Abuallut Ismail I, Dibaji Mohammed Q, Assiri Ahmad, Mawkili Wedad, Najmi Ahmed Y, Ageeli Safa Abdu, Hamdi Amaal Abdulaziz, Ayoub Raum Abdu, Muyidi Abdulaziz Yahya, Hakami Hussam T, Alhazmi Abrar Khalid, Rekini Moayad Hassan
Department of Surgery, Ophthalmology Division, Jazan University, Jazan, Saudi Arabia.
Prince Mohammed Bin Nasser Hospital - Jazan Health cluster, Jazan, 82943, Saudi Arabia.
Clin Ophthalmol. 2024 Dec 30;18:4041-4052. doi: 10.2147/OPTH.S491757. eCollection 2024.
Oral isotretinoin is a derivative of vitamin A, used to treat acne vulgaris. One of its effects is altering the corneal surface and ocular glands, resulting in eye dryness and various other symptoms. This study aimed to analyze the impact of systemic isotretinoin treatment on ocular health and investigate the potential risk factors contributing to ocular pathology.
This cross-sectional study was conducted on 489 participants in the Jazan region using a convenience sampling method. An online questionnaire composed of five sections, including the Arabic version of the validated Ocular Surface Disease Index (OSDI), was used to assess the presence of ocular symptoms associated with isotretinoin usage as well as the potential contributing risk factors.
A significant association was established between oral isotretinoin use and specific eye symptoms, including a gritty feeling in the eye (66.4%), sore eyes (68.6%), blurry vision (75.9%), and the need for moisturizing drops (35%). OSDI severity varied according to isotretinoin usage status, with severe OSDI grades reported in 56.9% of current users, 51.2% of those who stopped < 2 months ago, and 38.8% of those who stopped ≥ 2 months ago. Furthermore, significant risk factors associated with worse OSDI grades included contact lens use and isotretinoin dose, with contact lens use being associated with a 17.5-point increase in OSDI scores, while each 10 mg increase in isotretinoin dose was linked to a 0.20-point rise in OSDI score.
This study emphasizes the importance of assessing individual risk factors before starting isotretinoin therapy and monitoring ocular health in patients undergoing therapy. Clinicians should be aware of preventive methods and should consider high-risk patients to an ophthalmologist for interventions, such as punctal plugs, that can reduce complications. Further research targeting specific populations with shared risk factors is needed to validate these findings.
口服异维A酸是维生素A的衍生物，用于治疗寻常痤疮。其作用之一是改变角膜表面和眼腺，导致眼睛干涩及其他各种症状。本研究旨在分析全身性异维A酸治疗对眼部健康的影响，并调查导致眼部病变的潜在风险因素。
本横断面研究采用便利抽样法，对吉赞地区的489名参与者进行了研究。使用一份由五个部分组成的在线问卷，包括经过验证的眼部表面疾病指数（OSDI）的阿拉伯语版本，来评估与异维A酸使用相关的眼部症状的存在情况以及潜在的促成风险因素。
口服异维A酸的使用与特定的眼部症状之间建立了显著关联，包括眼睛有沙砾感（66.4%）、眼睛疼痛（68.6%）、视力模糊（75.9%）以及需要使用润眼液（35%）。OSDI严重程度根据异维A酸使用状态而有所不同，当前使用者中有56.9%报告为严重OSDI等级，在停药<2个月的人群中有51.2%，在停药≥2个月的人群中有38.8%。此外，与更差的OSDI等级相关的显著风险因素包括隐形眼镜使用和异维A酸剂量，隐形眼镜使用与OSDI得分增加17.5分相关，而异维A酸剂量每增加10 mg与OSDI得分增加0.20分相关。
本研究强调在开始异维A酸治疗前评估个体风险因素以及在接受治疗的患者中监测眼部健康的重要性。临床医生应了解预防方法，并应将高危患者转介给眼科医生进行干预，如泪小点栓塞，以减少并发症。需要针对具有共同风险因素的特定人群进行进一步研究，以验证这些发现。
