Sistemik isotretinoin tedavisinin oküler yüzey ve gözyaşi bezlerine etkisi

Acne vulgaris is a chronic illness that is frequently seen in clinical practice. Because of this disease, systemic isotretinoin (13-cis-retinoik acid) treatment is frequently used and the ocular surface and meibomian glands are also significantly effected. In our study, we evaluated 20 patients who were referred to our clinic for indications of the initiation of systemic isotretinoin treatment by Hacettepe University Medical Faculty Dermatology Department and 20 patients who applied for routine eye examination to our clinic with appropriate age distribution for the control group. The control group and the patient group were examined by the same physician. Tear break up time, Schirmer test with anesthesia, ocular staining with lissamine green and florescein, corneal sensitivity measurements with Cochet-Bonnet esthesiometry, Meibomian gland dysfunctional staging with ocular surface examination findings, upper and lower lid meiboscore measurements with meibography and evaluation of basal epithelial and subbasal nerve plexus of the cornea by in vivo confocal microscopy were evaluated. The patient group was evaluated before treatment and at the end of the first and third months in terms of these parameters. It was found that there was a statistically significant difference between control group and patient group before treatment with MGD stages, lower and upper lid meiboscores with higher values in the patient group (p<0,005 for each value). During the treatment period, there was a significant increase in meibomian gland dysfunction (MGD) stage and lower and upper lid meiboscores in the patient group. In addition, there was an increase in ocular surface staining with fluorescein and a shortening in tear break up time (p = 0.043, p = 0.017). Our study suggests that both acne vulgaris and isotretinoin which is used in the treatment of acne vulgaris, causes both anatomical and functional disability on the meibomian glands and this treatment brings out significant changes in a short time on ocular surface.