title: Effects of topical acne treatment on the ocular surface in patients with acne vulgaris.
abstract: OBJECTIVE
  To assess the ocular side effects during topical retinoid-antibiotic combination treatment in patients with facial acne vulgaris.
  
  
  METHODS
  Forty-three patients applying topical isotretinoin+erythromycin combination (isotrexin gel, GlaxoSmithKline) once daily for the treatment of acne vulgaris were enrolled. Full ophthalmologic examination, Schirmer test (with topical anesthesia), fluorescein break-up time (BUT), corneal fluorescein staining and tear osmolarity measurement with the TearLab system (TearLab Corporation) were carried out before and at the end of the first month of the treatment. For evaluation of symptoms participants completed the ocular surface disease index (OSDI) questionnaire at each visit.
  
  
  RESULTS
  The mean age of the patients was 23.16±3.03 (18-30) years. Mean tear osmolarity increased significantly from 282.09±8.95 mOsm/L at baseline to 300.39±16.65 mOsm/L after the treatment (p<0.001). BUT decreased from an average of 11.93±1.12s at baseline to 6.65±3.03s at the end of the first month (p<0.001). The OSDI score worsened significantly (5.41±3.65 vs 21.53±12.95, p<0.001) and punctate epitheliopathy was seen in 51% of eyes after the treatment. The average Schirmer values were 13.09±1.90 and 12.41±2.44mm/5min before and at the end of the first month of the treatment, respectively (p=0.117).
  
  
  CONCLUSIONS
  The findings of this study indicate that topical retinoid-antibiotic combination treatment causes significant signs and symptoms of dry eye. Patients receiving topical treatment for acne should be evaluated regularly to ensure the timely detection and treatment of pathologic signs on the ocular surface.
authors.affiliation: Bozok University Faculty of Medicine, Ophthalmology Department, Yozgat, Turkey. Electronic address: seraybayhan@Hotmail.com.
authors.forename: Seray
authors.initials: S
authors.lastname: Aslan Bayhan
authors.affiliation: Bozok University Faculty of Medicine, Ophthalmology Department, Yozgat, Turkey.
authors.forename: Hasan Ali
authors.initials: HA
authors.lastname: Bayhan
authors.affiliation: Bozok University Faculty of Medicine, Dermatology Department, Yozgat, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Çölgeçen
authors.affiliation: Bozok University Faculty of Medicine, Ophthalmology Department, Yozgat, Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Gürdal
mesh_terms: D000152:Acne Vulgaris / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D060433:Administration, Ophthalmic; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003879:Dermatologic Agents / Q000008:administration & dosage; D004338:Drug Combinations; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D004917:Erythromycin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015474:Isotretinoin / Q000008:administration & dosage*; D008297:Male; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D003879:Dermatologic Agents; D004338:Drug Combinations; D004917:Erythromycin; D015474:Isotretinoin
keywords: Acne vulgaris; Dry eye; Topical treatment