The effect of oral contraceptive pills on the macula, the retinal nerve fiber layer, the ganglion cell layer and the choroidal thickness

Abstract

BackgrounTo evaluate the effect of oral contraceptive pills (OCP) on the macula, the retinal nerve fiber layer (RNFL), the ganglion cell layer (GCL), and the choroidal thickness (CT).MethodsIn this prospective observational cross-sectional study, 60 eyes of 30 healthy women taking monophasic OCP (0.03 mg ethinylestradiol and 0.15 mg levonorgestrel) for contraception for at least 1 year were compared with 60 eyes of a control group of 30 healthy women who were not taking any OCP. Spectral-Domain Optical Coherence Tomography (SD-OCT) was used to evaluate the macula, the RNFL, the GCL, and the CT. Measurements were taken in the follicular phase (day 3) of the last menstrual cycle in all women. The body mass index (BMI) scores of all participants were also recorded.ResultsNo disparity in terms of age and BMI between both groups was observed (p = 0.444, p = 0.074, respectively). All the macular parameters measurements were considerably lower in the OCP group compared to the control group (p < 0.001). Also, the RNFL thickness, the GCL thickness, and the CT were all significantly thinner in the OCP group (p < 0.001).ConclusionsThe use of OCP can cause significant changes in the retina and choroid thickness over 1 year period. The women who are using OCP for a longer duration could have some eye problems. OCT should be routinely done for follow up. Further long term studies are required, using different preparations of OCP. It is important to find out when this thickness alterations can be clinically significant or symptomatic and if these changes are reversible or not.

The Effects of Sex, Oral Contraception, and Menstrual Cycle Phase on Intraocular Pressure, Central Corneal Thickness, and Foveal Thickness: A Descriptive Analysis

“…However, FT may be susceptible to exogenously administered sex hormones, as OC users in our study had thicker foveae than cycling women. Our results contrast with previous reported associations of macular thinning with OC use [ 18 , 60 ].…”

“…Pakistani and black Afrikaner women exhibited thicker maculae than men [ 13 , 14 ], while the opposite findings were observed in Chinese and Indian subjects [ 15 , 16 ]; no difference between genders was reported in white Caucasians [ 17 ]. Macular structural changes may be under the influence of sex hormones, as the use of oral contraceptives has been linked to macular thinning [ 18 ].…”

Visual impairment and associated factors among pregnant women attending antenatal care units at health institutions in Gondar City Administration, Northwest Ethiopia

“…The odds of developing VI among pregnant women who had a history of contraceptive use prior to their current pregnancy was found to be higher than their counterparts. This finding is in agreement with studies in Iran [ 40 ], Germany [ 14 ], Egypt [ 32 ], and Greece [ 41 ]. This can be due to the fact that using contraceptives (oral and injectable) for family planning methods will cause dry eye symptoms related to reduced lipid synthesis, corneal oedema, and a significant increase in the central corneal thickness associated with the hormonal effects (estrogen and progesterone) [ 42 , 43 ].…”

“…According to the previous studies in the globe, VI has a cross relation with the age of pregnant women [ 1 , 14 , 15 ], residence [ 1 , 16 ], educational status [ 17 – 19 ], occupation [ 20 , 21 ], gestational age (GA) [ 7 , 15 , 22 ], maternal parity [ 15 , 20 , 23 ], diabetes mellitus [ 24 , 25 ], gestational diabetes mellitus (GDM) [ 14 , 20 ], pre-existing hypertension [ 12 , 20 ], pregnancy-induced hypertension (PIH) [ 14 , 20 ], family history of vision problem [ 26 ], prolonged use of smart phones and computers [ 27 – 29 ], medication history [ 14 , 30 , 31 ], and history of contraceptive use [ 14 , 32 ].…”

The effect of systemic and topical ophthalmic medications on choroidal thickness: A review

“…45 In the first study, CT was significantly less in women taking 0.15 mg levonorgestrel and 0.03 mg ethinyloestradiol daily for contraception for at least 1 year than in women not taking any OCP. 44 In the second study, there was no difference in CT between women who have taken 3 mg drospirenone and 0.03 mg ethinylestradiol daily for contraception for at least 1 year and women who were not using an OCP. 45 The type of progesterone studied differed between the 2 studies.…”