The Effect of Phototherapy and Photochemotherapy on the Eye
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- Category: Vol. 79, June 2011
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The Effect of Phototherapy and Photochemotherapy on the Eye,MAALY A.M. ABD EL-FATTAH, SAMIA M. ESMAT, HEBA H. EL-HADIDI, GHADA M. EL-HANAFI, MEDHAT A. EL-MOFTY and BASSANT A. EZZAT
Abstract
Purpose: 1- Studying ocular changes that might occur due to exposure to different types of phototherapy and photo-chemotherapy. 2- Evaluating the methods used for ocular protection in Phototherapy Unit Dermatology Department, Faculty of Medicine Cairo University (Kasr Al-Aini Hospital).
Methods: The study included 57 patients with variable diseases. Thirty patients received PUVA, twenty patients received NB UVB and seven received both PUVA and UVB. Duration of treatment ranged from 4 to 13 months. Every patient was subjected to ocular examination before and after treatment (visual acuity testing using Snellen chart or decimal fraction chart; anterior segment examination by Slit lamp; measurement of intraocular pressure using applantation tonom-eter and fundus examination using indirect ophthalmoscope). Fundus fluorescein angiography or optical coherence tomog-raphy were done if any posterior segment abnormality was suspected by the ophthalmologist.
Results: Although there was no significant development of ocular changes in the anterior or posterior segment, mild diminution in VA (92 lines) was detected in a significant patients treated with PUVA, but not in NB UVB patients.
This diminution showed significant correlation with duration of treatment only in those who received both PUVA and UVB. There was no significant increase in the incidence of cataract in patients treated with PUVA or UVB; however some sporadic cases were reported during treatment with PUVA. The incidence of these changes might be related to other factors like aging, but the effect of PUVA can not be excluded.
Conclusion: We could therefore conclude that patients receiving PUVA, both PUVA and UVB or NBUVB in Derma-tology Department Kasr Al-Aini Hospital, are not at increased risk of developing cataract, anterior or posterior segments complications up to the duration of thirteen months of exposure. The significant incidence of diminution of visual acuity (mostly £2 lines); in patients receiving PUVA was not asso-ciated with significant ocular abnormalities and may be attributed to the use of unbranded sunglasses or to personal refractive error during examination. Patients receiving NBUVB showed no significant decrease of VA. This indicates that NBUVB is safer as regards effect on eye.