Abstract
Purpose :
In women receiving aromatase inhibitor (AI) therapy for breast cancer, dry eye is a significant cause of distress and treatment non-compliance. However, little is known of its effect on the ocular surface. This study aimed to compare dry eye clinical features in aromatase inhibitor (AI) therapy patients versus healthy postmenopausal women.
Methods :
A comparative observational study of postmenopausal women treated with AI therapy versus healthy controls was conducted. Symptoms were assessed using a validated questionnaire (Ocular surface disease index [OSDI]). Dry eye clinical assessments and investigations (i.e. visual acuity, Schirmer’s test II, non-invasive tear break up time [NIBUT], meibomiography) were performed. The primary outcome measure was dry eye symptoms measured via the OSDI and secondary outcome measures signs of dry eye disease.
Results :
A total of 65 women were recruited, 25 AI and 40 healthy control patients. The mean age in the AI and healthy control group was 62±10 and 60±8 years (p=0.132), respectively. The mean OSDI score in the AI group was 24±18 and controls 22±24 (p=0.174). In the AI group, 16 patients were considered symptomatic (OSDI ≤13) and 9 were asymptomatic. In the controls, 20 were symptomatic and 20 were asymptomatic for dry eye. Comparative analysis of the AI and control group found no significant difference between visual acuity (p=0.728) or Schirmer score (p=0.108). NIBUT was significantly longer in the AI group compared to controls (p<0.001) (11±6 vs 3±2, respectively). Increased loss of meibomian gland was also observed (p=0.022) in the AI group (3 [IQR 2- 4]) compared to the controls (2 [IQR 1 – 3]).
Conclusions :
Aromatase inhibitor therapy was associated with increased NIBUT and meibomian gland drop out. Increased NIBUT maybe due to tear film instability due to the higher meibomian gland drop. Meibography assessments could be used to screen women on AI therapy at risk of developing evaporative dry eye.
This is a 2021 ARVO Annual Meeting abstract.