Purchase this article with an account.
Brian Jonathan Nguyen, Elana Meer, Angela S Gupta, Gao Jinpeng, Gui-Shuang Ying, Vatinee Y Bunya, Ilaria Macchi, Mina Massaro-Giordano; The effect of finasteride on dry eye disease. Invest. Ophthalmol. Vis. Sci. 2022;63(7):427.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The purpose of this retrospective study was to characterize dry eye disease (DED) in patients taking finasteride, a potent targeted anti-androgenic medication.
An extended case series with retrospective chart review of all cases of patients on finasteride seen in the Scheie Eye Institute Dry Eye Clinic at the University of Pennsylvania from January 1, 2005 to the December 1, 2021. Patient demographics, diagnosis, prior treatment, questionnaire data, and DED clinical exam outcomes were extracted. Statistical analysis was performed to assess clinical characteristics and Ocular Surface Disease Index (OSDI) quality of life measures among patients on varying doses of finasteride.
116 patients with a history of DED on finasteride were included with an average age of 67.9 years (SD 13.9). The population was predominantly male (95%), and Caucasian (86%). 23 patients were on a finasteride dosage of 1 mg or 2.5 mg, and 93 patients were on a finasteride dosage of 5 mg. Mean follow up was 55.3 months (SD 35.1, range 2.5 to 119.2). When comparing exam findings during initial and followup visit, a significantly greater percent of patients was noted to have meibomian gland disease (MGD) (62.9% [initial] vs 85.3% [followup], p = 0.0001), conjunctival abnormalities (21.1% [initial] vs 41.9% [followup], p = 0.0002), and corneal abnormalities (26.3% [initial] vs 40.5% [followup], p = 0.0047) at final exam. Mean OSDI score was 24.4 (SD 19.6) and was slightly higher in patients taking 5mg, though this was not statistically significant. Lower dose finasteride use was significantly associated with a greater frequency of cyclosporine use at first exam (26.1% vs 6.5%, p = 0.01) and last exam (25.0% vs. 3.4%, p = 0.0168). Otherwise, treatment modalities were no different between the lower and high dose groups.
To our knowledge, this represents the largest demographic study over 15 years of DED patients on finasteride, demonstrating an association with finasteride usage and MGD, conjunctival, and corneal abnormalities. The androgen sensitive meibomian glands may be altered in those taking anti-androgen medications, and especially finasteride given its unique potency and targeted effects compared to other anti-androgenics. This study reinforces the importance of considering the long-term effects of finasteride use on DED as part of the systemic sequelae of androgen depletion and provides anticipatory guidance for patients and ophthalmologists.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
This PDF is available to Subscribers Only