Effects of topical acne treatment on the ocular surface in patients with acne vulgaris

• Published in: Contact lens & anterior eye Vol. 39; no. 6; pp. 431 - 434
• Main Authors: Aslan Bayhan, Seray, Bayhan, Hasan Ali, Çölgeçen, Emine, Gürdal, Canan
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2016
• Subjects: Acne vulgaris; Acne Vulgaris - complications; Acne Vulgaris - diagnosis; Acne Vulgaris - drug therapy; Administration, Ophthalmic; Administration, Topical; Adolescent; Adult; Anti-Bacterial Agents - administration & dosage; Dermatologic Agents - administration & dosage; Drug Combinations; Dry eye; Dry Eye Syndromes - diagnosis; Dry Eye Syndromes - drug therapy; Dry Eye Syndromes - etiology; Erythromycin - administration & dosage; Female; Humans; Isotretinoin - administration & dosage; Male; Ophthalmology; Topical treatment; Treatment Outcome; Young Adult; Acne vulgaris; Dry eye; Topical treatment
• ISSN: 1367-0484; 1476-5411
• DOI: 10.1016/j.clae.2016.06.009

Abstract Purpose To assess the ocular side effects during topical retinoid-antibiotic combination treatment in patients with facial acne vulgaris. Methods Forty-three patients applying topical isotretinoin + erythromycin combination (isotrexin gel, GlaxoSmithKline) once daily for the treatment of acne vulgaris were enrolled. Full ophthalmologic examination, Schirmer test (with topical anesthesia), fluorescein break-up time (BUT), corneal fluorescein staining and tear osmolarity measurement with the TearLab system (TearLab Corporation) were carried out before and at the end of the first month of the treatment. For evaluation of symptoms participants completed the ocular surface disease index (OSDI) questionnaire at each visit. Results The mean age of the patients was 23.16 ± 3.03 (18–30) years. Mean tear osmolarity increased significantly from 282.09 ± 8.95 mOsm/L at baseline to 300.39 ± 16.65 mOsm/L after the treatment (p < 0.001). BUT decreased from an average of 11.93 ± 1.12 s at baseline to 6.65 ± 3.03 s at the end of the first month (p < 0.001). The OSDI score worsened significantly (5.41 ± 3.65 vs 21.53 ± 12.95, p < 0.001) and punctate epitheliopathy was seen in 51% of eyes after the treatment. The average Schirmer values were 13.09 ± 1.90 and 12.41 ± 2.44 mm/5 min before and at the end of the first month of the treatment, respectively (p = 0.117). Conclusions The findings of this study indicate that topical retinoid-antibiotic combination treatment causes significant signs and symptoms of dry eye. Patients receiving topical treatment for acne should be evaluated regularly to ensure the timely detection and treatment of pathologic signs on the ocular surface.