Wydanie 3/2014
str. 21

Hormony płciowe a powierzchnia oka

Sex Hormones and Ocular Surface

Emilia Rębała1, Anna M. Ambroziak1,2, Justyna Izdebska1,2

1 Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie
Dyrektor: prof. dr hab. n. med. Jerzy Szaflik
2 Zakład Optyki Informacyjnej Instytutu Geofizyki Wydziału Fizyki Uniwersytetu Warszawskiego
Kierownik: dr hab. Rafał Kotyński
3 Katedra i Klinika Okulistyki II Wydziału Lekarskiego Warszawskiego Uniwersytetu Medycznego
Kierownik: prof. dr hab. n. med. Jerzy Szaflik

Summary: The ocular surface is a structure where all components are interdependent and specifically integrated and imbalance between these components results in inadequate surface lubirication, dryness and discomfort. Ocular surface disorders are common condition that increases with age in both genders, however with higher incidence among female especially after menopause. This suggests a role of sex hormones in maintaining ocular surface homeostasis. Presence of receptors for androgens, oestrogens and progesterone in ocular tissues (lacrimal and Meibomian glands, cornea, conjunctiva, lens and retina) shows that eye is sex hormones target organ.
The aim of this paper is to review available literature on the effect of the sex hormones on ocular surface. The main role in maintaining the integrity of the ocular surface plays tear film. Tear film dysfunction can lead to ocular surface disorder especially dry eye syndrome. Analyzing both forms of DES authors described androgen effect on lacrimal and Meibomian glands additionally showing the impact of androgens deficiency characteristic for menopause, complete androgen insensitivity syndrome , Sjogren's syndrome, systemic lupus erythematosus, rheumatoid arthritis and related with age in both gender or with antiandrogen therapy. This paper show also unclear effects of oestrogens and progesterone on Meibomian glands.
Literature analysis also include hormone change periods such as pregnancy, lactation, use of oral contraceptives and postmenopausal period together with effect of hormone replacement therapy on ocular surface. Complete understanding of the correct mechanisms of hormones action, their role in the pathogenesis, course and use in prevention and treatment of ocular surface diseases seems to be a key element.

Słowa kluczowe: zaburzenia powierzchni oka Zespół Suchego Oka (ZSO), hormonalna terapia zastępcza (HTZ) androgeny, estrogeny.

Keywords: Dry Eye Disease (DED), Ocular Surface Disease (OSD), Meibomian Glands Dysfunction (MGD), hormone replacement therapy, androgens, estrogens.