Multimodal imaging of isotretinoin-induced retinal pigment epithelium atrophy and keratoconus

Isotretinoin is a US Food and Drug Administration-approved drug for the management of acne vulgaris. However, it is associated with various ophthalmic side effects. Herein, we report a case of a 31-year-old female presenting with blurring of vision after the use of isotretinoin. Ocular tomography confirmed the keratoconus, whereas optical coherence tomography was suggestive of retinal pigment epithelium (RPE) atrophy. Electroretinogram also revealed reduced macular cone photoreceptor functions due to toxic maculopathy.