Does endogenous serum oestrogen play a role in meibomian gland dysfunction in postmenopausal women with dry eye?

• Main Authors: Blanka Golebiowski, Blanka, Noor Badarudin, Noor Ezailina, John Eden, John, You, Jingjing, Hampel, Ulrike, Stapleton, Fiona
• Format: Article
• Language: English
• Published: 2016
• Subjects: RE Ophthalmology
• Online Access: http://irep.iium.edu.my/52736/1/Br%20J%20Ophthalmol-2016-Golebiowski-bjophthalmol-2016-308473.pdf; http://irep.iium.edu.my/52736/; http://bjo.bmj.com/content/early/2016/04/13/bjophthalmol-2016-308473
• Institution: Universiti Islam Antarabangsa Malaysia

Aim To explore the relationship between serum concentration of sex hormones and dry eye symptoms and signs in postmenopausal women. Methods A cross-sectional analysis was undertaken. Subjects were 46 postmenopausal women with dry eye (mean age 64.4±5.2 years, 13.7±6.4 years since menopause; not undergoing hormone replacement therapy). Ocular symptoms (Ocular Surface Disease Index (OSDI) and Ocular Comfort Index (OCI)), tear function (tear osmolarity, non-invasive tear break-up time, tear secretion), corneal and conjunctival staining, and meibomian gland (MG) appearance, were recorded. Venous blood was collected and serum concentrations of 17β-oestradiol (E2), 3-α-androstanediol-glucuronide (3α-diol-G), and dehydroepiandrosterone sulfate (DHEAS) were determined using ELISA. Multiple linear regression analysis was used to examine predictors of dry eye symptoms and signs. Results Mean serum concentration of E2, 3α-diol-G and DHEA-S was 9.02±13.40 pg/mL, 1.59±1.02 ng/mL and 0.74±0.53 μg/mL, respectively. Ocular symptoms were elevated (mean scores 27.0±18.1 (OSDI) and 40.3 ±8.4 (OCI)) but signs were within normal ranges. Higher serum E2 concentration along with capped glands, lid telangiectasia and older age was a significant predictor of worse MG secretion quality (p<0.001, R2 adj=0.75). Serum hormones were not significant predictors of ocular symptoms in multivariate analysis (p>0.05). Conclusion Serum oestrogen appears to be a key factor in MG signs. Although serum hormone levels did not contribute significantly to dry eye symptoms in this study, it is possible that oestrogen plays a role through its effect on meibum secretion. These findings suggest that MG dysfunction underpins dry eye symptoms in non-Sjögren’s dry eye in postmenopausal women