Abstract
Purpose :
To investigate the relationship between macular telangiectasia (MacTel) type 2 and systemic levels of sex steroids or their antagonization.
Methods :
In 41 male MacTel patients as well as 115 age related healthy controls, free serum testosterone levels were measured. 49 female patients were evaluated for previous surgical (e.g. ovariectomy) and/or pharmacological (e.g. aromatase inhibitors, tamoxifen) therapies resulting in reduced systemic availability of sex steroids or suppression of their effects. Disease onset was determined by an interview about the patients’ first disease-related visual disturbances.
Results :
Female patients frequently (33%, 14/49) had a history of pharmacological suppression of sex steroids and/or ovariectomy, and this subgroup was significantly younger at disease-onset when compared to those without previous therapy affecting sex steroids (mean ± SD: 47.1±7.8 versus 60.1±7.6; p<0.01). The mean interval (±SD) between initiation of therapy/surgery and first symptoms was 3.4±5.0 years. Male MacTel patients showed significantly lower free serum testosterone levels compared to age related controls. Differences were highly significant in young patients, as opposed to non-significant differences in older patients. In men aged ≤60 years, a biochemical hypogonadism (defined as free serum testosterone <0.05 ng/ml) was present in 53% (8/15) and 4% (2/49) of patients and controls, respectively. Due to the age-related physiological decline in sex steroids, this difference was less pronounced in those >60 years-of-age (patients: 54%, 14/26; controls: 36%, 24/66).
Conclusions :
The results indicate that steroidal sex hormones might be involved in the pathophysiology of MacTel type 2, a complex, multifactorial disease.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.