Mokhtar, Saira Fairma Ismail
(2003)
Comparative study on the occurrence and severity of dry eyes between menopausal women not on hormone replacement
therapy (HRT) and those on HRT in HUSM.
Comparative study on the occurrence and severity of dry eyes between menopausal women not on hormone replacement therapy (HRT) and those on HRT in HUSM.
(Submitted)
Abstract
Introduction:
It is a known fact that Dry Eye Syndrome (DES) occurs more commonly in females
of older age group compared to men. Menopausal women have lack of hormones that may
contribute to dry eye. Hormone replacement therapy, therefore, is expected to prevent the
occurrence of dry eye. However, this has never been scientifically proven.
Objective:
To investigate the occurrence and severity of Dry Eye in menopausal women in
HUSM and to compare the results between women taking hormone replacement therapy
and those not taking any hormone replacement therapy.Methodology:
Menopausal women tn HUSM underwent eye examination consisting of the
Schirmer's test, the tear film breakup time and the rose bengal staining. At least 2 of the
tests need to be abnormal to diagnose dry eye. After the ocular examination, blood was
taken from every patient for estradiol, progesterone and dehydroepiandrosterone sulfate
levels.Results:
Fifty-four women were examined, 30 (55.6°/o) of which were on honnone
replacement therapy (HRT group), while 24 (44.4o/o) women were not on any honnone
replacement therapy (control group). In the HRT group, 11 patients were on estrogen
(Estrogen group) and 19 patients were on combined estrogen and progesterone (Combined
group). Dry eye was found in 29.2% of patients in the control group and in 70.0% of
patients in the HRT group [p<0.05]. Comparing the patients in the HRT group, dry eye
occurred more frequently in the combined estrogen and progesterone group (84.2%) as
compared to the estrogen only group (45.5%) [p<0.05]. When analysed separately, the
only dry eye test found to be statistically significant was a positive BUT test between the
Combined group (94.7%) and the Estrogen group (45.5°/o) [p<0.05]. The severity of dry
eye was not statistically significant between groups.
Conclusion:
Dry eye was found more commonly in menopausal women who took hormone
replacement therapy in Hospital Universiti Sains Malaysia. Combined estrogen and
progesterone therapy was associated with a higher occurrence of dry eye compared to
estrogen only therapy. These results, therefore, are in contrast to the previous assumption
that HRT would prevent dry eye.
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