Effect of Oral Isotretinoin on Ocular Surface and Meibomian Glands

Purpose: This study investigated the effects of oral isotretinoin treatment for acne vulgaris on the ocular surface and meibomian gland morphology. Isotretinoin, a common and effective acne medication, is known to cause dry eye symptoms, but its specific impact on ocular surface parameters and meibomian glands requires further detailed assessment.

Study Design: This was a prospective, non-randomized, controlled study involving 60 participants. Thirty patients with moderate to severe acne vulgaris, who were candidates for oral isotretinoin therapy, were recruited as the case group. A control group of 30 age- and gender-matched healthy individuals without acne vulgaris was also included. The case group received low-dose oral isotretinoin (0.1-0.4 mg/kg/day) for 6 months, while the control group received no intervention.

Outcome Measures: Primary outcome measures included changes in Meibomian gland Morphology (assessed by Meiboscore via non-contact meibography) and Ocular Surface Disease Index (OSDI) scores. Secondary outcome measures included changes in Invasive Tear Film Break-Up Time (ITF-BUT), Schirmer II test results, Ocular Surface Staining (Oxford Scale), Meibum Expressibility Score (MES), Eyelid Score, and Non-Invasive Tear Film Break-Up Time (NIF-BUT). All ocular parameters were assessed at baseline and after 6 months of treatment in the case group and at baseline in the control group.

Inclusion criteria

• Patients with clinically diagnosed acne vulgaris with various degrees of severity candidates for oral isotretinoin treatment.
• Moderate to advanced stage of acne vulgaris.
• No significant improvement with local and systemic antibiotic therapy.
• Normal liver transaminase (AST, ALT) and lipid (Cholesterol, TG) levels

Exclusion criteria

• Patients with only comedonal acne.
• Prior use of systemic isotretinoin.
• Contact lens wearers.
• History of ocular trauma or surgery (within 1 year).
• Other systemic or dermatologic diseases.
• Active conjunctivitis or allergy.
• Use of medications affecting the ocular surface or meibomian glands. Lid deformity or abnormal lid movement