Are Patients Prescribed Isotretinoin more Likely to Experience Eye side Effects?

Eye Related Side Effects Increased Two Fold among Those Prescribed Isotretinoin

In 2012, Neudorfer et al set out to evaluate the ocular side effects of isotretinoin.    14 682 new users of isotretinoin for acne were eligible for analysis. They were compared with 14 682 age- and sex-matched isotretinoin-naive patients having acne and with 14 682 age- and sex-matched acne-free patients. The mean age of the populations was 16.55 years.

Inflammatory, structural and other ocular events were more likely to be documented in isotretinoin users than those who did not use isotretinoin. The observed relative risks for the isotretinoin users vs non-users were 2.23, 2.06, and 1.44 for inflammatory, structural, and other ocular events, respectively. 13.8 % of isotretinoin users reported ocular eye concerns within 1 year of use of the medication. This compared to a 9.6 % incidence of eye concerns in those who never used isotretinoin. The most common ocular diagnoses were conjunctivitis (4%), hordeolum or stye (1.4%), chalazion (1.4%),  blepharitis (1%), eye pain (0.3 %) and dry eye (0.7%)

Individuals using isotretinoin were more likely to report using eye lubricants within the first year of using isotretinoin. 3.4 % of males and 5.1 % of females needed eye lubricants compared to 0.5-0.8 % of individuals who never used isotretinoin.  The isotretinoin users were more likely to require ophthalmic medications (19.4% of patients) compared to those who never used isotretinoin (9.8% of patients). As time went on, patients prescribed isotretinoin reported an ever increasing number of side effects. A small number reported side effects right away but this increased as the weeks and months went by.

Conclusion

A variety of inflammatory and structural eye side effects can occur among isotretinoin users. It is important for prescribers to be aware of these side effects.

REFERENCE

Neudorfer et al. Ocular Adverse Effects of Systemic Treatment With Isotretinoin. Arch Dermatol. 2012;148(7):803-808