Background: The aim of this study was to investigate the effect of estrogen and progesterone on central corneal thickness, corneal curvature, and the development of dry eye in postmenopausal women.Methods: This is a case-control study including 54 premenopausal and 54 postmenopausal women. The two groups were compared in terms of follicle stimulating hormone, estradiol, progesterone, and horizontal and vertical curvatures, astigmatism, central corneal thickness, Schirmer I test scores, and dry eye scores of both eyes.Results: In the postmenopausal women, central corneal thickness was significantly thinner in both eyes (p=0.017) and the Schirmer test scores were significantly lower both for the right (p=0.001) and the left eye (p=0.003). Estradiol levels were positively correlated with central corneal thickness (p=0.003-0.006) and Schirmer test scores (p=0.004-0.002) whereas progesterone levels showed a positive correlation only with Schirmer test scores (p=0.036-0.044). Although a significant positive correlation was found between estradiol levels and dry eye scores (p=0,009), no significant correlation was found between progesterone levels and dry eye scores (p=0,118).Conclusions: Age-related hormonal abnormalities lead to central corneal thinning, increased dry eye symptoms, and decreased tear flow, particularly in the postmenopausal term. Decreased estrogen levels are associated with central corneal thickness and dry-eye symptoms, decreased estrogen and progesterone levels correlates well with diminished tear production but progesterone levels does not effect dry-eye symptoms.

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Vascular endothelial growth factor (VEGF) is a molecule implicated in the pathogenesis of several eye diseases. In this experimental study, we planned to evaluate the effects of surgical menopause and hormone replacement therapy on VEGF levels. Thus, we studied the effects of treatments involving estrogen, estrogen and progesterone (E/P) in combination, and genistein, which is a selective estrogen modulator, on serum VEGF levels and the expression of VEGF in the retinas of rats with surgical menopause.The rats were randomly divided into five groups. Bilateral ovariectomy (OVX) was performed in all groups except for the shamoperated group. estrogen, E/P, genistein or water (sham and control groups) treatments were given for 8 weeks through the orogastric catheter. Serum VEGF level and immunohistochemical staining of VEGF in retinal tissue were analyzed in each group.Serum VEGF levels were significantly higher in the OVX + estrogen and OVX + genistein groups than in the control and sham groups.It was also higher in the OVX + E/P group than in the sham and control groups; however, in this case, the difference was not statistically significant. The OVX + estrogen, OVX + E/P, and OVX + genistein groups exhibited increased VEGF staining in comparison with the control and sham groups. However, the difference was not statistically significant. The current study demonstrated that estrogen replacement treatment (ERT) leads to an increase in serum VEGF levels and progesterone plays a protective role in this increase. The ERT used in this study had no effect on VEGF expression in the retina. Ratlarda Östrojen Replasman Tedavisinin Serum ve Retina VEGF Üzerine EtkisiÖZET Vasküler endoteliyal büyüme faktörü (VEGF) bir çok retinal hastalığın patogenezinde suçlanan bir moleküldür. Bu deneysel çalışmada, cerrahi menapoz ve hormon replasman tedavisinin VEGF düzeyine etkisi araştırılmak istenmiştir. Bu nedenle cerrahi olarak menapoza sokulmuş ratlarda östrojenin, östrojen ve progesteron kombinasyonunun ve selektif bir östrojen modülatörü olan genisteinin serumda VEGF seviyesine ve retinal dokuda VEGF ekspresyonuna bakılmıştır. Ratlar randomize olarak 5 gruba ayrıldı. Şam operasyonu yapılan grup hariç bütün ratlara bilateral ovariektomi (OVX) yapıldı. Bütün ratlara 8 hafta boyunca, orogastrik katerter yoluyla östrojen, progesteron, E/P veya su (şam ve kontrol grupları) tedavileri verildi. Her grupta serum VEGF düzeyi ve retinal dokuda immünhistokimyasal boyama ile VEGF analizi yapıldı. Serum VEGF seviyesi OVX + Östrojen ve OVX + Genistein grubunda kontrol ve şam grubundan daha yüksek bulundu. Serum VEGF düzeyi OVX + E/P grubunda da kontrol ve şam grubundan yüksek bulunda fakat fark istatistiksel olarak anlamlı saptanmadı. OVX + Östrojen, OVX + Progsteron ve OVX + E/P gruplarında VEGF boyanması diğer gruplardan daha fazla olmasına rağmen aradaki fark istatistiksel olarak anlamlı değildi. Bu çalışma göstermiştir ki ovariektomize ratlarda östrojen replasman tedavisi (ERT) serum VEGF seviyesini arttırmıştır, ve progesteron bu artışta ko...

We present an evaluation of a bilateral exotropia case following a bilateral pterijium surgery that was treated by medial rectus muscle advancement and right muscle transposition in a 52-year-old women. At the examination performed after pterygium surgery with autograft, adduction in the right eye was lost and in the left eye was restricted. Diplopia was revealed in the primary up-down direction of gaze position. Orbital and magnetic resonance imaging was normal. Bilateral medial rectus advancement was planned but because of right medial rectus muscle was not found during the operation, right muscle transposition and left medial rectus muscle advancement operations were performed. The presence of an incomitant exotropia with diplopia immediately after pterygium surgery should alert us to the possibility of having injured the medial rectus during the surgery and the surgery of pterygium should not be left in unexperienced hands. J Clin Exp Invest 2014; 5 (3): 456-458Key words: Pterygıum, exotropia, complications ÖZET 52 yaşında kadın hastada bilateral pterjium cerrahisi sonrası gelişen bilateral ekzotropyanın değerlendirilmesi ve bunun medial rektus kası ilerletilmesi ve sağ kas transpozisyonu ile tedavisi sunulmuştur. Hastanın otogreftli pterjium operasyonu sonrası muayenesinde sağ gözde adduksiyon hiç yoktu, sol gözde ise adduksiyon kısıtlı idi. Primer yukarı -aşağı bakış yönlerinde diplopi mevcuttu. Orbital ve Manyetik Rezonans görüntülemesi normaldi. Hastaya bilateral medial rektus ilerletilmesi girişimi planlandı ancak operasyon sırasında sağ medial rektus kası bulunamadığından sağ kas transpozisyonu ve sol medial rektus kasına ilerletme operasyonu yapıldı. Pterjium cerrahisi sonrası diplopi ile beraber inkomitant ekzotropya varlığı cerrahi sırasında oluşan medial rektus kas zedelenmesi ihtimalini akla getirmeli ve pterjium cerrahisi tecrübesiz ellere bırakılmamalıdır.

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