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Gokcen Gokce, Ugur Keskin, Uzeyir Erdem, Umit Goktolga; Controlled Ovarian Hiperstimulation Induced Changes in Lacrimal and Pupillary Functions, Wavefront Aberrations and Intra Ocular Pressure in Infertil Women. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3735.
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© ARVO (1962-2015); The Authors (2016-present)
The aim of this study was to evaluate the effect of recombinant follicle-stimulating hormone (r-FSH) and hyperestrogenic state during the controlled ovarian hyperstimulation (c-OHS) on the lacrimal function, pupil diameter, wavefront (WF) aberrations and intra ocular pressure (IOP).
One hundred and ten eyes of 55 infertil women who were planning to receive r-FSH for ovulation induction were included in this study. Pituitary desensitization was achieved with the gonadotrophin-releasing hormone agonist (Triptoreline®). This was followed by ovarian stimulation with r-FSH (Gonal F®). Monitoring of the cycle was performed by assessment of plasma level of Estradiol (E2), and transvaginal ultrasonography. Serum E2 levels were measured before and during c-OHS [E2(1): Estradiol level two day before the oocyte retrival (1910.3±825.9); E2(2): Estradiol level on the oocyte retrieval day (3087.7±1083.1)]. Schirmer test was performed at the begining and the end of therapy. At the last visit airpuff tonometry (Nidek, Japan) was used to evaluate IOP. WF aberrations, photopic and mesopic pupil sizes were measured using OPD-Scan II Pupillometer/Corneal WF Analyser ARK-10000 system (Nidek, Japan). Correlations between E2 levels and other parameters were analysed by Pearson correlation coefficent test. The difference between schirmer scores were analyzed by Wilcoxon signed rank test.
The Schirmer test scores of eyes after r-FSH therapy were significantly lower than initial scores (17.4±5.7 mm; 11.5±4.7 mm p<0.001). Correlation between pachymetry and E2 levels was statistically significant [E2(1) r= -0.226, p=0.02 and E2(2) r= -0.192, p=0.05). When measuring WF aberrations, there were negative significant correlations between E2 levels and total coma and tilt aberrations [E2(1)-coma r= -0.296, p<0.01; E2(2)-coma r= -0.222; E2(1)-tilt r= -0.257, p=0.01; E2(2)-tilt r= -0.205, p=0.03]. No significant correlation between E2 levels and pupil diameters was observed. There was no significant correlation between E2 levels and IOP.
The results of this study suggests that hyperestrogenic state during the c-OHS in infertile women may increase the incidence of dry eye. Ocular surface changes in cornea associated with E2 level may lead to alterations in central corneal thickness and WF aberrations.
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