Yılmaz Uğur, Küçük Erkut, Koç Çağdaş, Özköse Ayşe
a Ophthalmology Department , Nigde State Hospital , Niğde , Turkey.
b Dermatology Department , Niğde State Hospital , Niğde , Turkey.
J Dermatolog Treat. 2017 Jun;28(4):314-317. doi: 10.1080/09546634.2016.1254146. Epub 2016 Nov 10.
To investigate the effects of systemic isotretinoin therapy on retina by measuring retinal nerve fiber layer (RNFL) and macular thicknesses.
This prospective, cross-sectional study was conducted in patients prescribed systemic isotretinoin therapy. Seventy-two eyes of 36 patients were included in the study. The patients were followed during three months. Detailed ophthalmologic examination including anterior and posterior segment examination, best corrected visual acuity and intraocular pressure measurement, RNFL and macular thicknesses measurement by Spectral Domain Cirrus Optical Coherence Tomography Model 400 (Carl Zeiss Meditech, Jena, Germany) were performed at baseline, first, second and third months after the beginning of systemic isotretinoin therapy in ophthalmology clinic.
Thirty (83.3%) of the 36 patients were women and six (16.7%) of them were men. Mean age was 21.17 years. Mean RNFL thickness in the temporal quadrant at first, second, third months after beginning of treatment were found as significantly lower compared to baseline (p = .001). Mean macular thicknesses in superior outer, nasal outer and temporal outer quadrants at second and third months after beginning of treatment were found to be significantly lower compared to baseline and first month after beginning of treatment (p ≤ .001, .002 and .001, respectively). Macular thicknesses in superior inner quadrant at first, second and third months were found to be significantly lower than baseline values (p< .01). No significant difference was detected between groups in other quadrants (p> .05).
The effect of oral isotretinoin therapy may cause regional thinning in RNFL and macula, directly visible part of central nervous system.
通过测量视网膜神经纤维层（RNFL）和黄斑厚度，研究系统性异维A酸治疗对视网膜的影响。
本前瞻性横断面研究针对接受系统性异维A酸治疗的患者进行。研究纳入了36例患者的72只眼。对患者进行了为期三个月的随访。在眼科诊所，于系统性异维A酸治疗开始后的基线、第一个月、第二个月和第三个月进行了详细的眼科检查，包括眼前节和眼后节检查、最佳矫正视力和眼压测量，以及使用光谱域Cirrus光学相干断层扫描模型400（德国耶拿卡尔蔡司医疗技术公司）测量RNFL和黄斑厚度。
36例患者中30例（83.3%）为女性，6例（16.7%）为男性。平均年龄为21.17岁。发现治疗开始后第一个月、第二个月和第三个月颞侧象限的平均RNFL厚度与基线相比显著降低（p = 0.001）。发现治疗开始后第二个月和第三个月，上外、鼻外和颞外象限的平均黄斑厚度与基线及治疗开始后第一个月相比显著降低（分别为p≤0.001、0.002和0.001）。发现第一个月、第二个月和第三个月上内象限的黄斑厚度显著低于基线值（p<0.01）。其他象限组间未检测到显著差异（p>0.05）。
口服异维A酸治疗的效果可能导致RNFL和黄斑局部变薄，黄斑是中枢神经系统的直接可见部分。
