Neudorfer Meira, Goldshtein Inbal, Shamai-Lubovitz Orna, Chodick Gabriel, Dadon Yuval, Shalev Varda
Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel.
Arch Dermatol. 2012 Jul;148(7):803-8. doi: 10.1001/archdermatol.2012.352.
To examine whether isotretinoin therapy could result in deleterious ocular effects, as previously described in case report studies.
Retrospective cohort study.
The study was conducted using the electronic medical databases of a large health maintenance organization in Israel.
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).
Ocular adverse effects (AEs) or purchases of ophthalmic medications within 1 year after the first dispensed isotretinoin prescription.
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.
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.
如既往病例报告研究中所描述的那样，研究异维甲酸治疗是否会导致有害的眼部影响。
回顾性队列研究。
该研究使用以色列一家大型健康维护组织的电子医疗数据库进行。
研究人群包括14682名开始使用异维甲酸治疗痤疮的青少年和青年，以及2个年龄和性别匹配的对照组（未使用过异维甲酸的痤疮患者和无痤疮患者）。
首次开具异维甲酸处方后1年内的眼部不良反应（AE）或眼科药物购买情况。
异维甲酸组共有13.8%的患者出现眼部AE，未使用过异维甲酸的痤疮组为9.6%，无痤疮组为7.1%。在1年的随访期内，与无痤疮组相比，异维甲酸组发生任何眼部AE的风险显著更高（风险比，1.70；P<0.001）。未使用过异维甲酸的痤疮组未观察到这种风险增加。异维甲酸组发生炎症性和结构性AE的相对风险更高。
使用异维甲酸可能与短期眼部事件有关，尤其是结膜炎，这突出了对患者和护理人员进行关于该治疗潜在重要AE教育的重要性。
