Androgen Deficiency, Meibomian Gland Dysfunction, and Evaporative Dry Eye

Abstract

Our findings show that the meibomian gland is an androgen target organ and that androgen deficiency may promote meibomian gland dysfunction and evaporative dry eye. Overall, these results support our hypothesis that androgen deficiency may be an important etiologic factor in the pathogenesis of evaporative dry eye in women with Sjögren's syndrome.

Age- and gender-related tear function changes in normal population

“…Decreasing androgen levels with the advancing age may lead to the reduction of tear production. [14][15][16] The demonstration of androgen treatment to increase tear production in mice with Sjogren syndrome also substantiates this idea. 22 When the Schirmer test results were compared separately for every decades, it was seen that there was no significant difference between men and women.…”

“…7,8,12,13 Some studies introduced a relationship between the serum androgen level and meibomian gland function. [14][15][16] According to these studies, decreased serum androgen level may cause a disorder of meibomian gland functions and evaporative dry eye. A mucin deficiency may occur and this may cause tear instability in advancing age, but we cannot found any study in the literature about this possibility.…”

Detection of Oestrogen receptors (ER) α and β in conjunctiva, lacrimal gland, and tarsal plates

“…2,3 Additionally, an attenuation in androgen synthesis during menopause contributes to KCS by leading to meibomian gland dysfunction. 1 Since Oestrogen-dependent cycle-associated histological changes of the conjunctiva have been observed, systemic hormone replacement therapy (HRT) was suggested to be indicated in patients with KCS. 2 This was supported by investigations in climacteric women with a lower incidence of dry eye complaints under systemic HRT.…”

“…[1][2][3] Meibomian gland dysfunction and evaporative dry eye often occur during menopause and aging. 1 In climacteric women, presumably the lower Oestrogen level is responsible for the higher incidence of KCS.…”

“…[1][2][3] Meibomian gland dysfunction and evaporative dry eye often occur during menopause and aging. 1 In climacteric women, presumably the lower Oestrogen level is responsible for the higher incidence of KCS. 2,3 Additionally, an attenuation in androgen synthesis during menopause contributes to KCS by leading to meibomian gland dysfunction.…”