Longitudinal assessment of meibomian glands and tear film layer in systemic isotretinoin treatment

Abstract

Purpose: This study aimed to analyze the changes in meibomian glands (MGs) and tear film layer over time in patients taking systemic isotretinoin treatment. Methods: Patients who received systemic isotretinoin treatment between 4 and 8 months were prospectively followed up. In addition to full ophthalmologic examination, MG dysfunction (MGD), noncontact meibography, noninvasive and invasive tear break-up time (TBUT), ocular surface disease index (OSDI), corneal staining, and eyelid margin abnormality scores were recorded before, during, and after treatment. Results: A total of 88 eyes of 88 patients were included in the study. The right eyes of all the patients were included. The mean age of the patients was 21 +/- 2.9 years. Of the 88 patients, 70 (79.6%) were females and 18 (20.4%) were males. Before the treatment, MGD, noncontact meibography, first noninvasive TBUT, mean noninvasive TBUT, invasive TBUT, OSDI, corneal staining, and eyelid margin abnormality scores were 0.29 +/- 0.45, 4.93 +/- 3.50, 13.78 +/- 3.89 s, 14.47 +/- 3.09 s, 12.96 +/- 3.61 s, 0.54 +/- 1.00, 0.04 +/- 0.20, and 0.09 +/- 0.28, respectively. Twelve months after the end of treatment, the scores were 0.97 +/- 0.87 (p < 0.001), 9.62 +/- 3.89 (p < 0.001), 11.24 +/- 3.52 s (p < 0.001), 12.34 +/- 3.02 s (p < 0.001), 11.31 +/- 2.90 s (p < 0.001), 1.90 +/- 2.44 (p < 0.001), 0.20 +/- 0.40 (p < 0.001), and 0.56 +/- 0.49 (p < 0.001), respectively. Conclusion: Systemic isotretinoin treatment causes morphological changes in the MGs. However, this treatment may negatively affect the tear film layer of patients. Some of these changes may persist for a long time even if the treatment is discontinued.