Itchy-dry eye associated with polycystic ovary syndrome.
OBJECTIVE
The authors aimed to define the ocular symptomatology of women with polycystic ovaries and hyperandrogenism.


METHODS
Prospective, observational case series.


METHODS
Of the 62 consecutive patients with an ultrasonographic diagnosis of polycystic ovary (PCO), 16 were identified as having clinical and biochemical signs of hyperandrogenism. All women with a history of ocular symptoms (20/62 total patients [32.3%], 15/16 polycystic ovary syndrome (PCOS) patients [93.7%], and 5/46 PCO patients [10.8%]) underwent a complete eye examination with conjunctival impression cytologic sampling. Clinical measurements of tear function (tear film break-up time [BUT], Schirmer I test) were completed along with analysis of conjunctival goblet cell number, conjunctival immunostaining, and reverse-transcriptase polymerase chain reaction for the mucins MUC1 and MUC5AC. Clinical, histologic, and biochemical data of patients with PCOS were compared statistically with that of patients with PCO and with eight age- and gender-matched healthy controls. Eight of the most severely affected patients received systemic antiandrogen therapy and underwent further ocular evaluation four months after systemic therapy.


RESULTS
Women with PCOS had greater conjunctival hyperemia (P < .001), dryness (P < .001), itching (P < .001), mucous discharge (P < .001), and contact lens intolerance (P < .001) than patients with PCO. Patients with PCOS had a significant reduction of the tear film BUT accompanied by a significant increase in goblet cell number and conjunctival MUC5AC messenger ribonucleic acid expression compared with both PCO patients and healthy subjects.


CONCLUSIONS
Evaluation of the ocular surface should be considered in patients with PCO or PCOS. Women with PCOS were more likely to have itchy-dry eyes, decreased tear film BUT, and increased goblet cell density.
Bonini
Stefano
S
Interdisciplinary Center for Biomedical Research (CIR), Laboratory of Ophthalmology, University Campus Bio-Medico of Rome, Rome, Italy. s.bonini@unicampus.it
Mantelli
Flavio
F
Moretti
Costanzo
C
Lambiase
Alessandro
A
Bonini
Sergio
S
Micera
Alessandra
A
D000328:Adult; D000951:Antigens, Neoplasm / Q000235:genetics / Q000378:metabolism; D003228:Conjunctiva / Q000098:blood supply / Q000473:pathology; D015352:Dry Eye Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D005260:Female; D020397:Goblet Cells / Q000473:pathology; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications / Q000175:diagnosis / Q000378:metabolism; D006940:Hyperemia / Q000209:etiology; D007124:Immunoenzyme Techniques; D055271:Mucin 5AC; D018396:Mucin-1; D009077:Mucins / Q000235:genetics / Q000378:metabolism; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism; D011446:Prospective Studies; D011537:Pruritus / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D012333:RNA, Messenger / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014463:Ultrasonography
D000951:Antigens, Neoplasm; C060192:MUC1 protein, human; C524678:MUC5AC protein, human; D055271:Mucin 5AC; D018396:Mucin-1; D009077:Mucins; D012333:RNA, Messenger