Short Course Low Dose Isotretinoin Consumption and Tear Film Function

To evaluate tear film status and refractive conditions during and one month after treatment of acne vulgaris with isotretinoin (Accutane). This prospective study was performed on 26 eyes of 13 known cases of acne vulgaris. All cases were referred by a dermatologist and were candidates for low dose isotretinoin (0.5 mg/kg). Full anterior and posterior segment examination and objective and subjective refraction were conducted. Tear film function was assessed by the anesthetized Schirmer test, tear breakup time (TBUT) and tear osmolarity test before, during and after treatment with systemic isotretinoin. Collected data were analyzed using paired t-test No significant difference was observed in BCVA and refractive conditions in patients before, during, or after systemic isotretinoin prescription. Increased TBUT results were observed in 2 and 3 patients during and one month after use of the medication, respectively which was not significant. Anesthetized Schirmer test showed a significant decrease during treatment (P=0.01). However this trend did not remain significant after drug cessation (p=0.78). On the other hand, tear film osmolarity showed a significant increase during (303.91±15.71osm/L) (p< 0.05) and even one month after drug discontinuation (312.7 ±28.39osm/L) (p= 0.01). Although after 2 months of low dose isotretinoin consumption and one month after drug cessation significant alterations in basal tear secretion were not observed, this study showed that such can lead to therapy alterations in tear film osmolarity persisting for at least one month after drug cessation. Therefore both patients and practitioners should be aware of these changes is important before isotretinoin prescription.