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Isotretinoin treatment raised risk for eye infections

Patients using isotretinoin to treat acne might be at greater risk for conjunctivitis and other short-term ocular events, according to recent study results.

The Israeli-based retrospective investigation compared the rate of eye infections in 14,682 adolescents (average age 16.55 years) taking isotretinoin with those of age- and sex-matched groups (n=14,682) that had acne but did not use the drug, and a third group (n=14,682) that neither had acne nor used isotretinoin.

Within 1 year of treatment, 13.8% of the acne medication group experienced ocular adverse effects (AE) compared with 9.6% in the acne group that did not take isotretinoin and 7.1% in the acne-free group. The most common diagnoses were conjunctivitis, hordeolum, chalazion, blepharitis, and dry eye. During a 1-year follow-up, the isotretinoin group had a significantly higher risk for ocular AE compared with the acne-free group (HR=1.70; P<.001).

Researchers said isotretinoin, which reduces oil production in the sebaceous glands, also caused dysfunction of the meibomian glands, where oil in the eyelids is produced to help protect the eyes. Less lubrication may mean more eye irritation and dryness, which may cause patients to rub their eyes more and introduce bacteria.

The results “underscore the importance of primary and secondary prevention measures,” the researchers said. “Dermatologists and primary care physicians who prescribe isotretinoin are urged to also prescribe ocular lubricants [eg, preservative-free artificial tears] as a primary preventive measure. … To ensure early detection and treatment, it is important that patients and caregivers should be informed of the potential ocular AEs associated with isotretinoin use.”