Gender Difference in the Pathophysiology and Treatment of Glaucoma

Abstract

Glaucoma is the principal cause of irreversible blindness in the world, the second leading cause of blindness in the United States, and it results in optic nerve head axonal degeneration and corresponding visual field deficits. Intraocular pressure (IOP) is the only known modifiable risk factor in glaucoma. Non-modifiable risk factors for glaucoma include age, ethnicity, central corneal thickness, and family history. While our understanding of the role of gender as a risk factor in glaucoma development and progression remains nascent, multiple observations have shown gender differences in the incidence and prevalence of glaucoma. Depending on the type of glaucoma, hormone therapy, oral contraceptive use and menopausal status have also been associated with glaucoma. In addition, pregnancy leads to changes in IOP, while the treatment of glaucoma must be tailored based on the systemic effects of topical therapeutics on the mother and fetus. This review will focus on the epidemiologic, anatomic and endocrinologic differences in male and female glaucoma patients. In addition, this review will discuss treatment modalities that may be more appropriate for one gender than the other, especially with respect to a woman's pregnancy status.

Characteristics of Primary Glaucoma in Eye Clinic of RA Basoeni Hospital, Mojokerto, Indonesia

“…This is in accordance with the meta-analysis of Cheng which found that generally, glaucoma is affected more in women (Cheng et al 2014). The cause of women suffering more from glaucoma, especially angle closure glaucoma, is the short axis of the eye, hormonal factors, pregnancy, and shallow anterior chamber in the eye (Tehrani 2014). In primary open-angle glaucoma patients there were no significant differences between men and women.…”

“…The high blindness rate in glaucoma patients may be because the patients are too late to seek for treatment due to the ignorance to the illness or lack of the compliance in using glaucoma drugs. In addition, according to Tehrani (2014), glaucoma is the most common cause of irreversible blindness. So, if someone has experienced visual acuity or narrowing of the visual field due to glaucoma, the therapy given is only aimed at maintaining the vision that still exists and so as not to get worse, not to restore the visual function.…”

Changes of intraocular pressure in different trimesters of pregnancy among Syrian refugees in Turkey: A cross-sectional study

“…Therefore, episcleral venous pressure also decreases in pregnancy (14,15) . AH outflow is facilitated by this decrease.…”

The estrogenic retina: The potential contribution to healthy aging and age-related neurodegenerative diseases of the retina

“…Clinical results from oestrogen therapy (either alone or combined with progesterone) are also controversial. For more detailed information concerning these topics, readers are referred to some recent reviews [13,[15][16][17][18][19][20][21][22]. Before going into the scope of this review article, a brief summary on the retinal organization in terms of neural cell types and vascularization is given below.…”