Clinical, Cosmetic and Investigational Dermatology (Sep 2021)

Dermatologists’ Knowledge and Attitude Toward Isotretinoin Ocular Side Effects in Egypt

  • Elshafie M,
  • Srour A,
  • el-Ansarey H,
  • Abdel-kader M,
  • Kabbash I,
  • Mashaly M

Journal volume & issue
Vol. Volume 14
pp. 1295 – 1301

Abstract

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Mohammed Elshafie,1 Azza Srour,2 Hussien el-Ansarey,2 Mostafa Abdel-kader,2 Ibrahim Kabbash,3 Mohamed Mashaly4 1Ophthalmology, Faculty of Medicine, KafrELSheikh University, Mansoura, Egypt; 2Faculty of Medicine, KafrELSheikh University, KafrELSheikh, Egypt; 3Public Health & Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt; 4Dermatology, Andrology and STDs, Faculty of Medicine, Port Said University, Mansoura, EgyptCorrespondence: Mohamed Mashaly 35511 Tel +201067123134Email [email protected]: The FDA approved isotretinoin for moderate and severe nodulo-cystic acne, in which it proved effective. However, this misled the dermatologists into using isotretinoin for mild cases as well. This misuse increased the risk of developing adverse effects, especially on the ocular system. These adverse effects vary from mild reversible eye dryness to severe irreversible loss of night vision. Also, it causes contact lens intolerance and corneal ulcer on top. Both ophthalmologists and dermatologists have different perceptions of the drug.Purpose: To evaluate dermatologists’ knowledge and attitude toward ocular adverse effects of isotretinoin in Egypt.Methods: This cross-sectional study was conducted via an online questionnaire. The questionnaire had three parts: 1) demographic data, 2) knowledge about isotretinoin dry eye disorders, contact lens intolerance, and refractive surgery precautions and 3) dermatologists’ management of a case on isotretinoin therapy. We contacted 111 participants from Facebook dermatologists’ groups between March and April 2021.Results: We surveyed 111 dermatologists. One hundred and five (94.6%) reported their knowledge about ocular side effects. One hundred of them (90.1%) informed their patients about the drug’s adverse effects. Eighty-three (74.8%) reported their knowledge about contact lens intolerance. Forty-one dermatologists (36.9%) screened their patients for recent refractive surgery before isotretinoin therapy. Nearly, all dermatologists routinely prescribed lubricant eye drops for the patients, and 63 (56.8%) dermatologists sometimes referred their patients to an ophthalmologist. We found an association between knowledge about contact lens intolerance and years of experience (p=0.012). As well, we found that the academic degree of dermatologists is directly proportional with warning patients about ocular side effects (p=0.003) and refractive surgery (p=0.039).Conclusion: Egyptian dermatologists were knowledgeable about the effects of isotretinoin on eyes with inappropriate clinical practice.Keywords: awareness, ophthalmic adverse effects, ocular dryness, academic

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