title: Ocular adverse effects of systemic treatment with isotretinoin.
abstract: OBJECTIVE
  To examine whether isotretinoin therapy could result in deleterious ocular effects, as previously described in case report studies.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  The study was conducted using the electronic medical databases of a large health maintenance organization in Israel.
  
  
  METHODS
  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 acne-free patients).
  
  
  METHODS
  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.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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel.
authors.forename: Meira
authors.initials: M
authors.lastname: Neudorfer
authors.forename: Inbal
authors.initials: I
authors.lastname: Goldshtein
authors.forename: Orna
authors.initials: O
authors.lastname: Shamai-Lubovitz
authors.forename: Gabriel
authors.initials: G
authors.lastname: Chodick
authors.forename: Yuval
authors.initials: Y
authors.lastname: Dadon
authors.forename: Varda
authors.initials: V
authors.lastname: Shalev
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy*; D000293:Adolescent; D016022:Case-Control Studies; D015331:Cohort Studies; D003231:Conjunctivitis / Q000139:chemically induced / Q000453:epidemiology; D016208:Databases, Factual; D003879:Dermatologic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005128:Eye Diseases / Q000139:chemically induced* / Q000453:epidemiology; D005500:Follow-Up Studies; D006279:Health Maintenance Organizations; D006801:Humans; D015474:Isotretinoin / Q000009:adverse effects* / Q000627:therapeutic use; D007557:Israel / Q000453:epidemiology; D008297:Male; D010353:Patient Education as Topic / Q000379:methods; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012306:Risk; D055815:Young Adult
chemical_list: D003879:Dermatologic Agents; D015474:Isotretinoin