Retinoids and the eye

Area of Science:

• Ophthalmology
• Dermatology
• Pharmacology

Background:

• Systemic retinoids are increasingly prescribed for dermatological conditions, including keratinization disorders.
• Their potential in cancer chemoprevention suggests future widespread use.
• Both natural and synthetic retinoids can impact ocular structures and visual metabolism.

Purpose of the Study:

• To review the ocular side effects associated with systemic retinoid therapy.
• To evaluate the incidence and nature of these adverse effects, particularly with isotretinoin and fenretinide.
• To inform clinical management and future drug development.

Main Methods:

• Literature review of studies on systemic retinoid use and ocular side effects.
• Analysis of reported cases of blepharoconjunctivitis, pseudotumor cerebri, and night blindness.
• Comparison of side effect profiles across different synthetic retinoids.

Main Results:

• Common ocular side effects include blepharoconjunctivitis (prominent with isotretinoin), pseudotumor cerebri, and night blindness (reported with isotretinoin and fenretinide).
• Increased use of isotretinoin may contribute more to observed side effect incidence than individual retinoid metabolism.
• Ocular manifestations appear to be dose-dependent and reversible.

Conclusions:

• Systemic retinoids, while beneficial, necessitate careful monitoring for ocular side effects.
• Clinicians can manage these adverse events by adjusting dosage, as they are generally reversible.
• Further evaluation of ocular safety is crucial for developing new synthetic retinoids.