Abstract

P 003

Protective effect of estrogen on glaucoma

Terai N., Kanzow-Terai B., Spoerl E., Boehm A. G., Pillunat L. E. 
Department of Ophthalmology Carl Gustav Carus University Hospital, Dresden

Objective: In the pathogenesis of glaucoma different changes in cellular and biomechanical metabolism have been discussed. Estrogen seems to interfere in these cellular mechanisms. Aim of the study was to assess if there is a relation between a modified hormone level of estrogen and glaucoma by measuring serum estrogen levels in blood samples of glaucoma patients and healthy subjects.
Methods: Fourty-one female patients were included in this prospective analysis. The control group (group I) consisted of 20 patients without any clinical signs of glaucoma. The remaining 21 glaucoma patients (group II) were identified by means of the visual field, intraocular pressure and the excavation of the optic nerve head. Only patients were permitted to the study who did not take any additional hormone medication (e.g. birth control pill). Blood samples were taken from all participants on the 18^th day of menstruation cycle. Estrogen concentration was measured using the competitive chemiluminescent immunoassay. LH and FSH were determined by the microparticle enzym immunoassay. The mean of estrogen concentration values was compared using the t-test. A P-value <0.05 was considered statistically significant.
Results: Mean age in group I was 46.4±8.2 years (range: 29-60, median: 47.0) compared to 50.4±7.3 years (range: 36-60, median: 52.0) in group II. Statistical analysis showed no significant difference between both groups (P-value =0.112). The estrogen concentration in group I was 242.6±305.9 pmol/ l compared to 94.8±110.8 pmol/ l in group II. This difference was statistically significant (P-value=0.04).
Conclusions: Our results showed that the estrogen concentration in patients with glaucoma was significantly reduced compared to an age matched control group. Yet it has not been elucidated in how far low estrogen levels in glaucoma patients might have an adversarial effect on the onset and progression of glaucoma. An antioxidative and neuroprotective effect of estrogen has already been described experimentally. In consideration of the observed low estrogen levels a possible protective effect of estrogen might be reduced in glaucoma patients. This suggests that estrogen might be a reasonable therapeutic approach remaining theoretically so far. Further studies need to be undertaken to gain more information about a possible clinical use of this hormone for the treatment of glaucoma.

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