Tear function changes of postmenopausal women in response to hormone replacement therapy

Abstract

Objective: The goal of this study was to search the effect of hormone replacement therapy (HRT) on tear function changes in postmenopausal women. Methods: Following initial ophtalmic evaluation and tear sample collection, the subjects were given daily 0.625 mg conjugated estrogen, and either continuous combined or cyclic 5 mg medroxyprogesterone acetate was added. Eye examination included visual acuity, slit-lamp examination, fundus examination, tonometry, Schirmer's test, and break up time (BUT) evaluation. Six months later, control examination was done and repeat tear samples were obtained. Tear immune globulin A (IgA) and lysozyme levels were measured by gel electrophoresis. The pictures of the bands were evaluated by digital image analysis with Scion Image program. Results: Conjunctival vascular congestion, laxity and corneal desquamation did not change before and after HRT ( P>0.05). A significant improvement was noted in meibomian gland inflammation ( P=0.034). We have not observed any significant difference in burning, foreign body sensation, and tearing ( P>0.05). In addition, no significant difference was noted in BUT ( P=0.370) and Schirmer's test values ( P=0.271). Though both lysozyme and IgA levels were elevated following the therapy, only IgA levels increased significantly ( P=0.04) ( Fig. 2). Conclusion: HRT decreased meibomian gland inflammation and increased tear lysozyme and IgA levels in postmenopausal women.