Visual function in menopause: the role of hormone replacement therapy

The effects of different hormone replacement therapy regimens on tear function, intraocular pressure and lens opacity

“…The literature contains a few prospective and epidemiological studies that directly assess the potential relationship of exogenous estrogen use with dry eye syndrome. A reduction of important ocular surface parameters such as tear production and stability has been found in postmenopausal women, and HRT has been shown by some authors to recover Schirmer test values in the normal range [12][13][14], although others did not report any role of HRT in tear production [15]. Two studies found no statistically significant relationship of HRT with the presence of self-reported dry eye symptoms [2,16].…”

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

“…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, topical E 2 drops appear to alleviate dry eye symptoms Synthesis of oestrogens.…”

“…Some report no effect of hormone therapy on IOP (Guaschino et al 2003, Abramov et al 2005, and one study (Khurana et al 2006) found that HRT raises IOP in postmenopausal females with dry eye syndrome. However, most studies observed that hormone therapy significantly lowers IOP in menopausal (Sator et al 1998) and postmenopausal women (Guaschino et al 2003, Altintas et al 2004, Uncu et al 2006, Tint et al 2010, Coksuer et al 2011; data given in Table 1). This conclusion is supported by animal models, where it has been reported that E 2 prevents retinal ganglion cell loss induced by acute IOP elevation in rats (Russo et al 2008).…”

“…There is also evidence that visual sensitivity improves in pregnancy, being greatest in the third trimester when oestrogen levels are at their highest (Akar et al 2005). Contrast sensitivity is lower in postmenopausal than in premenopausal women (Siesky et al 2008), particularly at high spatial frequencies (between 9 and 18 cycles/degree), and improves after hormone therapy (Guaschino et al 2003). Contrast sensitivity may also vary with normal cycling oestrogen (Johnson & Petersik 1987), being best towards the middle of the cycle when E 2 levels in the blood are at their highest.…”

Does HRT Change İntraocular Pressure in Postmenopausal Women ?

“…In another study in which patients were followed up 6-months done by Coksuer and colleagues, 2 mg drospirenone + 1 mg estradiol treatment has been shown to reduce the mean IOP (18). Studies have been reported that HRT use in postmenopausal women alters IOP (19,20). Again in another study there is a decline in IOP by 12 months only estrogen treatment in postmenopausal women (in this study mean IOP value was 14.6 mmHg before treatment, and 12.6 mmHg after 12 months estrogen treatment).…”