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Charles G. Connor; The Effect of HRT on Dry Eye Patient Response to Transdermal Testosterone. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3820.
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Hormone replacement therapy (HRT) has been associated with increased incidence of dry eye. Clinical observation of women taking HRT suggests they may be more responsive to transdermal testosterone than patients not on HRT. The present retrospective studies looks at the response of female dry eye patients taking HRT and then treated with 5% transdermal testosterone cream for dry eye. This data was then compared to age matched controls not on HRT but treated with testosterone cream.
There were 12 patients charts that fit the study criteria. They were all using HRT and were treated with testosterone cream for their dry eye. The average age of these patients was 51 years+/- 15.7.The age of the matched control group of 12 patients was 50.8 yrs+/-16. The control group was also treated with testosterone for dry eye but was not taking HRT. The clinical response of these two groups was gauged by TBUT and Schirmer with anesthetic.
Pre-treatment TBUT for the HRT group was 3.25sec+/- 1.7 and 4.6sec +/-1.8 for the control. After treatment the TBUT increased for the HRT group to 9.27 sec +/- 4.4 while it was 7 sec +/- 2.9 for the control. The difference in TBUT for the HRT group was significant at the p=.05 level by ANOVA and post hoc test for significance. The results for the Schirmer test were less dramatic although they did increase. Pre-treatment level for HRT was 6.12+/-3.5 mm and increased to 11 +/-5 after treatment while the control Schirmer was 9.2+/- 5.4 and rose to 13+/- 5.6mm. None of the Schirmer changes were statistically significant.
While this study is based on a small sample size it does suggest that the presence of HRT may positively influence the response to transdermal testosterone. A potential explanation is that HRT creates a more permissive environment within the lacrimal and meibomian gland, so the glands response is greater than would occur in the absence of HRT. Alternatively, it may be that women on HRT have a more severe dry eye and therefore show a greater response.
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