title: Effects of androgen replacement therapy on cornea and tear function in men with idiopathic hypogonadotropic hypogonadism.
abstract: OBJECTIVE
  Idiopathic hypogonadotropic hypogonadism (IHH) is an endocrine disorder defined with the presence of typical clinical signs and symptoms plus laboratory confirmation of serum testosterone (T) levels lower than 300 ng/dl. Androgen replacement therapy (ART) is the first-step treatment of male IHH. To date, no clinical trial, which investigates the changes on corneal structure and tear function, of systemic ART in men have been published. The objective of this study was to investigate the effects of ART on cornea and tear function in patients with IHH.
  
  
  METHODS
  This prospective, interventional study was conducted at the Gulhane Military Medical Academy, Ankara, Turkey, a tertiary referral military hospital. Thirty-four eyes of 17 men with IHH patients were evaluated with Schirmer I test, ultrasound pachymeter, applanation tonometer and confocal microscopy. A Testosterone compound (Sustanon® 250 mg) was administered by intramuscular injection in the course of a 3-week period to induce puberty, and human chorionic gonadotropin (Pregnyl® 5000 IU) was administered twice weekly for 3 months to induce fertility. The patients were re-evaluated at the third month of the treatment. Main Outcome Measures were Schirmer score, central corneal thickness (CCT), intraocular pressure (IOP), endothelial cell density, coefficient of variation and cell shape.
  
  
  RESULTS
  Schirmer scores showed similar results after the treatment compared to pre-treatment levels (p = 0.14). There was no statistically significant difference in CCT and IOP compared to baseline data (p = 0.96, p = 0.73, respectively), and no significant differences were found in corneal endothelial cell density, percentage of cell size variability or hexagonality (p = 0.83, p = 0.58, p = 0.64, respectively).
  
  
  CONCLUSIONS
  This is the first study that investigates the effects of ART on corneal structure and tear function in men. ART seems to have no short-term effects on corneal structure and tear function. Further publications of larger, long-term and controlled studies are needed.
authors: Department of Ophthalmology, Kayseri Military Hospital , Kayseri , Turkey.
authors: Gokcen
authors: G
authors: Gokce
authors: Volkan
authors: V
authors: Hurmeric
authors: Tarkan
authors: T
authors: Mumcuoglu
authors: Gokhan
authors: G
authors: Ozge
authors: Yalcin
authors: Y
authors: Basaran
authors: Hilmi Umut
authors: HU
authors: Unal
authors: Erol
authors: E
authors: Bolu
authors: Fatih Mehmet
authors: FM
authors: Mutlu
mesh_terms: D000328:Adult; D003315:Cornea / Q000187:drug effects*; D020249:Hormone Replacement Therapy; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy*; D008297:Male; D011446:Prospective Studies; D013666:Tears / Q000187:drug effects* / Q000502:physiology*; D013739:Testosterone / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D013739:Testosterone
keywords: Androgen; confocal microscopy; cornea; dry eye; hypogonadism