The Effects of Menopause and Hormone Replacement Therapy on Quality and Quantity of Tear, Intraocular Pressure and Ocular Blood Flow

Abstract

Objective: To evaluate the effects of menopause and hormone replacement therapy (HRT) on the quality and amount of tear, intraocular pressure (IOP) and retrobulbar blood flow velocities. Patients and Methods: Twenty women aged between 40 and 50 years, free of ocular and systemic diseases and planning to receive HRT were recruited as the study group. Twenty-four healthy, age-matched but still menstruating women were enrolled as controls. On the first day of study basal and reflex Schirmer test, tear break-up time and IOP measurements (at 08.00, 12.00 and 16.00 h) were performed for all groups. On the second day of the study, the peak systolic velocity (PSV), end diastolic velocity (EDV) and resistivity index (RI) of the ophthalmic (OA), central retinal (CRA), nasal (NSPCA) and temporal short posterior ciliary (TSPCA) arteries were determined by color Doppler imaging. The menopausal group received HRT for 2 months, when all measurements were repeated for the 15 women who had received HRT on a daily basis. Results: The quality and amount of tear decreased (p < 0.01), IOP (p < 0.01) and RI of the CRA, TPCA and NPCA (p < 0.05) increased in postmenopausal women compared with the control group. After 2 months of HRT, the quality and amount of tear had increased (p < 0.001) and the IOP had decreased (p < 0.001). The PSV of the CRA and TSPCA had decreased (p < 0.05), as had the RI in the CRA (p < 0.001), NSPCA and TSPCA (p < 0.05). Conclusion: We conclude that age-induced changes on quality and amount of tear, IOP and retrobulbar blood flow are intensified by the menopause and that it may be possible to decrease the menopausal effects on these parameters by HRT.

Longitudinal analysis of age-related changes in intraocular pressure in South Korea

“…Some inferred that increasing IOP was associated with postmenopause. 22,23 Also, the fact that females have a higher portion of fat in body mass than males as well as hormones that are associated with postmenopause may affect IOP change due to aging. 24 In addition to age and gender, many systemic factors showed correlations with IOP.…”

Oestrogen, ocular function and low-level vision: a review

“…Although its causes are multifactorial, increased prevalence in older women may reflect postmenopausal oestrogen (E 2 ) reduction. Tear production decreases after menopause (Altintas et al 2004). Although some studies have found that hormone replacement therapy (HRT) leads to a decrease in tear function (Schaumberg et al 2001, Uncu et al 2006, the majority have shown that dry eye improves after HRT (Affinito et al 2003, Guaschino et al 2003, Altintas et al 2004, Taner et al 2004, Coksuer et al 2011).…”

“…In addition, patients prescribed tamoxifen, a selective ER antagonist, for the treatment of breast cancer are more likely to develop cataracts (Paganini-Hill & Clark 2000, Lee et al 2004). There is also some evidence that HRT might reduce the risk of increased lens opacity and cataract development (Worzala et al 2001), although this is still a matter of debate, as others report no effect (Altintas et al 2004, Kanthan et al 2010.…”

Does HRT Change İntraocular Pressure in Postmenopausal Women ?

“…(11,12). Additionally, animal models and clinical studies have shown that the perfusion of the optic nerve, retinal ganglion cells, and their supporting structures are increased by estradiol (13)(14)(15). Finally, estradiol has neuroprotective effect which appears to be mediated at least in part through estrogen receptors in the retinal ganglion cells in glaucoma animal models (4,13).…”