title: Treatment of menopausal keratoconjunctivitis sicca with topical oestradiol.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Vienna, Austria.
authors.forename: M O
authors.initials: MO
authors.lastname: Sator
authors.forename: E A
authors.initials: EA
authors.lastname: Joura
authors.forename: T
authors.initials: T
authors.lastname: Golaszewski
authors.forename: D
authors.initials: D
authors.lastname: Gruber
authors.forename: P
authors.initials: P
authors.lastname: Frigo
authors.forename: M
authors.initials: M
authors.lastname: Metka
authors.forename: A
authors.initials: A
authors.lastname: Hommer
authors.forename: J C
authors.initials: JC
authors.lastname: Huber
mesh_terms: 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
chemical_list: D004958:Estradiol