Comparison of visual function and ocular hemodynamics between pre- and post-menopausal women.
OBJECTIVE
The incidence of eye disease increases with age and can often be linked to worsening cardiovascular function and increasing intraocular pressure. Estrogen is known to have vasodilatory effects in the systemic circulation. Decreased estrogen levels during menopause may therefore complicate or contribute to ocular pathologies as estrogen receptors are found in both retinal and choroidal tissue. The purpose of this investigation was to determine the effects of menopause on visual function and cardiovascular and ocular hemodynamics.


METHODS
Twelve premenopausal and 24 postmenopausal women were evaluated at the Indiana University School of Medicine during a single study visit. Vision screening and ocular blood flow evaluations were performed, including blood pressure, heart rate, visual acuity, contrast sensitivity, intraocular pressure, and retinal capillary and retrobulbar blood flow imaging. Vision and ocular hemodynamics were compared using unpaired Student t-tests with p<0.05 regarded as statistically significant.


RESULTS
The premenopausal group had significantly lower heart rate (-16.1 b/m, p=0.0001) and systolic blood pressure (-17.7 mmHg, p=0.003) than postmenopausal subjects. Contrast sensitivity was significantly higher (measured in log units) in premenopausal women in both the right (0.25, p=0.039; 0.16, p=0.039) and left (0.45, p=0.001; 0.27, p=0.032) eyes at 9 and 18 cycles per degree, respectively. Premenopausal women also had significantly lower intraocular pressure in both the right (-2.19 mmHg, p=0.024) and left (-1.74 mmHg, p=0.035) eyes. Total ocular perfusion was not significantly different between groups.


CONCLUSIONS
This pilot work suggests that postmenopausal women have lower contrast sensitivity detection and elevated intraocular pressures compared to premenopausal women. Premenopausal women have lower cardiovascular risk factors, while total ocular circulation was similar to postmenopausal women.
Siesky
B A
BA
Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN 46202 USA.
Harris
A
A
Patel
C
C
Klaas
C L
CL
Harris
M
M
McCranor
L J
LJ
Lauer
J
J
Kaplan
B
B
D000328:Adult; D001783:Blood Flow Velocity; D001794:Blood Pressure / Q000502:physiology; D019842:Ciliary Arteries / Q000502:physiology*; D015350:Contrast Sensitivity / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007429:Intraocular Pressure; D017078:Laser-Doppler Flowmetry; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000502:physiology*; D009898:Optic Disk / Q000098:blood supply; D017698:Postmenopause / Q000502:physiology*; D017697:Premenopause / Q000502:physiology*; D012161:Retinal Artery / Q000502:physiology*; D018615:Ultrasonography, Doppler, Color; D014792:Visual Acuity / Q000502:physiology*