2Ophthalmologist, MD, Kartal Dr. Lutfi Kırdar Training and Research Hospital, Dermatology Department, İstanbul, Turkey DOI : 10.37845/ret.vit.2021.30.25 Purpose: To compare the effects of high- (Group 1) and low-dose (Group 2) systemic isotretinoin effects on spectral domain optic coherence tomography parameters in patients with acne vulgaris.
Material and methods: Thirty patients receiving high-dose (>0.5 mg/kg per day) systemic isotretinoin treatment and 32 patients treated with low-dose systemic isotretinoin (<0.5 mg/kg per day) were enrolled. Subfoveal choroidal thickness (SFCT), peripapillary retinal nerve fi bre layer (pRNFL) and macular ganglion cell complex (mGCC) thicknesses were evaluated at before the treatment, at fourth month visit and one month after the cessation of treatment.
Results: There was no statistically signifi cant difference in mGCC thickness and SFCT values between the two groups during the study (p>0.05). But, at the fourth month visit, temporal and inferior quadrants of pRNFL in patients received high dose isotretinoin were signifi cantly lower than patients received low dose (p=0.037 and p=0.041, respectively). At the one month after the cessation of treatment, only temporal quadrant of pRNFL in Group 1 was signifi cantly lower than Group 2 (p=0.033). No statistically signifi cant difference was observed in other quadrants of pRNFL and mean pRNFL between two groups during the study.
Conclusion: Low dose isotretinoin seems to have safety profi le for SFCT, mGCC and pRNFL. However, according to our results, high dose isotretinoin caused pRNFL thinning while caused no SFCT and mGCC thinning. High dose therapy may have a toxic effect on pRNFL, especially temporal and inferior quadrant. Therefore, it may be useful to monitor patients receiving high doses in clinical practice with the SD-OCT.
Keywords : Acne vulgaris, Ganglion cell complex, Isotretinoin therapy, Retinal nerve fi bre layer, Subfoveal choroidal thickne