To investigate the effect of hormone replacement therapy (HRT) on postmenopausal tear function and the conjunctival epithelium.
Methods
Schirmer I-Jones test, tear film break-up time (BUT), and impression cytology findings were analyzed in 34 eyes of 17 women who were at least two years postmenopausal and not taking HRT. This series of tests was repeated after three months on HRT.
Results
The patients' average age was 53.82 ± 3.6 years, and the mean time postmenopause was 35.29 ± 11.59 months. There was no significant difference in the Schirmer I-Jones test results before and after three months of HRT (p > 0.05). However, the BUT (p<0.05) and impression cytology (p<0.05) findings were significantly affected by HRT.
Conclusions
HRT may alleviate postmenopausal dry eye symptoms by increasing goblet cell density.
MeldrumD.R.DavidsonB.J.TatarynI.V.JuddH.L.. Changes in circulating steroids with aging in postmenopausal women.Obstet Gynecol1981; 57: 624–8.
2.
MaheuxR.NaudF.RiouxM.A randomized, double blind, placebo-controlled study on the effect of conjugated estrogens on skin thickness.Am J Obstet Gynecol1994; 170: 642–9.
3.
Castello-BrancoC.PonsF.GratacosE.FortunyA.VanrellJ.A.Gonzalez-MerloJ.. Relationship between skin collagen and bone changes during aging.Maturitas1994; 18: 199–206.
4.
DunnL.B.DamesynM.MooreA.A.ReubenD.B.GreendaleG.A.. Does estrogen prevent skin aging? Results from the First National Health and Nutrition Examination Survey (NHANES I).Arch Dermatol1997; 133: 339–42.
5.
KramerP.LubkinV.PotterW.JakobsM.LabayG.SilvermanP.. Cyclic changes in conjunctival smears from menstruating females.Ophthalmology1990; 97: 303–7.
6.
MathersW.D.StovallD.LaneJ.A.ZimmermanM.B.JohnsonS.. Menopause and tear function: the influence of prolactin and sex hormones on human tear production.Cornea1998; 17: 353–8.
7.
WenderleinM.MattesS.. The “dry eye” phenomenon and ovarian function. Study of 700 pre- and postmenopausal women.Zentralbl Gynakol1996; 118: 643–9.
8.
NelsonD.J.HavenerV.R.CameronD.J.. Cellulose acetate impressions of the ocular surface: Dry eye states.Arch Ophthalmol1983; 101: 1869–72.
9.
GuttridgeN.M.. Changes in ocular and visual variables during the menstrual cycle.Ophthalmic Physiol Opt1994; 14: 38–48.
10.
GansL.A.LeeS.F.LempM.A.PeposeJ.S.. Estrogen and progesterone receptors and human conjunctiva.Am J Ophthalmol1990; 109: 474–7.
11.
WickhamL.A.GaoJ.TodaI.RochaE.M.OnoM.SullivanD.A.. Identification of androgen, estrogen and progesterone receptor mRNAs in the eye.Acta Ophthalmol2000; 78: 146–53.
12.
LempM.A.. General measures in management of the dry eye.Int Ophthalmol Clin1987; 27: 36–43.
BaudouinC.. The pathology of dry eye.Surv Ophthalmol2001; 45: 211–20.
15.
Van HaeringenN.J.. Aging and the lacrimal system.Br J Ophthalmol1997; 81: 824–6.
16.
AzzaroloA.M.WoodR.L.MircheffA.K.RichtersA.. Androgen influence on lacrimal gland apoptosis, necrosis and lymphocytic infiltration.Invest Ophthalmol Vis Sci1999; 3: 592–602.
17.
KrenzerK.L.Reza DanaM.UllmanM.D.Effect of androgen deficiency on the human meibomian gland and ocular surface.J Clin Endocrinol Metab2000; 85: 4874–82.
18.
SullivanD.A.WickhamL.A.RochaE.M.Androgens and dry eye in Sjogren's syndrome.Ann NY Acad Sci1999; 876: 312–24.
19.
NatadisastraG.WittpennJ.R.WestK.P.Jr.MuhilalSommerA.. Impression cytology for detection of vitamin A deficiency.Arch Ophthalmol1987; 105: 1224–8.
20.
Abdel-KhalekL.M.R.WilliamsonT.H.LeeW.R.. Morphological changes in the human conjunctival epithelium. I. In the normal elderly population.Br J Ophthalmol1978; 62: 792–9.
21.
PaschidesC.A.PetroutsosG.PsilasK.. Correlation of conjunctival impression cytology results with lacrimal function and age.Acta Ophthalmol1991; 69: 422–5.
KinoshitaS.KiorpesT.C.FriendJ.ThoftR.A.. Goblet cell density in ocular surface disease. A better indicator than tear mucin.Arch Ophthalmol Copenh1983; 101: 1284–7.
24.
VavilisD.AgorastosT.VakianiM.The effect of transdermal estradiol on the conjunctiva in postmenopausal women.Eur J Obstet Gynecol Reprod Biol1997; 72: 93–6.
