Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Evaluation of the Effect of Postmenopausal Hormone Replacement Therapy on Pupil Size
Postmenopozal Hormon Replasman Tedavisinin Pupil Boyutuna Olan Etkisinin Değerlendirilmesi
Ümit YOLCUa, Abdullah İLHANb, Salih ALTUNb, Üzeyir ERDEMc
aANKASU Eye Diseases Center, Ankara, TURKEY
bERA Eye Diseases Center, Ankara, TURKEY
cPrivate Physician, Ankara, TURKEY
Turkiye Klinikleri J Ophthalmol. 2020;29(2):103-7
doi: 10.5336/ophthal.2019-65612
Article Language: EN
Full Text
ABSTRACT
 Objective: Corneal refractive surgery has been gaining popularity among postmenopausal women over the past several years. Previous studies with different methods showed increased adrenergic activity in the postmenopausal period and suppressed sympathetic response with hormone replacement therapy. As pupil size may alter with sympathetic activity, we hypothesized that the success rate of corneal refractive surgery may be affected by hormone replacement therapy. The aim of this study was to evaluate the effects of hormone replacement therapy on pupil diameter. Material and Methods: Sixty-five healthy postmenopausal women who received hormone replacement therapy that was consisted of conjugated estrogen and medroxyprogesteron acetate have participated in this study. Pupil diameter was measured with an infrared pupillometer [OPD-Scan II Pupillometer/Corneal Wavefront Analyser ARK-10000 system (Nidek, Japan)] at the time of study enrollment and atleast 3 months (4.9 ±1.3) after the initiation of hormone replacement therapy. Results: Mean pupil diameters under mesopic/photopic conditions were 5.84±0.86mm/ 4.60±0.79mm before hormone replacement therapy and, 5.85±0.77mm/4.62±0.76 mm after hormone replacement therapy. The differences between 'before hormone replacement therapy' and 'after hormone replacement therapy' assessments were statistically insignificant (p=0,860 ve p=0,552 respectively). Conclusion: The effect of hormone replacement therapy on pupil size, either directly or via autonomic nervous system, was insignificant in postmenopausal women. However, it is recommended that the results of our study need to be confirmed by more detailed studies.

Keywords: Menopause; pupil size; hormone replacement therapy; autonomic nervous system
ÖZET
 Amaç: Son yıllarda korneal refraktif cerrahi, postmenopozal kadınlar tarafından da giderek daha fazla rağbet görmektedir. Farklı yöntemler ile yapılan daha önceki birçok çalışma menopoz sonrası dönemde adrenerjik aktivitenin arttığını ve hormon replasman tedavisi ile sempatik cevabın baskılandığını göstermiştir. Pupil çapının sempatik aktivite ile değişkenlik gösterdiği düşünülürse, hormon replasman tedavisinin korneal refraktif cerrahi başarısını etkileyebileceği öngörülmüştür. Bu çalışmanın amacı hormon replasman tedavisinin pupil çaplarına olan etkisini değerlendirmektir. Gereç ve Yöntemler: Konjuge öströjen ve medroksiprogesteron asetat içeren hormon replasman tedavisi kullanan 65 sağlıklı postmenopozal kadın çalışmaya dahil edildi. Pupil çapı, hormon replasman tedavisi kullanımı öncesi ve tedavi başlangıcından en az 3 ay geçtikten sonra (4,9±1,3), infrared pupillometre [OPD-Scan II Pupillometer/ Corneal Wavefront Analyser ARK-10000 sistem (Nidek, Japan)] ile ölçüldü. Bulgular: Mezopik ve fotopik koşullarda ortalama pupil çapları hormon replasman tedavisi öncesi sırasıyla 5,84±0,86 mm /4,60±0,79 mm ve hormon replasman tedavisi sonrası sırasıyla 5,85±0,77 mm / 4,62±0,76 idi. Hormon replasman tedavisi öncesi ve sonrası yapılan pupil çapı ölçümleri arasındaki fark istatistiksel olarak anlamlı değildi (sırasıyla p=0,860 ve p=0,552). Sonuç: Sonuç olarak, çalışmamızda hormon replasman tedavisinin, post menopozal kadınlarda direkt veya otonom sinir sistemi aracılığı ile pupil çapını anlamlı düzeyde etkilemediği saptanmıştır. Ancak, çalışmamızda elde ettiğimiz bu sonuçların çok daha geniş kapsamlı araştırmalarla desteklenmesi gerekmektedir.

Anahtar Kelimeler: Menopoz; pupil çapı; hormon replasman tedavisi; otonom sinir sistemi
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