title: Tear function changes of postmenopausal women in response to hormone replacement therapy.
abstract: OBJECTIVE
  The goal of this study was to search the effect of hormone replacement therapy (HRT) on tear function changes in postmenopausal women.
  
  
  METHODS
  Following initial ophtalmic evaluation and tear sample collection, the subjects were given daily 0.625 mg conjugated estrogen, and either continuous combined or cyclic 5 mg medroxyprogesterone acetate was added. Eye examination included visual acuity, slit-lamp examination, fundus examination, tonometry, Schirmer's test, and break up time (BUT) evaluation. Six months later, control examination was done and repeat tear samples were obtained. Tear immune globulin A (IgA) and lysozyme levels were measured by gel electrophoresis. The pictures of the bands were evaluated by digital image analysis with Scion Image program.
  
  
  RESULTS
  Conjunctival vascular congestion, laxity and corneal desquamation did not change before and after HRT (P>0.05). A significant improvement was noted in meibomian gland inflammation (P=0.034). We have not observed any significant difference in burning, foreign body sensation, and tearing (P>0.05). In addition, no significant difference was noted in BUT (P=0.370) and Schirmer's test values (P=0.271). Though both lysozyme and IgA levels were elevated following the therapy, only IgA levels increased significantly (P=0.04).
  
  
  CONCLUSIONS
  HRT decreased meibomian gland inflammation and increased tear lysozyme and IgA levels in postmenopausal women.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Celal Bayar University, Manisa, Turkey. kemal.kuscu@bayar.edu.tr
authors.forename: Naci Kemal
authors.initials: NK
authors.lastname: Kuscu
authors.forename: Ahmet Baris
authors.initials: AB
authors.lastname: Toprak
authors.forename: Seda
authors.initials: S
authors.lastname: Vatansever
authors.forename: Faik Mumtaz
authors.initials: FM
authors.lastname: Koyuncu
authors.forename: Cenap
authors.initials: C
authors.lastname: Guler
mesh_terms: D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D007765:Lacrimal Apparatus / Q000187:drug effects*; D008875:Middle Aged; D017698:Postmenopause; D013666:Tears / Q000737:chemistry*