Abstract
Purpose: :
Chronic use of topical glucocorticoids, such as prednisolone, can result in elevated IOP. There is some cross–reactivity of steroid hormone receptors such that elevation of IOP could become a concern with long term use of testosterone. This study examines long term changes in ocular health for patients using transdermal testosterone cream to relieve dry eye symptoms.
Methods: :
The records of 23 female patients who consistently used testosterone cream applied to the eyelids twice a day for at least 3 years were analyzed for changes in TBUT, Schirmer, IOP and contact lens wear time. Fifteen of these 23 patients were contact lens wearers. The patients ranged in age from 40 to 69 with a mean age 55.5 yrs. Statistical significance of the changes in TBUT (tear breakup time), Schirmer test, IOP and contact lens wear time was determined by a two tailed t–test.
Results: :
Baseline TBUT went from 4.1 sec to 6.1 sec this change was significant at p=.05 level. Baseline Schirmer rose from 7.31 mm to 10.54 mm was also significant at p=.05. Baseline IOP was 13.85 mm Hg and was not significantly different from the 13.27 mm Hg measured at an office visit 3 years after initiation of cream use. Baseline contact lens wear time increased from 7.6 to 11.7 hours and was significant at p=.05 level. The increased wear time commenced 4 weeks after initiation of cream use and has been maintained for 3 years.
Conclusions: :
Transdermal testosterone cream use results in statistically significant changes in TBUT, Schirmer and contact lens wear time. Despite the fact that testosterone cream is a steroid hormone, no elevation in IOP was observed after 3 years of patient use. Transdermal delivery of testosterone appears to be a safe and effective treatment for dry eye.
Keywords: cornea: tears/tear film/dry eye • intraocular pressure