Treatment of menopausal keratoconjunctivitis sicca with topical oestradiol.
OBJECTIVE
To investigate the effect of 17 beta-oestradiol ophthalmic drops in comparison with a traditional tear substitute in postmenopausal women with keratoconjunctivitis sicca.


METHODS
Randomised prospective trial.


METHODS
Menopause clinic.


METHODS
Eighty-four postmenopausal women suffering from keratoconjunctivitis sicca and necessitating a hormone replacement therapy (HRT) for general climacteric symptoms.


METHODS
The women were randomised into two groups and were given 17 beta-oestradiol eye drops (n = 42, group 1) or a tear substitute (n = 42, group 2). Both groups received a systemic HRT.


METHODS
A Schirmer's test was performed immediately before the beginning of therapy and after four months. In addition, eye symptoms were assessed using a visual analogue scale.


RESULTS
A comparison of visual analogue scores at four months in the women who received 17 beta-oestradiol eye drops versus those who received a tear substitute demonstrated a statistically significant difference in all observed ocular symptoms (P < 0.0001). The Schirmer's test revealed a significant difference of results before and after treatment in the oestradiol group (P < 0.0001) while in group 2 no significant difference was found.


CONCLUSIONS
Our study demonstrates that topical oestrogen is successful in treating keratoconjunctivitis sicca while it seems that the blood-eye barrier prevents systemic oestrogens from acting on the conjunctivae.
Sator
M O
MO
Department of Obstetrics and Gynaecology, University of Vienna, Austria.
Joura
E A
EA
Golaszewski
T
T
Gruber
D
D
Frigo
P
P
Metka
M
M
Hommer
A
A
Huber
J C
JC
D000287:Administration, Topical; D004958:Estradiol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007637:Keratoconjunctivitis / Q000188:drug therapy*; D008593:Menopause; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
D004958:Estradiol