Effects of testosterone on intraocular pressure, thicknesses of retinal nerve fiber layer, ganglion cell complex, macula and on ocular blood flow in female-to-male transgender persons

Alpogan, Okşan; Dönmez, Emin Erhan; Balık, Ayşe Özlem; Vural, Fisun; Kaplan, Gizem

doi:10.1007/s10792-021-01921-y

Cited by 11 publications

(5 citation statements)

References 34 publications

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“…Additionally, ADT would cause the decrement of testosterone and the expression of testosterone would decrease the ocular blood flow [36], which is a significant risk factor for OAG development [26]. Other than ocular blood flow, the high level of testosterone was correlated to higher IOP in previous researches [37,38], and the injectable testosterone can directly induce OAG episode [39]. In addition to the direct effect, testosterone can elevate the blood pressure, in which hypertension is a known risk factor for glaucoma development [15,40].…”

Section: Discussionmentioning

confidence: 93%

The Use of Androgen Deprivation Therapy for Prostate Cancer Lead to Similar Rate of Following Open Angle Glaucoma: A Population-Based Cohort Study

Yang

Lin

Lee

et al. 2023

Cancers

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This study aimed to survey the effect of androgen deprivation therapy (ADT) on the development of open angle glaucoma (OAG) in prostate cancer using the data from national health insurance research database (NHIRD) of Taiwan. A retrospective cohort study was conducted and patients were regarded as prostate cancer with ADT according to related diagnostic, procedure and medication codes. Each prostate subject with ADT was matched to one patient with prostate cancer, but without ADT, and two participants without both prostate cancer and ADT; 1791, 1791 and 3582 patients were recruited in each group. The primary outcome was set as the OAG development according to related diagnostic codes. Cox proportional hazard regression was used to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) of ADT for the incidence of OAG. There were 145, 65 and 42 newly developed OAG cases in the control group, prostate cancer without ADT group and prostate cancer with ADT group. The prostate cancer with ADT group showed a significantly lower risk of OAG development compared to the control group (aHR: 0.689, 95% CI: 0.489–0.972, p = 0.0341), and the risk of OAG development in the prostate cancer without ADT group was similar compared to that in the control group (aHR: 0.825, 95% CI: 0.613–1.111, p = 0.2052). In addition, ages older than 50 years old would lead to higher incidence of OAG development, respectively. In conclusion, the use of ADT will lead to a similar or lower rate of OAG development.

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Section: Discussionmentioning

confidence: 93%

The Use of Androgen Deprivation Therapy for Prostate Cancer Lead to Similar Rate of Following Open Angle Glaucoma: A Population-Based Cohort Study

Yang

Lin

Lee

et al. 2023

Cancers

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“…29,30 In addition, testosterone has been shown to have an effect on the increase in myelin sheath thickness and axonal caliber. 31 In a recent study, Alpogan et al 32 reported an increase in RNFL and GCC in transgender individuals using testosterone. This evidence suggested that the positive correlation between postmenopausal duration and RNFL and GCC values in our study may be related to increased androgen levels in the postmenopausal period.…”

Section: Discussionmentioning

confidence: 97%

Effects of menopause on the retinal nerve fiber layer and ganglion cell complex and on intraocular pressure

Alpogan

Tekcan

2022

Menopause

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Objective: To compare the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness and intraocular pressure in reproductive age and postmenopausal women.Methods: The study included 94 eyes of 47 reproductive age women (Group 1) and 94 eyes of 47 postmenopausal women (Group 2). In all women, RNFL and GCC thicknesses were measured by optical coherence tomography. Intraocular pressure levels were measured by Goldmann applanation tonometry. Generalized linear mixed models were conducted to test the differences between groups. Age-and body mass index (BMI)-adjusted partial correlation analysis was used to examine the associations between parameters.Results: There was a statistically significant difference in age and BMI between the two groups (P < 0.001, P < 0.001, respectively). There was no difference in all RNFL and GCC values between the reproductive age and postmenopausal women. The duration of postmenopause versus average, superior hemisphere, and superior values of RNFL and superior and inferior values of GCC were positively correlated with statistical significance in age-and BMI-adjusted partial correlation coefficient tests (r ¼ 0.254, P ¼ 0.017; r ¼ 0.303, P ¼ 0.004; r ¼ 0.317, P ¼ 0.003; r ¼ 0.301, P ¼ 0.004; r ¼ 0.313, P ¼ 0.003; r ¼ 0.271, P ¼ 0.011, with 95% confidence, respectively).Conclusions: In this study, there was no significant difference in all RNFL and GCC values between the reproductive age and postmenopausal women after adjusting for age and BMI. However, we observed that a long postmenopausal period was associated with higher RNFL and GCC values.

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“…The negative influence testosterone had on ocular blood flow was further increased in postmenopausal women. More recently, Alpogan et al did not observe a difference in ocular blood flow in the central retinal artery or ocular artery in transgender men receiving testosterone supplements [ 52 ]. The neuroprotective effect of testosterone has been scarcely investigated, but unlike the ocular blood flow, was more consistent with testosterone being associated with an increased RNFL thickness and neuroprotection [ 52 , 53 ].…”

Section: Discussionmentioning

confidence: 99%

“…More recently, Alpogan et al did not observe a difference in ocular blood flow in the central retinal artery or ocular artery in transgender men receiving testosterone supplements [ 52 ]. The neuroprotective effect of testosterone has been scarcely investigated, but unlike the ocular blood flow, was more consistent with testosterone being associated with an increased RNFL thickness and neuroprotection [ 52 , 53 ]. In the present study, we confirmed these findings, but only in men, where higher testosterone tended to be associated with larger RNFL and GCL +.…”

Section: Discussionmentioning

confidence: 99%

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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Effects of testosterone on intraocular pressure, thicknesses of retinal nerve fiber layer, ganglion cell complex, macula and on ocular blood flow in female-to-male transgender persons

Cited by 11 publications

References 34 publications

The Use of Androgen Deprivation Therapy for Prostate Cancer Lead to Similar Rate of Following Open Angle Glaucoma: A Population-Based Cohort Study

The Use of Androgen Deprivation Therapy for Prostate Cancer Lead to Similar Rate of Following Open Angle Glaucoma: A Population-Based Cohort Study

Effects of menopause on the retinal nerve fiber layer and ganglion cell complex and on intraocular pressure

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

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