Itchy-Dry Eye Associated with Polycystic Ovary Syndrome - 21/08/11

Doi : 10.1016/j.ajo.2007.01.030

Stefano Bonini ^a,^b,^⁎ , Flavio Mantelli ^a, Costanzo Moretti ^c, Alessandro Lambiase ^a,^b, Sergio Bonini ^d, Alessandra Micera ^a,^b
^a Interdisciplinary Center for Biomedical Research (CIR), Laboratory of Ophthalmology, University Campus Bio-Medico of Rome, Italy
^b IRCCS G.B. Bietti Eye Foundation, Rome, Italy
^c Department of Endocrinology, University of Rome Tor Vergata, Rome, Italy
^d II University of Naples and National Research Council (CNR), Rome, Italy.

Inquiries to Stefano Bonini, Department of Ophthalmology, University Campus Bio-Medico of Rome, Via Emilio Longoni 83, 00155 Rome, Italy

Résumé

Purpose

The authors aimed to define the ocular symptomatology of women with polycystic ovaries and hyperandrogenism.

Design

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.

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