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      Association Between Serum Levels of Testosterone and Estradiol With Meibomian Gland Assessments in Postmenopausal Women

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          The aims of this analysis were to determine if there is an association between serum levels of testosterone and estradiol with meibomian gland (MG) morphology and lipid layer thickness.


          The data used for this analysis were collected from postmenopausal women with and without dry eye disease. Meibography was used to assess MG dropout on the central two-thirds of the eyelid and biomicroscopy was used for assessing MG expressibility and meibum quality. Venous blood samples were drawn for serum hormone level analysis. The Kruskal-Wallis test and Spearman correlations were used for statistical analysis.


          One hundred ninety-eight postmenopausal women with an average age of 61.2 (±9.1) years were included in this analysis. Testosterone levels showed significant differences between MG dropout grades 1 and 4 ( P = 0.002) and grades 2 and 4 ( P = 0.01), whereas estradiol levels were different based on MG dropout ( P = 0.53). No significant correlations were found between testosterone ( r = 0.10, P = 0.17) or estradiol ( r = 0.05, P = 0.45) and lipid layer thickness.


          Testosterone levels were increased with MG dropout, which was significant between the mild and severe dropout groups, whereas no significant differences were found with estradiol and any MG assessment. Although the literature suggests an association of serum hormone levels and pathogenesis of dry eye disease in postmenopausal women, analysis of active sex steroid precursors and local tissue hormone levels may prove more useful.

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          Most cited references 40

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          Prevalence of dry eye syndrome among US women.

          Dry eye syndrome (DES) is believed to be one of the most common ocular problems in the United States (US), particularly among older women. However, there are few studies describing the magnitude of the problem in women and how this may vary with demographic characteristics. Cross-sectional prevalence survey. we surveyed 39,876 US women participating in the Women's Health Study about a history of diagnosed DES and dry eye symptoms. we defined DES as the presence of clinically diagnosed DES or severe symptoms (both dryness and irritation constantly or often). We calculated the age-specific prevalence of DES and adjusted the overall prevalence to the age distribution of women in the US population. We used logistic regression to examine associations between DES and other demographic factors. The prevalence of DES increased with age, from 5.7% among women or = 75 years old. The age-adjusted prevalence of DES was 7.8%, or 3.23 million women aged > or = 50 in the US. Compared with Whites, Hispanic (odds ratio [OR] = 1.81, confidence interval [CI] = 1.18-2.80) and Asian (OR = 1.77, CI = 1.17-2.69) women were more likely to report severe symptoms, but not clinically diagnosed DES. There were no significant differences by income (P([trend]) =.78), but more educated women were less likely to have DES (P([trend]) =.03). Women from the South had the highest prevalence of DES, though the magnitude of geographic differences was modest. Dry eye syndrome leading to a clinical diagnosis or severe symptoms is prevalent, affecting over 3.2 million American women middle-aged and older. Although the condition is more prevalent among older women, it also affects many women in their 40s and 50s. Further research is needed to better understand DES and its impact on public health and quality of life.
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            The international workshop on meibomian gland dysfunction: report of the subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland.

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              The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee.


                Author and article information

                Invest Ophthalmol Vis Sci
                Invest. Ophthalmol. Vis. Sci
                Investigative Ophthalmology & Visual Science
                The Association for Research in Vision and Ophthalmology
                1 February 2016
                February 2016
                : 57
                : 2
                : 295-300
                School of Optometry University of Alabama at Birmingham, Birmingham, Alabama, United States
                Author notes
                Correspondence: Kelly K. Nichols, University of Alabama at Birmingham, 1716 University Boulevard, HPB 112, Birmingham, AL 35294-0010, USA; nicholsk@ 123456uab.edu .
                iovs-57-01-40 IOVS-15-18158

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                Clinical and Epidemiologic Research


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