.: ORİJİNAL ARAŞTIRMA
Changes in Ocular Surface and Corneal Epithelial Thickness with Systemic Isotretinoin Treatment
Sistemik İzotretinoin Tedavisinin Oküler Yüzey ve Kornea Epitel Kalınlığı Üzerine Etkisi
Turkiye Klinikleri J Ophthalmol. 2020;29(4):259-63
doi: 10.5336/ophthal.2019-72632
Makale Dili: EN
Tam Metin
ABSTRACT
Objective:To evaluate the effect of systemic isotretinoin treatment on central corneal epithelial (CET), tear film corneal epithelial thickness(TCET) and mean central corneal thickness (CCT) measured by anterior segment optical coherence tomography (AS-OCT). Material and Methods: Patients who had severe nodulocystic acne disease and evaluated in our clinic prior to oral 0.5-1 mg/kg/day isotretinoin treatment were recruited. Ocular surface changes were evaluated by tear film break-up time (BUT) and Schirmer tests and ocular complaints were scored by Ocular Surface Disease Index (OSDI) questionnaire. Mean central CET, TCET and mean CCT were measured by using AS-OCT. These detailed examinations and measurements were performed prior to systemic isotretinoin intake and on the following first, third and sixth months of treatment. These data were compared statistically to find out the changes with this treatment. Results: Sixty four eyes of 17 female and 15 male patients were recruited. The mean age of the patients was 17.5±2.3 years. The mean CCT decreased gradually in three months (p=0.001). The mean TCET was not affected during treatment (p=0.154).The mean CET increased on the first month and decreased on the third month and increased again on the sixth month of the treatment (p=0.041, p=0.010, p=0.006). Tear film BUT decreased gradually in six months (p<0.001).The change in Schirmer test was not statistically significant (p=0.079).The OSDI scores gradually increased (p<0.001). Conclusion: Mean central CET and CCT measured by AS-OCT were found to be affected in the early period of oral isotretinoin treatment.
Keywords: Oral isotretinoin treatment; corneal epithelial thickness; anterior segment optical coherence tomography
Objective:To evaluate the effect of systemic isotretinoin treatment on central corneal epithelial (CET), tear film corneal epithelial thickness(TCET) and mean central corneal thickness (CCT) measured by anterior segment optical coherence tomography (AS-OCT). Material and Methods: Patients who had severe nodulocystic acne disease and evaluated in our clinic prior to oral 0.5-1 mg/kg/day isotretinoin treatment were recruited. Ocular surface changes were evaluated by tear film break-up time (BUT) and Schirmer tests and ocular complaints were scored by Ocular Surface Disease Index (OSDI) questionnaire. Mean central CET, TCET and mean CCT were measured by using AS-OCT. These detailed examinations and measurements were performed prior to systemic isotretinoin intake and on the following first, third and sixth months of treatment. These data were compared statistically to find out the changes with this treatment. Results: Sixty four eyes of 17 female and 15 male patients were recruited. The mean age of the patients was 17.5±2.3 years. The mean CCT decreased gradually in three months (p=0.001). The mean TCET was not affected during treatment (p=0.154).The mean CET increased on the first month and decreased on the third month and increased again on the sixth month of the treatment (p=0.041, p=0.010, p=0.006). Tear film BUT decreased gradually in six months (p<0.001).The change in Schirmer test was not statistically significant (p=0.079).The OSDI scores gradually increased (p<0.001). Conclusion: Mean central CET and CCT measured by AS-OCT were found to be affected in the early period of oral isotretinoin treatment.
Keywords: Oral isotretinoin treatment; corneal epithelial thickness; anterior segment optical coherence tomography
ÖZET
Amaç: Sistemik izotretinoin tedavisi alan hastalarda ön segment optik koherens tomografi (ÖS-OKT) ile merkezi kornea epitel kalınlığı (MKEK), gözyaşı filmi korneal epitel kalınlığı (GYKEK) ve ortalama merkezi korneal kalınlık (MKK) ölçümlerindeki değişimlerin değerlendirilmesi. Gereç ve Yöntemler: Şiddetli nodülokistik akne sebebiyle oral 0,5-1 mg/kg/gün izotretinoin tedavisi alacak olan hastalar değerlendirildi. Oküler şikayetler oküler yüzey hastalık indeksi (OSDI) anketi ile oküler yüzey değişiklikleri ise gözyaşı filmi kırılma zamanı (GYKZ) ve Schirmer testleri ile değerlendirildi. Ortalama MKEK, GYKEK ve MKK, ÖS-OKT ile ölçüldü. Ölçümler izotretinoin tedavisi başlangıcında, bir, üç ve altıncı ay sonunda yapılarak, zaman içindeki değişimi istatistiksel olarak analiz edildi. Bulgular: Onyedi kadın, 15 erkek hastanın 64 gözü çalışmaya alındı. Hastaların yaş ortalaması 17,5±2,3 idi. Ortalama MKK üçüncü ayda azaldı (p=0,001). Ortalama GYKEK tedavi sırasında etkilenmedi (p=0,154). Ortalama MKEK 1. ayda arttı, 3. ayda azaldı ve tedavinin 6. ayında tekrar arttı (p=0,041, p=0,010, p=0,006). GYKZ altı ayda yavaş yavaş azaldı (p<0,001). Schirmer testindeki değişiklik istatistiksel olarak anlamlı değildi (p=0,079). OSDI skoru kademeli olarak arttı (p<0,001). Sonuç: Oral izotretinoin tedavisinin erken döneminde ortalama MKEK ve MKK'ın ÖS-OKT ile yapılan ölçümlerini etkilediği görüldü.
Anahtar Kelimeler: Oral izotretinoin tedavisi; kornea epitel kalınlığı; ön segment optik koherens tomografi
Amaç: Sistemik izotretinoin tedavisi alan hastalarda ön segment optik koherens tomografi (ÖS-OKT) ile merkezi kornea epitel kalınlığı (MKEK), gözyaşı filmi korneal epitel kalınlığı (GYKEK) ve ortalama merkezi korneal kalınlık (MKK) ölçümlerindeki değişimlerin değerlendirilmesi. Gereç ve Yöntemler: Şiddetli nodülokistik akne sebebiyle oral 0,5-1 mg/kg/gün izotretinoin tedavisi alacak olan hastalar değerlendirildi. Oküler şikayetler oküler yüzey hastalık indeksi (OSDI) anketi ile oküler yüzey değişiklikleri ise gözyaşı filmi kırılma zamanı (GYKZ) ve Schirmer testleri ile değerlendirildi. Ortalama MKEK, GYKEK ve MKK, ÖS-OKT ile ölçüldü. Ölçümler izotretinoin tedavisi başlangıcında, bir, üç ve altıncı ay sonunda yapılarak, zaman içindeki değişimi istatistiksel olarak analiz edildi. Bulgular: Onyedi kadın, 15 erkek hastanın 64 gözü çalışmaya alındı. Hastaların yaş ortalaması 17,5±2,3 idi. Ortalama MKK üçüncü ayda azaldı (p=0,001). Ortalama GYKEK tedavi sırasında etkilenmedi (p=0,154). Ortalama MKEK 1. ayda arttı, 3. ayda azaldı ve tedavinin 6. ayında tekrar arttı (p=0,041, p=0,010, p=0,006). GYKZ altı ayda yavaş yavaş azaldı (p<0,001). Schirmer testindeki değişiklik istatistiksel olarak anlamlı değildi (p=0,079). OSDI skoru kademeli olarak arttı (p<0,001). Sonuç: Oral izotretinoin tedavisinin erken döneminde ortalama MKEK ve MKK'ın ÖS-OKT ile yapılan ölçümlerini etkilediği görüldü.
Anahtar Kelimeler: Oral izotretinoin tedavisi; kornea epitel kalınlığı; ön segment optik koherens tomografi
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