Abstract
Hormone replacement therapy (HRT) for dry eye syndrome (DES) is controversial in clinical practice. The goal of this study was to review relevant studies and analyze the pooled data to determine whether HRT is effective for DES. In this study, a literature search of PubMed, Embase, and Cochrane databases up to May 2015 was performed, with the search restricted to English language publications. The studies were screened after reading the abstract and full text. Only studies related to the effect of HRT on DES were included in the meta-analysis. Results of Schirmer tests with and without anesthetics and tear break-up time (BUT) values data were extracted and entered into RevMan software to meta-analyze the overall effect of HRT on DES. A total of 43 studies were identified, and 21 of these studies were found to be related to the effect of HRT on DES. Ultimately, 5 studies were included in the final meta-analysis. The pooled results revealed that HRT can affect Schirmer test results without anesthetics but does not affect Schirmer test results with anesthetics and BUT. The results indicate that HRT might improve DES symptoms when measuring basal tear production without anesthesia.
Highlights
Dry eye syndrome (DES) is a multifactorial disorder of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface [1]
In the current meta-analysis, we evaluated only studies that (1) assessed postmenopausal women at least one year; (2) obtained consent from the patients; (3) included DES patients who had undergone hormone replacement therapy (HRT) with any route except topical application; (4) had data obtained from control patients who were given placebo or no HRT treatment; and (5) included Schirmer test values before and after HRT
The remaining 25 articles were divided into two categories: 21 studies were related to the effect of HRT on DES in postmenopausal women, while 4 studies were related to the incidence of DES in postmenopausal women treated with HRT
Summary
Dry eye syndrome (DES) is a multifactorial disorder of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface [1]. DES symptoms are very common in postmenopausal women and the presence of hormone receptors in eye surface suggested that gonadal steroid hormones may play an important role in regulating tear film function [5]. This was supported by the studies that the tear production and stability were reduced in postmenopausal women, and hormone replacement therapy (HRT) could recover Schirmer test values to within the normal range [6, 7]. To the best of our knowledge, Journal of Ophthalmology this study is the first meta-analysis of the effect of HRT on DES
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