December 2010
Volume 51, Issue 12
Letters to the Editor  |   December 2010
Author Response: Eu-estrogenemia and Retinal Blood Flow
Author Affiliations & Notes
  • Micheline C. Deschênes
    Departments of Ophthalmology and
    the Maisonneuve-Rosemont Hospital Research Center, Montréal, Québec, Canada; and
  • Denise Descovich
    the Maisonneuve-Rosemont Hospital Research Center, Montréal, Québec, Canada; and
  • Michèle Moreau
    Family Medicine, Faculty of Medicine, and
  • George A. Kuchel
    the UConn Center on Aging, University of Connecticut Health Center, Farmington, Connecticut.
  • Elvire Vaucher
    School of Optometry, University of Montréal, Montréal, Québec, Canada;
  • Mark R. Lesk
    Departments of Ophthalmology and
    the Maisonneuve-Rosemont Hospital Research Center, Montréal, Québec, Canada; and
Investigative Ophthalmology & Visual Science December 2010, Vol.51, 6902. doi:
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      Micheline C. Deschênes, Denise Descovich, Michèle Moreau, George A. Kuchel, Elvire Vaucher, Mark R. Lesk; Author Response: Eu-estrogenemia and Retinal Blood Flow. Invest. Ophthalmol. Vis. Sci. 2010;51(12):6902. doi:

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      © ARVO (1962-2015); The Authors (2016-present)

  • Supplements
We thank Drs. Turner and Kerber for their supportive letter in the importance of the findings of our study published in the May issue of the journal, “Postmenopausal Hormone Therapy Increases Retinal Blood Flow and Protects the Retinal Nerve Fiber Layer.” 1 This study was designed to bring to light the significant beneficial role that estrogens play by increasing retinal blood flow and protecting the retinal nerve fiber layer in women. There is a large body of evidence indicating that estrogens have beneficial vasomotor effects in several vascular beds, and there is a growing body of evidence that they have protective and trophic effects on the neurons in the brain. However, our understanding of the role of estrogens in the retina and optic nerve is limited, and we are just seeing the tip of the iceberg. 
We are pleased that Drs. Turner and Kerber have called gynecologists' and ophthalmologists' attention to the visual function of women who are chronically hypoestrogenemic. Particularly, we believe that this hypoestrogenemic state could be important in women who experience early menopause onset, premature ovarian failure caused by chemotherapy and radiotherapy, genetic disorders, and hypopituitarism, 2 and in women undergoing aromatase inhibitor or selective estrogen receptor modulator therapy used for treating or preventing the recurrence of breast cancer. 3 Women who are chronically hypoestrogenemic may be susceptible to impaired ocular blood flow, which is hypothesized to be a contributing factor in the etiology and progression of age-related macular degeneration 4 and glaucoma 5 and to the thinning of the retinal nerve fiber layer, which is a clinical feature of glaucoma. 
Deschênes MC Descovich D Moreau M . Postmenopausal hormone therapy increases retinal blood flow and protects the retinal nerve fiber layer. Invest Ophthalmol Vis Sci. 2010;51:2587–2600. [CrossRef] [PubMed]
Nippita TA Baber RJ . Premature ovarian failure: a review. Climacteric. 2007;10:11–22. [CrossRef] [PubMed]
Visvanathan K Chlebowski RT Hurley P . American Society of Clinical Oncology Clinical Practice Guideline Update on the use of pharmacologic interventions including tamoxifen, raloxifene, and aromatsae inhibition for breast cancer risk reduction. J Clin Oncol. 2009;3235–3258.
Harris A Chung HS Ciulla TA Kagemann L . Progress in measurement of ocular blood flow and relevance to our understanding of glaucoma and age-related macular degeneration. Prog Retin Eye Res. 1999;18:669–687. [CrossRef] [PubMed]
Flammer J Orgül S Costa VP . The impact of ocular blood flow in glaucoma. Prog Retin Eye Res. 2002;21:359–393. [CrossRef] [PubMed]

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