Purpose: To prospectively investigate the impact of various hormone replacement therapies (HRT) on ocular surface and tear function tests. Methods: A total of 70 women in the postmenopausal period were enrolled in the study. The groups consisted of 16 women who were not on HRT (group 1), 29 women who were on HRT with tibolone (group 2) and 25 women who received estradiol plus medroxyprogesterone acetate treatment (group 3). All patients underwent tear film break-up time (TFBUT), Schirmer’s test and conjunctiva cytology at the time of enrollment and at 6 months’ follow-up. Results: Patients in group 2 showed improved Schirmer’s test and TFBUT results (p < 0.001); however, no significant changes occurred in group 1 and group 3 patients (p > 0.05). Conjunctival cytology scores did not differ at the time of enrollment and at 6 months’ follow-up in all groups. Conclusions: This is the first comparative clinical study on the effects of tibolone and estradiol plus medroxyprogesterone acetate on ocular surface and tear function tests. HRT with tibolone seems to improve tear function tests in postmenopausal women.

Schaumberg DA, Buring JE, Sullivan DA, Dana MR: Hormone replacement therapy and dry eye syndrome. JAMA 2001;286:2114–2119.
Jensen AA, Higginbotham EJ, Guzinski GM, Davis IL, Ellish NJ: A survey of ocular complaints in postmenopausal women. J Assoc Acad Minor Phys 2000;11:44–49.
Vavilis D, Agorastos T, Vakani M, Jafetas J, Panidis D, Konstantinidis T, et al: The effect of transdermal estradiol on the conjunctiva in postmenopausal women. Eur J Obstet Gynecol Reprod Biol 1997;72:93–96.
Albertazzi P, Di Micco R, Zanardi E: Tibolone: A review. Maturitas 1998;30/3:295–305.
Anagnostopoulou-Fotinopoulou I, Rammou-Kinia R: Cytobrush sampling in conjunctival cytology. Diagn Cytopathol 1993;9:113–115.
Nelson DJ, Havener VR, Cameron DJ: Cellulose acetate impressions of the ocular surface: Dry eye states. Arch Ophthalmol 1983;101:1869–1872.
Metka M, Enzelsberger H, Knogler W, Schurz B, Aichmair H: Ophthalmic complaints as a climacteric symptom. Maturitas 1991;14:3–8.
Sullivan DA, Edwards JA, Wickham LA, Pena JD, Gao J, Ono M, Kelleher RS: Identification and endocrine control of sex steroid binding sites in the lacrimal gland. Curr Eye Res 1996;15:279–291.
Azzarolo AM, Bjerrum K, Maves CA: Hypophysectomy induced regression of female rat lacrimal glands: Partial restoration and maintenance by dihydrotestosterone and prolactin. Invest Ophthalmol Vis Sci 1995;36:216–226.
Azzarolo AM, Mirchef AK, Kaswan RL: Androgen support of lacrimal gland function. Endocrine 1997;6:39–45.
Sullivan DA, Krenzer KL, Sullivan BD, Tolls DB, Toda I, Dana MR: Does androgen insufficiency cause lacrimal gland inflammation and aqueous tear deficiency? Invest Ophthalmol Vis Sci 1999;40:1261–1265.
Sullivan DA, Sullivan BD, Evans J, et al: Androgen deficiency, Meibomian gland dysfunction, and evaporative dry eye. Ann NY Acad Sci 2002;966:211–222.
Lange C, Fernande J, Shim D, Spurr-Michaud S, Tijdale A, Gipson IK: Mucin gene expression is not regulated by estrogen and/or progesterone in the ocular surface epithelia of mice. Exp Eye Res 2003;77/1:59–68.
Rocha EM, Wickham LA, da Silveira LA, Krenzer KL, Yu FS, Toda I, Sullivan BD, Sullivan DA: Identification of androgen receptor protein and 5alpha-reductase mRNA in human ocular tissues. Br J Ophthalmol 2000;84:76–84.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.