Effect of androgen deficiency on the human meibomian gland and ocular surface
Effect of androgen deficiency on the human meibomian gland and ocular surface
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DOI：
10.1210/jc.85.12.4874
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发表时间：
2000-12-01
影响因子：
5.8
通讯作者：
Sullivan, DA
中科院分区：
文献类型：
--
作者：
Krenzer, KL;Dana, MR;Sullivan, DA
本研究的目的是确定长期使用抗雄激素药物是否会导致睑板腺功能障碍、睑板腺分泌物中脂质谱改变、泪膜稳定性降低和蒸发性干眼。要求接受抗雄激素治疗的前列腺适应症受试者以及年龄相关对照者完成一份评估干眼症状的问卷，然后进行完整的眼前节检查。此外，从每只眼睛获得睑板腺分泌物，并通过高效液相色谱/质谱法分析胆固醇、胆固醇酯、蜡酯、甘油二酯、甘油三酯和甘油二酯组分中特定分子种类的相对含量。我们的研究结果表明，与年龄相关的对照组相比，接受抗雄激素治疗的患者有：1）泪膜碎片、异常泪膜半月板、不规则后眼睑边缘、结膜睑板充血和睑板腺口化生的出现频率显著增加; 2）眼表面活性染料染色程度显著增加; 3）泪膜破裂时间和睑板腺分泌物的质量显著降低;和4）光敏感、眼睛疼痛和视力模糊的频率显著增加。此外，抗雄激素药物的使用与睑板腺分泌物中脂质相对含量的显著变化相关。我们的研究结果表明，慢性雄激素缺乏症与睑板腺功能障碍和干眼症有关。
The purpose of this study was to determine whether the chronic use of antiandrogen medications leads to meibomian gland dysfunction, altered lipid profiles in meibomian gland secretions, decreased tear film stability, and evaporative dry eye. Subjects taking antiandrogen therapy for prostatic indications, as well as age-related controls, were asked to complete a questionnaire that assessed dry eye symptoms and then were given a complete anterior segment examination. Moreover, meibomian gland secretions were obtained from each eye and analyzed by high-performance liquid chromatography/mass spectrometry for the relative content of cholesterol, cholesterol esters, wax esters, diglycerides, triglycerides, and specific molecular species in the diglyceride fraction. Our results demonstrate that patients taking antiandrogen treatment, compared with age-related controls, had a: 1) significant increase in the frequency of appearance of tear film debris, an abnormal tear film meniscus, irregular posterior lid margins, conjunctival tarsal injection, and orifice metaplasia of the meibomian glands; 2) significant increase in the degree of ocular surface vital dye staining; 3) significant decrease in the tear film breakup time and quality of meibomian gland secretions; and 4) significant increase in the frequency of light sensitivity, painful eyes, and blurred vision. In addition, the use of antiandrogen pharmaceuticals was associated with significant changes in the relative amounts of lipids in meibomian gland secretions. Our findings indicate that chronic androgen deficiency is associated with meibomian gland dysfunction and dry eye.