Visual function in menopause: the role of hormone replacement therapy

Guaschino, Secondo; Grimaldi, Eva; Sartore, Andrea; Mugittu, Raffaela; Mangino, Francesco Paolo; Bortoli, Paula Saud De; Pensiero, Stefano; Vinciguerra, A.; Perissutti, Paolo

doi:10.1097/00042192-200310010-00009

Cited by 16 publications

(15 citation statements)

References 18 publications

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“…Given this background, it could be that estrogens have a deleterious impact on lacrimal gland function and reduce aqueous secretion. Consistent with this possibility are some (Sato and Sullivan, 1994; Sullivan, 2004; Toda et al, 1999), but not other (Affinito et al, 2003; Arakaki et al, 2010; Azzarolo et al, 2003; Forsblad-d'Elia et al, 2009; Guaschino et al, 2003; Hayashi et al, 2004; Ishimaru et al, 2003; Ishimaru et al, 1999; Kuscu et al, 2003; Mostafa et al, 2012; Pelit et al, 2003; Shim et al, 2004; Sullivan, 2004; Takahashi et al, 1997; Taner et al, 2004), research findings. Indeed, with the possible exception of specific genes (Suzuki et al, 2006), no consensus exists concerning the cellular targets for, or the cellular processes that may be regulated by, estrogens in lacrimal tissue (Affinito et al, 2003; Azzarolo et al, 2003; Imbert et al, 2009; Ishimaru et al, 2008; Kuscu et al, 2003; Paliwal and De, 2006; Pelit et al, 2003; Sato and Sullivan, 1994; Seamon et al, 2008; Srikantan and De, 2008; Srikantan et al, 2007; Sullivan, 2004; Suzuki et al, 2006; Taner et al, 2004; Zylberberg et al, 2007).…”

Section: Discussionmentioning

confidence: 88%

“…Researchers have also posited that estrogen insufficiency promotes a SjS-like autoimmune exocrinopathy (Arakaki et al, 2010; Hayashi et al, 2004; Ishimaru et al, 2003; Ishimaru et al, 1999; Shim et al, 2004; Sullivan, 2004; Takahashi et al, 1997). Conversely, estrogen treatment purportedly corrects such defects in lacrimal gland anatomy and physiology, and promotes aqueous secretion (Affinito et al, 2003; Guaschino et al, 2003; Mostafa et al, 2012; Sullivan, 2004). …”

Section: Introductionmentioning

confidence: 99%

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Does estrogen deficiency cause lacrimal gland inflammation and aqueous-deficient dry eye in mice?

Darabad¹,

Suzuki²,

Richards³

et al. 2014

Experimental Eye Research

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Researchers have proposed that estrogen deficiency will lead to a Sjögren's syndrome (SjS)-like lacrimal gland inflammation, aqueous tear deficiency and dry eye. The purpose of this study was to determine whether this proposal is correct. Lacrimal glands were obtained from adult, age-matched wild type (WT) and aromatase knockout (ArKO) mice, in which estrogen synthesis is completely eliminated. Tissues were also obtained from autoimmune MRL/Mp-lpr/lpr (MRL/lpr) mice as inflammation controls. Tear volumes in WT and ArKO mice were measured and glands were processed for molecular biological and histological evaluation. Our results demonstrate that estrogen absence does not lead to a SjS-like inflammation in lacrimal tissue or to an aqueous-deficient dry eye. There was no upregulation of genes associated with inflammatory pathways in lacrimal glands of male or female ArKO mice. Such inflammatory activity was prominent in autoimmune MRL/lpr tissues. We also found no evidence of inflammation in lacrimal gland tissue sections of estrogen-deficient mice, and tear volumes of ArKO males were actually increased as compared to those WT controls. Interestingly, our study did show that estrogen absence influences the expression of thousands of lacrimal gland genes, and that this impact is sex- and genotype-specific. Our findings demonstrate that estrogen absence is not a risk factor for the development of SjS-like lacrimal gland inflammation or for aqueous-deficient dry eye in mice.

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Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Does estrogen deficiency cause lacrimal gland inflammation and aqueous-deficient dry eye in mice?

Darabad¹,

Suzuki²,

Richards³

et al. 2014

Experimental Eye Research

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“…42,43,44,45, 46,47,48 Interesting, there are a few studies that show PMH use has no effect on IOP. 49,50,51 …”

Section: Resultsmentioning

confidence: 99%

Is Estrogen a Therapeutic Target for Glaucoma?

Dewundara

Wiggs

Sullivan

et al. 2016

Seminars in Ophthalmology

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Objective To provide an overview of the association between estrogen and glaucoma. Methods A literature synthesis of articles published in peer review journals screened through May 05, 2015 using the PubMed database. Key words used were “estrogen and glaucoma,” “reproductive factors and glaucoma,” “estrogen, nitric oxide and eye.” Forty three journal articles were included. Results Markers for lifetime estrogen exposure have been measured by several studies and show that the age of menarche onset, oral contraceptive (OC) use, bilateral oophorectomy, age of menopause onset and duration between menarche to menopause are associated with primary open angle (POAG) risk. The Blue Mountain Eye Study found a significantly increased POAG risk with later (>13 years) compared with earlier (≤12 years) age of menarche. Nurses’ Health Study (NHS) investigators found that OC use of greater than 5 years was associated with a 25% increased risk of POAG. The Mayo Clinic Cohort Study of Oophorectomy and Aging found that women who underwent bilateral oophorectomy before age 43 had an increased risk of glaucoma. The Rotterdam Study found that women who went through menopause before reaching the age of 45 years had a higher risk of open-angle glaucoma (2.6-fold increased risk) while the NHS showed a reduced risk of POAG among women older than 65 who entered menopause after age ≥ 54 years. Increased estrogen states may confer a reduced risk of glaucoma or glaucoma related traits such as reduced intraocular pressure (IOP). Pregnancy, a hyperestrogenemic state, is associated with decreased IOP during the third trimester. Though the role of post-menopausal hormone (PMH) use in the reduction of IOP is not fully conclusive, PMH use may reduce the risk of POAG. From a genetic epidemiologic perspective, estrogen metabolic pathway single nucleotide polymorphisms (SNPs) were associated with POAG in women and polymorphisms in endothelial nitric oxide synthase, a gene receptive to estrogen regulation, are associated with glaucoma. Conclusions Increasing evidence suggests that lifetime exposure to estrogen may alter the pathogenesis of glaucoma. Estrogen exposure may have a neuroprotective effect on the progression of POAG but further studies need to confirm this finding. The role of sex-specific preventive and therapeutic treatment may be on the horizon.

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“…An improvement in ocular symptoms has been reported with oral and transdermal supplementation with oestrogen and oestrogen/progesterone, 159,[195][196][197][198] as well as a positive impact on tear volume and stability. 159,166,195,197,[199][200][201] Topically applied oestrogen drops and ointment may also improve symptoms and tear function. 202,203 Unfortunately, the evidence for the effects of hormone treatment on dry eye from this body of work is limited, as only one placebocontrolled (pilot) study has been published 203 and many are not controlled.…”

Section: Oestrogen and Progesterone Treatmentmentioning

confidence: 99%

Sex hormones and the dry eye

Truong

Cole

Stapleton

et al. 2014

Clinical and Experimental Optometry

120

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The greater prevalence of dry eye in women compared to men suggests that sex hormones may have a role in this condition. This review aims to present evidence for how sex hormones may affect the ocular structures involved in the production, regulation and maintenance of the normal tear film. It is hypothesised that hormone changes alter the homeostasis of the ocular surface and contribute to dry eye. Androgens impact on the structure and function of the meibomian and lacrimal glands and therefore androgen deficiency is, at least in part, associated with the aetiology of dry eye. In contrast, reports of the effects of oestrogen and progesterone on these ocular structures and on the conjunctiva are contradictory and the mechanisms of action of these female-specific sex hormones in the eye are not well understood. The uncertainty of the effects of oestrogen and progesterone on dry eye symptoms is reflected in the controversial relationship between hormone replacement therapy and the signs and symptoms of dry eye. Current understanding of sex hormone influences on the immune system suggests that oestrogen may modulate a cascade of inflammatory events, which underlie dry eye.

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Visual function in menopause: the role of hormone replacement therapy

Abstract: HRT improves visual function, promoting a better contrast sensitivity and a higher tear production, but does not modify intraocular pressure.

Cited by 16 publications

References 18 publications

Does estrogen deficiency cause lacrimal gland inflammation and aqueous-deficient dry eye in mice?

Does estrogen deficiency cause lacrimal gland inflammation and aqueous-deficient dry eye in mice?

Is Estrogen a Therapeutic Target for Glaucoma?

Sex hormones and the dry eye

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