Abstract
Purpose: :
Clinical experience treating female dry eye patients with transdermal testosterone has suggested that women of different ages do not respond equally to this treatment. Menopausal women appear to respond best while geriatric women have a dramatically reduced response. The present study attempts to describe this age-related response to testosterone in female dry eye patients more precisely.
Methods: :
The charts of 62 female patients who were treated with 5% testosterone twice a day were separated into three age related groups for analysis: Group 1 under age 40, Group 2 age 40 to 60 and Group 3 over age 60. The average age for each group was 26.57 +/- 5 yrs, 48.56+/- 4.23 yrs, and 68.08+/-6.35 yrs, respectively. Before treatment, baseline TBUT, Schirmer test with anesthetic and Ocular Surface Disease Index (OSDI) survey results were obtained. After three weeks of treatment with testosterone cream, measurements were retaken, and the data was analyzed with a one-way analysis of variance and post hoc test for significance.
Results: :
Group 1 had average baseline TBUT of 4.82 +/- 1.70 sec, Schirmer of 10.2 +/- 6.70 mm and OSDI value of 33.7 +/- 11.6 with post treatment values of TBUT 6.20 +/- 2.40 and Schirmer 12.4 +/- 7.7 and OSDI 19.2 +/-14.1. Group 2 baseline results were TBUT 3.87+/- 1.76, Schirmer 11.9 +/- 6.20 and OSDI 41.7+/-7.34 with post treatment values of TBUT 6.35 +/- 2.79, Schirmer 16.4 +/- 6.98 and OSDI 18.9 +/- 14.9. Group 3 baseline values were TBUT 3.20 +/- 1.78, Schirmer 9.60 +/- 4.50 and OSDI 36.0 +/- 15.5 with post treatment values of TBUT 4.24 +/- 1.97, Schirmer 10.3 +/- 5.0 and OSDI 26.0 +/- 15.6. Only Group 2 (the 40 to 60 year old group) had statistically significant improvement at the p=0.01 level for both the TBUT and OSDI tests.
Conclusions: :
Only Group 2 (40 - 60 yrs) had statistically significant improvement in dry eye symptoms as well as TBUT, but all groups had some positive changes in their dry eye tests. Group 3 (over age 60) was the least responsive to treatment. Women ages 40 to 60 appear to be the target group for androgenic treatment of dry eye.
Keywords: cornea: tears/tear film/dry eye