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Thao N Yeh, Meng C Lin; Isotretinoin Study: Ocular Surface Comparison between Exposed and Unexposed Groups. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2856.
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© 2017 Association for Research in Vision and Ophthalmology.
Determine if ocular surface characteristics differ between a group previously treated with systemic isotretinoin (ISO) and an age-, gender-, and contact lens (CL) wearing history-matched untreated group (NISO).
Retrospective, observational study. Isotretinoin-exposed subjects were matched with unexposed subjects (1:2) by age (+4 years), gender, and CL use. Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire (Korb 2005) was used to assess symptoms. Meiboscore (Arita 2008) was used to analyze meibography images (Oculus Keratograph 5). Line of Marx (LOM) positioning (Yamaguchi 2006), MG expressibility (Korb 2008), tear lipid layer (TLL) thickness (LipiView), non-invasive (NITBUT, Medmont) and fluorescein (FTBUT, 1 ml of 2% NaF) tear breakup time, and lid wiper epitheliopathy (Korb 2010) were also measured. Repeated measures analysis of variance and logistic regression with the Huber-White standard error estimator were used to estimate statistical significance while accounting for correlations between eyes.
Four participants (8 eyes) in the ISO group (mean age ± SD: 23 ± 3 years (range: 19-31 years); 3 females, 1 male; 2 CL wearers and 2 non-wearers) and eight matched participants (16 eyes) in the NISO group were included in the analysis. All differences between the groups were not statistically significant, but comparison of means suggest a trend that those in the ISO group have overall worse symptoms (SPEED: 8.0 ± 4.6 vs. 3.4 ± 3.1; p=0.075), slightly more severe MG atrophy (Meiboscore; Upper Lid (UL): 0.8 ± 0.9 vs. 0.3 ± 0.5, p=0.168; Lower Lid (LL): 1.0 ± 1.3 vs. 0.5 ± 0.7, p=0.373), and reduced overall MG expressibility of the UL (12 ± 14 vs. 22 ± 14, p=0.452) compared to the NISO group.
Trends of clinically significant worse dryness symptoms and reduced UL MG expressibility were observed in the ISO group compared to the NISO group. It is possible that time-since-treatment is a factor in ocular surface health, and if so, a longitudinal study monitoring change during and after treatment compared to baseline is warranted.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
Figure 1. Meibography images of the upper and lower lids of the right (left column) and left (right column) eyes belonging to (a) a subject with a recent history of isotretinoin treatment and (b and c) subjects with no prior history of isotretinoin treatment.
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