title: Low levels of 17-β-oestradiol, oestrone and testosterone correlate with severe evaporative dysfunctional tear syndrome in postmenopausal women: a case-control study.
abstract: OBJECTIVE
  To evaluate the role of 17-β-oestradiol, oestrone and total testosterone (TT) deficiency in the pathogenesis of severe evaporative dry eye syndrome (DES), investigating the relationship between tear osmolarity, tear film break-up time (TF-BUT), Schirmer test and serum sex hormones in postmenopausal women.
  
  
  METHODS
  44 postmenopausal women were recruited for a case-control study: 22 women with severe evaporative DES (Group A) and 22 without DES (Group B). The tests performed included laboratory blood analysis: fasting plasma profile (17-β-oestradiol, oestrone and TT), glucose level and lipid profile. Detailed eye examinations, including corneal and conjunctival staining, tear osmolarity measurement, tear volume and TF-BUT, were performed. The Ocular Surface Disease Index Questionnaire was also administered.
  
  
  RESULTS
  Values of Schirmer test and TF-BUT in Group A were significantly lower in comparison with Group B (p<0.001). Serum levels of 17-β-oestradiol, oestrone and TT were significantly lower in Group A compared with Group B (p<0.05). In women with severe evaporative DES, the levels of 17-β-oestradiol, oestrone and TT were inversely correlated with the tear film osmolarity (r=-0.7, -0.88, -0.81, respectively).
  
  
  CONCLUSIONS
  In postmenopausal women with severe evaporative DES, sex hormone levels are lower than control and that tear osmolarity is negatively correlated with sex hormone levels.
authors.affiliation: University of Catania, Eye Clinic, , Catania, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Gagliano
authors.forename: Salvatore
authors.initials: S
authors.lastname: Caruso
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Napolitano
authors.forename: Giulia
authors.initials: G
authors.lastname: Malaguarnera
authors.forename: Maria Vittoria
authors.initials: MV
authors.lastname: Cicinelli
authors.forename: Roberta
authors.initials: R
authors.lastname: Amato
authors.forename: Michele
authors.initials: M
authors.lastname: Reibaldi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Incarbone
authors.forename: Claudio
authors.initials: C
authors.lastname: Bucolo
authors.forename: Filippo
authors.initials: F
authors.lastname: Drago
authors.forename: Teresio
authors.initials: T
authors.lastname: Avitabile
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D015352:Dry Eye Syndromes / Q000097:blood*; D004958:Estradiol / Q000097:blood*; D004970:Estrone / Q000097:blood*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D009994:Osmolar Concentration; D017698:Postmenopause / Q000097:blood*; D011795:Surveys and Questionnaires; D013666:Tears / Q000737:chemistry*; D013739:Testosterone / Q000097:blood*
chemical_list: D001786:Blood Glucose; D008055:Lipids; D004970:Estrone; D013739:Testosterone; D004958:Estradiol
keywords: Diagnostic tests/Investigation; Ocular surface; Pharmacology; Tears