Evaluation of Retinal Nerve Fiber Layer Changes with Oral Isotretinoin Treatment

Abstract

IntroductionCentral nervous system toxicity is a well-known side effect of isotretinoin treatment. The aim of this study was to establish the effects of isotretinoin on retinal nerve fiber layer (RNFL) thickness.Materials and MethodsStudy subjects received oral isotretinoin treatment for nodulocystic acne. All patients underwent a detailed ophthalmologic examination including best-corrected visual acuity, slit-lamp examination, tonometry, color vision assessment, fundoscopy, and RNFL measurement. RNFL measurements by optical coherence tomography were done at onset, and were repeated at the 1st and 6th months of therapy.ResultsA total of 22 eyes of 11 patients (seven males and four females) were included in this study. The mean age of the patients was 20.18 ± 5.13 (14–26) years. Mean RNFL thickness was 90.72 ± 9.19 (78.2–112.0) μm before treatment, 90.40 ± 9.24 (79.5–112.4) μm after 1 month of treatment, and 90.52 ± 8.92 (78.4–114.8) μm after 6 months. No statistically significant change was detected between RNFL thickness values before and after treatment.ConclusionNo adverse effects of systemic isotretinoin treatment on RNFL thickness were observed.

Macular Ganglion Cell Layer Thickness In Patients Using Oral Isotretinoin

“…Ucak et al [13] reported the possible toxic effects of isotretinoinon RNFL, especially in the temporal layer. In the study conducted by Kapti et al [14] It is reported that isotretinoin has no effect on RNFL thickness We did not find a statistically significant difference in RNFL thickness in our study. Sari et al [9] investigated the optical nerve function, both clinically and in vision field test in patients treated with oral tretinoin and have not observed any differences in the same findings during 5.5 months.…”

Isotretinoin and the eye: A review for the dermatologist

“…29 Nevertheless, other studies evaluating the RNFL and GCC thickness after systemic isotretinoin use for 6 and 12 months, respectively, found no significant differences. 5,30 Other retina-related complications including vascular occlusions, 31 premacular hemorrhage, 32 serous retinal detachment, 33 and vitreous disturbance have been reported. 24 However, none of the side effects mentioned above fulfills the WHO criteria mentioned above to be considered as "certain."…”

Effects of systemic isotretinoin treatment on retinal nerve fiber layer thickness and corneal endothelial cell density

“…In the literature, studies investigating the effects of isotretinoin treatment on RNFL thickness show different results. Kapti et al7 found no significant difference in RNFL thickness in the 6-month follow-up of patients who received systemic isotretinoin treatment compared to pretreatment. Sekeryapan et al6 examined the changes in RNFL and ganglion cell complex in patients receiving 1 mg/kg/day oral isotretinoin treatment and reported that systemic isotretinoin treatment had no negative effect on RNFL thickness and ganglion cell complex.…”