Effects of androgen replacement therapy on cornea and tear function in men with idiopathic hypogonadotropic hypogonadism

Gökçe, Gökçen; Hürmeriç, Volkan; Mumcuoğlu, Tarkan; Özge, Gökhan; Başaran, Yalçın; Ünal, Hilmi Umut; Bolu, Erol; Mutlu, Fatih Mehmet

doi:10.1080/00325481.2015.1033376

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…Contradicting findings have been reported for the association between IOP and testosterone in men. Intramuscular testosterone injections had no effect on the IOP in men with idiopathic hypogonadotropic hypogonadism [ 45 ], which is consistent with our results. However, in obese and overweight men IOP was found to be significantly correlated with testosterone levels [ 46 ].…”

Section: Discussionsupporting

confidence: 92%

Higher testosterone is associated with open-angle glaucoma in women: a genetic predisposition?

et al. 2023

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Background Testosterone may be a possible modifiable risk factor for open-angle glaucoma (OAG) and intraocular pressure (IOP), but evidence has been scarce and conflicting. In this study we evaluated the association of testosterone and its genetic predisposition with incident (i) OAG, IOP, retinal nerve fiber layer (RNFL), and ganglion cell-inner plexiform layer (GCL +). Methods Participants aged 45–100 years were derived from the prospective, population-based Rotterdam Study. Ophthalmic examinations and serum testosterone measurements (including bioavailable and free testosterone) were performed from 1991 onwards. Follow-up took place every 4–5 years. A total of 187 out of 7898 participants were diagnosed with incident (i) OAG during follow-up. Genotyping was performed in 165 glaucoma cases and 6708 controls. We calculated sex-specific weighted genetic risk scores (GRS) for total and bioavailable testosterone. Associations with iOAG were analyzed using multivariable logistic regression. Associations with IOP, RNFL, and GCL + were analyzed with multivariable linear regression. Analyses were stratified on sex and adjusted for at least age, body mass index, and follow-up duration. Results In men, testosterone was not associated with iOAG. However, the GRS for higher total testosterone was associated with an increased iOAG risk (odds ratio [OR] with 95% confidence interval [95% CI]: 2.48 [1.18; 5.22], per unit). In women, higher values of bioavailable testosterone (2.05 [1.00; 4.18] per nmol/L) and free testosterone (1.79 [1.00; 3.20] per ng/dL) were significantly associated with increased risk of iOAG. Moreover, the GRS for higher bioavailable testosterone was associated with an increased iOAG risk (2.48 [1.09; 5.65], per unit). Higher bioavailable and free testosterone were adversely associated with IOP (0.58 [0.05; 1.10] per nmol/L and 0.47 [0.04; 0.90] per ng/dL). Higher total testosterone was inversely associated with peripapillary RNFL and GCL + (Beta [95% CI]: − 3.54 [− 7.02; − 0.06] per nmol/L and − 2.18 [− 4.11; − 0.25] per nmol/L, respectively). Conclusions In women, higher testosterone levels increased the risk of iOAG. Both IOP-dependent and IOP-independent mechanisms may underlie this association. Managing testosterone levels may be particularly relevant for the prevention of neurodegeneration in the eye. Future research should confirm these findings.

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Section: Discussionsupporting

confidence: 92%

Higher testosterone is associated with open-angle glaucoma in women: a genetic predisposition?

et al. 2023

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“…20 Systemic testosterone replacement therapy had no significant effect on IOP in men with idiopathic hypogonadotropic hypogonadism. 21 As this study was based on short-term treatment for 3 months, there was a limitation in determining the long-term effects of testosterone replacement therapy on IOP. However, a recently published observational study showed that IOP was significantly associated with testosterone, and the IOP in patients with testosterone above 3.0 ng/mL was significantly higher than that in patients with testosterone levels below 3.0 ng/mL.…”

Section: Discussionmentioning

confidence: 99%

Androgen deprivation therapy may reduce the risk of primary open-angle glaucoma in patients with prostate cancer: a nationwide population-based cohort study

Ahn

Lee

Park

et al. 2021

Prostate International

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Background We evaluated the risk of developing primary open-angle glaucoma (POAG) according to androgen deprivation therapy (ADT) status in patients with prostate cancer. Materials and methods From the nationwide claims database in South Korea, 218,203 men with prostate cancer were identified between 2008 and 2017. After applying the inclusion and exclusion criteria, a total of 170,701 patients (42,877 in the ADT and non-ADT groups and 127,824 in the non-ADT group) were included in the analysis. To adjust for comorbidities between cohorts, exact matching was performed. Cox proportional hazard regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of POAG associated with ADT after controlling for potential confounding factors. Results In the matched cohort, the ADT group had a lower proportion of newly developed POAG than the non-ADT group (2.10% vs. 2.88%, respectively; P < 0.0001). Multivariable analysis revealed that the ADT group had a significantly lower risk of POAG than the non-ADT group (HR, 0.808; 95% CI, 0.739–0.884; P < 0.0001). The risk of POAG was lower in patients who underwent ADT for less than 2 years (HR, 0.782; 95% CI, 0.690–0.886; P = 0.0001) and in those receiving ADT for over 2 years (HR, 0.825; 95% CI, 0.744–0.916; P = 0.0003) compared with the non-ADT group. Conclusions The use of ADT was associated with a decreased risk of POAG in Korean patients with prostate cancer. Our findings suggest that testosterone may be involved in the pathophysiology of POAG, and this should be confirmed through further studies.

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“…Along these lines and as alluded to above, the topical use of 17-β-estradiol-3-phosphate drops did not significantly change Schirmer’s test scores in postmenopausal women [ 48 ]. In a study in men with idiopathic hypogonadotropic hypogonadism, androgen replacement therapy had little effect on the cornea and tear function [ 53 ].…”

Section: Methodsmentioning

confidence: 99%

The effects of female sex hormones on the human cornea across a woman’s life cycle

et al. 2023

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The cornea is a hormone-responsive tissue that responds to changing levels of female sex hormones. This review focuses on the structural and functional changes in the human cornea associated with the hormonal milestones of menarche, pregnancy, and menopause, as well as consequences stemming from the use of exogenous sex hormones for fertility control and replacement. Articles were identified by searching PubMed without language or region restrictions. The primary outcomes evaluated were changes in central corneal thickness (CCT), intraocular pressure (IOP), and quality of the ocular tear film. The potential impact of hormone-associated changes on the diagnosis and surgical management of common eye diseases, as well as the potential use of sex hormones as therapeutic agents is also considered. Understanding the physiological effects of female sex hormones on the cornea is important because that knowledge can shape the management decisions physicians and women face about ocular health across their life stages.

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Effects of androgen replacement therapy on cornea and tear function in men with idiopathic hypogonadotropic hypogonadism

Abstract: 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.

Cited by 6 publications

References 26 publications

Higher testosterone is associated with open-angle glaucoma in women: a genetic predisposition?

Higher testosterone is associated with open-angle glaucoma in women: a genetic predisposition?

Androgen deprivation therapy may reduce the risk of primary open-angle glaucoma in patients with prostate cancer: a nationwide population-based cohort study

The effects of female sex hormones on the human cornea across a woman’s life cycle

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