Itchy-Dry Eye Associated With Polycystic Ovary Syndrome

Abstract

Purpose:: The aim of this study is to define the ocular symptomatology of women with polycystic ovaries and hyperandrogenism.

Methods:: Of the 62 consecutive patients with an ultrasonographic diagnosis of polycystic ovaries (PCO), 16 were identified as having clinical and biochemical signs of hyperandrogenism (PCOS). All women with a history of ocular symptoms (20/62 total patients=32.3%; 15/16 PCOS=93.7%; and 5/46 PCO=10.8% patients) received a complete eye examination with conjunctival impression cytology sampling. Clinical measurements of tear function (tear film break-up time, Schirmer I test) were completed along with analysis of conjunctival goblet cell number, conjunctival immunostaining and RT-PCR for the mucins MUC1 and MUC5AC. Clinical, histological and biochemical data of patients with PCOS were compared statistically to patients with PCO and to 8 age- and sex-matched healthy controls. Eight of the most severely affected patients received systemic anti-androgen therapy and underwent further ocular evaluation four months after systemic therapy.

Results:: Women with PCOS had greater conjunctival hyperemia (p<.001), dryness (p<.001), itching (p<.001), mucous discharge (p<.001) and contact lens intolerance (p<.001) than patients with PCO. Patients with PCOS had a significant reduction of the tear film break-up time accompanied by a significant increase in goblet cell number and conjunctival MUC5AC mRNA expression compared to both PCO and healthy subjects.

Conclusions:: Females with PCOS were more likely to have itchy-dry eyes, decreased break-up time and increased goblet cell density. Our data show that evaluation of the ocular surface should be considered in patients with PCO/PCOS.

Keywords: cornea: tears/tear film/dry eye • cornea: surface mucins • conjunctiva