Lekskul Manapon, Thaiwat Supitchaya, Lekvijittada Jiraporn
Cornea External Disease and Refractive Surgery, Cornea Consultants, Boston, USA.
Cornea External Disease and Refractive Surgery, Wills Eye Hospital, Philadelphia, USA.
Int Ophthalmol. 2023 Dec;43(12):4683-4688. doi: 10.1007/s10792-023-02868-y. Epub 2023 Sep 9.
This study aimed to evaluate the recovery time of tear film function and ocular surface after discontinuing systemic isotretinoin treatment.
This was a prospective, cross-sectional study. 34 eyes of 17 patients treated with low- dose oral isotretinoin (< 0.5 mg/kg/day) were enrolled. The modified OSDI score, tear break-up time, Schirmer test, and corneal staining were performed in all patients at baseline, during the course of treatment and after withdrawing treatment every two weeks until the result returned to baseline.
Tear breakup time appeared to be the most sensitive and changed significantly at 2 weeks after starting treatment (p < 0.001) and returned to baseline at 4 weeks after withdrawal from treatment (p < 0.001). The Schirmer test results significantly decreased at 6 weeks and returned to baseline at 4 weeks after withdrawal from treatment (p < 0.001). OSDI scores were significantly changed at 6 weeks after treatment (81.8%) and returned to baseline at 2 weeks (54.5%) after withdrawal from treatment. No significant change was found in the MGD. Corneal staining was significantly positive 90.9% 6 weeks after starting treatment and returned to baseline 6 weeks after withdrawal from treatment (p < 0.001).
Dry eye disease can return to baseline levels after treatment withdrawal. At least 6 weeks later, they could wear contact lenses again, and it was useful to prepare all patients requiring further ocular surgery.
本研究旨在评估停用系统性异维甲酸治疗后泪膜功能和眼表的恢复时间。
这是一项前瞻性横断面研究。纳入了17例接受低剂量口服异维甲酸(<0.5mg/kg/天)治疗的患者的34只眼。在基线、治疗期间以及停药后每两周进行一次改良的眼表疾病指数(OSDI)评分、泪膜破裂时间、泪液分泌试验和角膜染色,直至结果恢复到基线水平。
泪膜破裂时间似乎是最敏感的指标,在开始治疗后2周时显著变化(p<0.001),并在停药后4周恢复到基线水平(p<0.001)。泪液分泌试验结果在6周时显著下降,并在停药后4周恢复到基线水平(p<0.001)。OSDI评分在治疗后6周时显著变化(81.8%),并在停药后2周(54.5%)恢复到基线水平。睑板腺功能障碍(MGD)无显著变化。角膜染色在开始治疗后6周时90.9%呈显著阳性,并在停药后6周恢复到基线水平(p<0.001)。
干眼症在停药后可恢复到基线水平。至少6周后,他们可以再次佩戴隐形眼镜,这对所有需要进一步眼科手术的患者都很有用。