival impression cytology changes induced by oral isotretinoin.
abstract: OBJECTIVE
  To evaluate the bulbar conjunctiva using impression cytology in patients submitted to oral isotretinoin treatment.
  
  
  METHODS
  A prospective, cohort study was carried out in a referral ophthalmology practice at the Federal University of Paraíba and in the External Eye Disease Laboratory of the Federal University of São Paulo. Twenty-eight patients with acne vulgaris were selected. Impression cytology specimens collected from the temporal bulbar conjunctiva and the superior bulbar conjunctiva of both eyes before and after 3 months of oral isotretinoin treatment were assessed. The doses of isotretinoin varied from 0.35 to 0.88 mg . kg . d.
  
  
  RESULTS
  The percentage of patients in whom impression cytology results were normal was significantly lower during oral isotretinoin treatment compared to the pretreatment phase, decreasing from 75% to 43% in the temporal bulbar conjunctiva and from 100% to 82% in the superior bulbar conjunctiva. In both regions, the parameters most affected were cell-to-cell contact, nucleus-to-cytoplasm ratio, and goblet cell density.
  
  
  CONCLUSIONS
  Oral isotretinoin for the treatment of acne induces alterations in the conjunctival epithelium of a significant percentage of patients treated with the drug. These alterations are seen both in the exposed conjunctiva (temporal bulbar region) and in the unexposed conjunctiva (superior bulbar region).
authors.affiliation: Referral Ophthalmological Clinic (CEROF), Federal University of Paraíba, Sao Paulo, Brazil. queiroga.i@ig.com.br
authors.forename: Isabella Bezerra Wanderley
authors.initials: IB
authors.lastname: de Queiroga
authors.forename: Luiz
authors.initials: L
authors.lastname: Antônio Vieira
authors.forename: Jeison de Nadai
authors.initials: Jde N
authors.lastname: Barros
authors.forename: Margareth de Fátima Formiga
authors.initials: Mde F
authors.lastname: Melo Diniz
authors.forename: Liana Clébia Soares Lima
authors.initials: LC
authors.lastname: de Morais
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy; D000284:Administration, Oral; D000328:Adult; D002452:Cell Count; D003228:Conjunctiva / Q000187:drug effects* / Q000473:pathology; D003229:Conjunctival Diseases / Q000139:chemically induced* / Q000473:pathology; D003879:Dermatologic Agents / Q000009:adverse effects*; D005260:Female; D020397:Goblet Cells / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D015474:Isotretinoin / Q000009:adverse effects*; D008297:Male; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D003879:Dermatologic Agents; D015474:Isotretinoin