■该研究旨在调查泪液功能的变化,接受全身异维甲酸治疗的患者的睑板腺和角膜内皮。
■这项前瞻性研究包括38例患者(23名女性和15名男性)的38只眼睛,这些患者在诊断为寻常痤疮后接受了全身性异维A酸(0.5-1mg/kg/天)治疗。所有患者在基线时接受了全面的眼科检查,第一个月,第三个月的治疗。使用眼表疾病指数(OSDI)评估主观投诉。通过非侵入性泪液破裂时间(NIBUT)和SchirmerI测试评估泪液功能。使用睑板腺图检查睑板腺(MG)的变化。角膜参数,包括内皮细胞密度(ECD),变异系数(CV),六边形细胞的数量(6A),平均细胞面积(AVG),使用非接触镜面反射显微镜评估中央角膜厚度(CCT)。
■患者的平均年龄为19.29±2.83岁。与眼部表面相关的不适,用OSDI分数测量,与治疗前相比,第三个月测量值显著恶化(p<0.001)。在治疗的第一个月,NIBUT显著下降(p<0.05)。在每次访视的Schirmer检验结果中没有发现统计学上的显著差异。根据第一个月和第三个月的分析,与治疗前相比,MG损失显著增加(p<0.001).ECD,CV,6A,与治疗前的值相比,第一个月和第三个月的AVG测量值显示出显着变化(p<0.001)。在治疗期间在CCT测量中未观察到显著差异。
■系统性异维A酸破坏了泪液稳定性,导致MG损失,角膜内皮恶化,并导致患者出现症状投诉。
UNASSIGNED: The study aims to investigate changes in tear function, meibomian glands and corneal endothelium in patients receiving systemic isotretinoin therapy.
UNASSIGNED: This prospective study included 38 eyes from 38 patients (23 females and 15 males) treated with systemic isotretinoin (0.5-1 mg/kg/day) following the diagnosis of acne vulgaris. All patients underwent a comprehensive ophthalmologic examination at baseline, 1st month, and third month of treatment. Subjective complaints were assessed using the Ocular Surface Disease Index (OSDI). Tear functions were evaluated through non-invasive tear break up time (NIBUT) and Schirmer I test. Meibomian gland (MG) changes were examined using meibography. Corneal parameters, including endothelial cell density (ECD), coefficient of variation (CV), the number of cells with a hexagonal shape (6A), average cell area (AVG), and central corneal thickness (CCT) were assessed using non-contact specular microscopy.
UNASSIGNED: The mean age of the patients was 19.29 ± 2.83 years. Ocular surface-related discomfort, measured with OSDI scores, significantly worsened at the third month measurements compared to the pre-treatment values (p < 0.001). In the 1st month of treatment, there was a significant decrease in NIBUT (p < 0.05). No statistically significant difference was found in the Schirmer test results at each visit. According to the 1st and third-month analysis, there was a significant increase in MG loss compared to the pre-treatment period (p < 0.001). ECD, CV, 6 A, AVG measurements at the first and third months showed a significant change compared to the pre-treatment values (p < 0.001). No significant difference was observed in the CCT measurements during the treatment.
UNASSIGNED: Systemic isotretinoin disrupted tear stability, caused MG loss, deterioration in corneal endothelium, and led to symptomatic complaints in patients.