tretinoin and Eye-Diseases

This is a review of the efficacy of etretinate/acitretin in the treatment of psoriasis and of the currently reported side-effects. The data indicate that retinoids bring significant improvement (if not total clearing) with frequent low-morbidity but rarely serious side-effects. The most serious side-effect of etretinate/acitretin is teratogenicity.

Topics: Abnormalities, Drug-Induced; Acitretin; Adult; Aged; Bone Diseases; Chemical and Drug Induced Liver Injury; Etretinate; Eye Diseases; Female; Humans; Lipids; Male; Middle Aged; Psoriasis; Risk Factors; Skin Diseases; Tretinoin

Contact dermatitis to topical tretinoin or retinoic acid is rarely described. We outline the case of a 20-year-old woman presenting with bilateral periorbital dermatitis against the background of longstanding use of retinoic acid for the ocular complications of toxic epidermal necrolysis. Patch testing confirmed a contact allergy to retinoic acid and the symptoms of the dermatitis resolved after the cessation of retinoic acid.

Topics: Administration, Topical; Dermatitis, Allergic Contact; Eye; Eye Diseases; Facial Dermatoses; Female; Humans; Keratolytic Agents; Tretinoin; Young Adult

Topics: Epithelium; Eye Diseases; Humans; Lung Diseases; Mouth Diseases; Tracheal Diseases; Tretinoin; Vitamin A; Vitamin A Deficiency

The aims were to obtain a controlled intravitreous release of retinoic acid (RA) by injecting drug loaded microspheres of biodegradable polymers and to study the potential use of this RA delivery system in a rabbit model of proliferative vitreoretinopathy (PVR).. The release of RA in vitro from 15 mg of 50-50 poly(DL-lactide-co-glycolide) (PLGA) in 1 ml of water at room temperature was measured with a spectrophotometer. In a rabbit model of PVR, 11 eyes were injected with 5 mg of microspheres containing 22 micrograms of RA/mg of PLGA, and seven control eyes were injected with microspheres of the same polymer that did not contain RA. In a third group, six rabbits were injected with 5 mg (n = 3) and 10 mg (n = 3) of microspheres containing RA.. The initial concentration of RA was 20.8 micrograms/mg of PLGA. The release curve showed a fairly constant daily release of 7 micrograms/d for about 30 days. At 40 days, the release rate decreased to about 6 micrograms/d. After 40 days, 82.8% of the RA was released. Four of 11 treated rabbits (36%) and 7/7 (100%) controls showed tractional retinal detachment (TRD) (P < 0.01) after 2 months. Histopathologically, a mild, localized, foreign body reaction was observed.. The authors obtained a sustained release of RA from PLGA microspheres in vitro for 40 days. A single injection of RA-loaded microspheres in suspension in BSS was effective in reducing the incidence of TRD after 2 months in a rabbit model of PVR.

Topics: Animals; Biocompatible Materials; Biodegradation, Environmental; Delayed-Action Preparations; Disease Models, Animal; Drug Carriers; Eye Diseases; Female; Lactic Acid; Male; Microspheres; Polyglycolic Acid; Polylactic Acid-Polyglycolic Acid Copolymer; Polymers; Rabbits; Retinal Detachment; Retinal Diseases; Tretinoin; Vitreous Body

To evaluate, in vitro, the solubility and stability of all-trans RA in silicone oil (SiO) and, in vivo, the stability and the antiproliferative effect of all-trans RA in SiO on an experimental model of PVR.. The solubility and stability of RA in SiO, in vitro and in vivo, were evaluated by HPLC. Rabbits underwent unilateral gas-compression vitrectomy and gas-SiO exchange. Rabbits received 10 micrograms (n = 17), 5 micrograms (n = 11), and 2 micrograms (n = 9) of all-trans RA in SiO, and SiO only (n = 12). All rabbits received an intravitreous injection of 150,000 fibroblasts.. RA is stable in SiO in vitro, but some isomerization from all-trans to 13-cis was observed under light exposure. In vivo, after 1 week, trace amounts of RA in SiO were observed in the controls and in the experimental animals, suggesting a steady state between the release of RA from the SiO and from the retina to the SiO. The rate of fractional retinal detachment was significantly lower in the animals that received 10 and 5 micrograms of RA than in the controls (P < 0.05). No statistical differences were found between the eyes treated with 10 and 5 micrograms of RA. Eyes that received 2 micrograms of RA showed no difference from the control group.. The in vivo data suggest that retinoic acid might be useful as an antiproliferative agent in human eyes.

Topics: Animals; Cell Division; Cells, Cultured; Chromatography, High Pressure Liquid; Disease Models, Animal; Drug Stability; Eye Diseases; Female; Fibroblasts; Male; Rabbits; Retinal Detachment; Retinal Diseases; Silicone Oils; Solubility; Tretinoin; Vitreous Body

Isotretinoin (Accutane Capsules) is a synthetic vitamin A compound used for treatment of recalcitrant cystic acne. It has numerous ocular toxic side effects which include anterior segment inflammation, dry eye syndrome, contact lens intolerance, altered refraction, photosensitivity, and reduced night vision. Eye care practitioners should be aware of these potential side effects and be prepared to communicate with the prescribing physician if side effects present.

Topics: Anterior Eye Segment; Epithelium; Eye Diseases; Humans; Isotretinoin; Night Blindness; Papilledema; Photosensitivity Disorders; Refraction, Ocular; Reproduction; Retina; Tretinoin; Vitamin A

Despite the diverse causes of dry-eye disorders, the ocular surface epithelia in these diseases all undergo squamous metaplasia, manifested by loss of goblet cells, mucin deficiency, and keratinization. These changes account for tearfilm instability, which leads to various ocular symptoms and corneal complications. This article reviews research in the use of topical tretinoin to treat severe dry-eye disorders. To classify squamous metaplasia into stages, a modified impression cytology technique was used to monitor the therapeutic effect of topical tretinoin ointment (0.01% or 0.1%, w/w) in 22 patients. This population had severe dry-eye disorders, including keratoconjunctivitis sicca, Stevens-Johnson syndrome, inactive ocular pemphigoid, drug-induced pseudopemphigoid, and surgery- or radiation-induced dry eyes. After treatment, clinical improvements were correlated with the reversal of squamous metaplasia as evidenced by the impression cytology technique. Tretinoin may also be effective in treating conjunctival keratinization without dry eyes, as illustrated by a case study. This may represent the first reported attempt to treat ocular surface disorders by reversing diseased epithelium.

Topics: Administration, Topical; Adolescent; Eye Diseases; Female; Humans; Keratoconjunctivitis; Keratoconjunctivitis Sicca; Pemphigoid, Benign Mucous Membrane; Postoperative Complications; Radiotherapy; Skin Diseases, Vesiculobullous; Stevens-Johnson Syndrome; Tretinoin

A total of 261 adverse ocular reactions occurred in 237 patients who received isotretinoin, a commonly used drug in the treatment of severe cystic acne. Blepharoconjunctivitis, subjective complaints of dry eyes, blurred vision, contact lens intolerance, and photodermatitis are reversible side effects. More serious ocular adverse reactions include papilledema, pseudotumor cerebri, and white or gray subepithelial corneal opacities; all of these are reversible if the drug is discontinued. Reported cases of decreased dark adaptation are under investigation. Isotretinoin is contraindicated in pregnancy because of the many reported congenital abnormalities after maternal use (including microphthalmos, orbital hypertelorism, and optic nerve hypoplasia).

Topics: Acne Vulgaris; Cataract; Conjunctivitis; Cysts; Eye; Eye Diseases; Eyelid Diseases; Humans; Inflammation; Isotretinoin; Photosensitivity Disorders; Skin Diseases; Tretinoin; Vision Disorders

Topics: Adult; beta Carotene; Canthaxanthin; Carotenoids; Cell Transformation, Neoplastic; Child; Child, Preschool; Electrosurgery; Eye Diseases; Female; Humans; Infant; Male; Neurologic Manifestations; Skin Diseases; Tretinoin; Xeroderma Pigmentosum