TY - JOUR
T1 - Isotretinoin-associated intracranial hypertension
AU - Fraunfelder, Frederick W.
AU - Fraunfelder, Frederick T.
AU - Corbett, James J.
N1 - Funding Information:
This study was supported in part by an unrestricted grant from Research to Prevent Blindness, New York, New York.
PY - 2004/6
Y1 - 2004/6
N2 - Purpose To evaluate the association between intracranial hypertension (IH) and isotretinoin use. Design Observational case series. Methods In this retrospective study, approximately 1950 case reports of adverse ocular side effects related to isotretinoin were received from spontaneous reporting systems. Reports were evaluated as to the occurrence of IH with isotretinoin use. A survey was mailed to all members of the North American Neuro-ophthalmology Society soliciting their opinions on whether isotretinoin caused IH. Results One hundred seventy-nine reports of IH were associated with isotretinoin use. The mean time from drug exposure to IH diagnosis was 2.3 months. There were 6 cases of positive rechallenge; 5 new cases are reported here, along with 1 previously published report. Of neuro-ophthalmologists surveyed (62% response rate), 6% believed an association between IH and isotretinoin use was certain; 32%, probable; 52%, possible; and 10%, unlikely. Twelve respondents (4%) had personally seen one or more cases of positive rechallenge with isotretinoin causing IH. Conclusions Based on the number and pattern of rapid IH onsets after isotretinoin exposure and the 6 cases of positive rechallenge, along with the probable similarity in metabolic pathways of this agent and vitamin A (a known cause of IH), it seems certain that there is a direct correlation between IH and isotretinoin use.
AB - Purpose To evaluate the association between intracranial hypertension (IH) and isotretinoin use. Design Observational case series. Methods In this retrospective study, approximately 1950 case reports of adverse ocular side effects related to isotretinoin were received from spontaneous reporting systems. Reports were evaluated as to the occurrence of IH with isotretinoin use. A survey was mailed to all members of the North American Neuro-ophthalmology Society soliciting their opinions on whether isotretinoin caused IH. Results One hundred seventy-nine reports of IH were associated with isotretinoin use. The mean time from drug exposure to IH diagnosis was 2.3 months. There were 6 cases of positive rechallenge; 5 new cases are reported here, along with 1 previously published report. Of neuro-ophthalmologists surveyed (62% response rate), 6% believed an association between IH and isotretinoin use was certain; 32%, probable; 52%, possible; and 10%, unlikely. Twelve respondents (4%) had personally seen one or more cases of positive rechallenge with isotretinoin causing IH. Conclusions Based on the number and pattern of rapid IH onsets after isotretinoin exposure and the 6 cases of positive rechallenge, along with the probable similarity in metabolic pathways of this agent and vitamin A (a known cause of IH), it seems certain that there is a direct correlation between IH and isotretinoin use.
UR - http://www.scopus.com/inward/record.url?scp=2942579189&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=2942579189&partnerID=8YFLogxK
U2 - 10.1016/j.ophtha.2003.09.044
DO - 10.1016/j.ophtha.2003.09.044
M3 - Article
C2 - 15177980
AN - SCOPUS:2942579189
SN - 0161-6420
VL - 111
SP - 1248
EP - 1250
JO - Ophthalmology
JF - Ophthalmology
IS - 6
ER -