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口服异维 A 酸治疗对视网膜神经纤维层厚度的影响。

Effect of oral isotretinoin treatment on retinal nerve fiber layer thickness.

出版信息

J Cutan Med Surg. 2014 Jul-Aug;18(4):236-42. doi: 10.2310/7750.2013.13168.

DOI:10.2310/7750.2013.13168
PMID:25008440
Abstract

BACKGROUND

Oral isotretinoin treatment can cause ocular side effects.

OBJECTIVE

This study was performed to detect possible toxic effects of oral isotretinoin treatment on the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL).

METHODS

The study population consisted of 54 eyes of 27 patients with nodulocystic acne who used oral isotretinoin (Roaccutane) treatment. Macular GCL and peripapillary RNFL thickness measurements were performed using spectral domain optical coherence tomography (OCT) before and after therapy.

RESULTS

Before and after treatment, a complete ophthalmologic examination was normal in all eyes. However, posttreatment lower temporal (TL) values were significantly lower (76.80 ± 16.31) than pretreatment TL values (84.96 ± 24.83) (p  =  .02). There was no statistically significant difference in the other OCT values, upper temporal, superotemporal, superonasal, upper nasal, lower nasal, inferonasal, and inferotemporal (p  =  .35, p  =  .40, p  =  .56, p  =  .95, p  =  .94, p  =  .93, p  =  .61, respectively). Also, there was no statistically significant difference between the right and left eyes and between genders for all parameters (p > .05).

CONCLUSION

The use of oral isotretinoin treatment has increased in recent years. In addition, oral isotretinoin treatment has a broad adverse effect potential on the ocular system. The measurement of RNFL thickness, especially TL thickness, by OCT may be useful for detecting the possible toxic effect of oral isotretinoin therapy on RNFL.

摘要

背景

口服异维 A 酸治疗可能会引起眼部副作用。

目的

本研究旨在检测口服异维 A 酸治疗对视网膜神经纤维层(RNFL)和神经节细胞层(GCL)的潜在毒性作用。

方法

研究对象为 27 例结节性囊肿性痤疮患者的 54 只眼,这些患者使用口服异维 A 酸(Roaccutane)治疗。使用频域光学相干断层扫描(OCT)分别在治疗前后对黄斑 GCL 和视盘周围 RNFL 厚度进行测量。

结果

治疗前后所有患者的眼科检查均正常。然而,治疗后下方颞侧(TL)值(76.80±16.31)明显低于治疗前的 TL 值(84.96±24.83)(p=0.02)。其他 OCT 值(上方颞侧、上颞侧、上鼻侧、上方鼻侧、下方鼻侧、下方鼻侧、下方颞侧和下方颞侧)之间无统计学差异(p=0.35、p=0.40、p=0.56、p=0.95、p=0.94、p=0.93、p=0.61)。此外,左右眼和性别之间所有参数均无统计学差异(p>0.05)。

结论

近年来,口服异维 A 酸的应用日益增多。此外,口服异维 A 酸治疗对眼部系统具有广泛的潜在不良反应。OCT 测量 RNFL 厚度,特别是 TL 厚度,可能有助于检测口服异维 A 酸治疗对 RNFL 的潜在毒性作用。

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