Publication: Evaluation of retinal nerve fiber layer and macula thickness, colour vision and electroretinogram in patients with acne vulgaris treated with systemic isotretinoin
Date
2021
Authors
Wahab, Nurul Zulaikha
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Abstract
Introduction
Isotretinoin (13-cis-retinoic acid) is a synthetic retinoid that is used specially for treating
acne vulgaris that does not respond to other therapies. Isotretinoin is an extremely effective
systemic medication for acne vulgaris which is widely used. However, isotretinoin is also
known to have a broad side effect including ocular toxicity. Some studies have shown its
effect on retinal nerve fiber layer (RNFL) and ganglion cell layer and visual functions.
Objectives
This study was performed to evaluate RNFL and macular thickness, colour vision and
electroretinogram (ERG) on systemic isotretinoin treatment in acne vulgaris patients.
Methods
Prospective observational cohort study involving patients with moderate to severe acne
vulgaris on systemic isotretinoin was conducted at Hospital Universiti Sains Malaysia and
Hospital Raja Perempuan Zainab II from June 2018 till May 2021. All patients had to
undergo a complete ophthalmologic examination. RNFL and macula thickness analysis
using optical coherence topography (OCT), colour vision analysis using Farnsworth-Munsell
100 Hue test and ERG were performed before the start of treatment and at three months of
treatment. Statistical analysis was done using SPSS Inc Version 26.
Results
Forty patients who were treated with 20 mg daily oral isotretinoin were enrolled in this study.
The mean age of the patients was 26.88 (7.16) years (which is between 17-43 years).
Measurements of mean RNFL and macula thickness before starting isotretinoin treatment
was 93.88 (11.08) μm and 300.94 (14.66) μm respectively, while the mean RNFL and
macula thickness at 3 months of treatment was 94.35(10.11) μm and 301.42(15.65) μm
respectively. Measurements showed no statistically significant change between two
measurements (p>0.05). The colour vision score was 76.30 (32.27) before starting treatment
and 74.15 (24.17) at 3 months of treatment. The amplitude of a wave and b wave in ERG
before starting treatment was measured as 269.45(57.00) μV and 450.48(70.07) μV
respectively. Whereas the amplitude of a wave and b wave at 3 months of treatment was
measured as 268.68 (55.13 μV) and 448.40 (69.91) μV respectively. No statistically
significant differences were observed in the colour vision score and ERG amplitude at three
months of treatment (p>0.05).
Conclusion
There was no statistically significant difference in mean RNFL and macula thickness, colour
vision and ERG of acne vulgaris patients before and at three months of systemic isotretinoin
treatment.
Description
Keywords
Acne vulgaris