This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Krenzer, K. L. Articles by Sullivan, D. A. Search for Related Content PubMed PubMed Citation Articles by Krenzer, K. L. Articles by Sullivan, D. A.

Effect of Androgen Deficiency on the Human Meibomian Gland and Ocular Surface¹

Schepens Eye Research Institute (K.L.K., M.R.D., J.M.C., D.A.S.), Brigham and Women’s Hospital (M.R.D., J.M.C.), Department of Ophthalmology, Harvard Medical School (M.R.D., J.M.C., D.A.S.), and New England College of Optometry (K.L.K., D.B.T.), Boston, Massachusetts 02114; Edith Norse Rogers Veterans Memorial Hospital (M.D.U.), Bedford, Massachusetts 01730; and Eunice Kennedy Shriver Center for Mental Retardation (J.E.E.), Waltham, Massachusetts 02452

Address correspondence and requests for reprints to: David A. Sullivan, Ph.D., Schepens Eye Research Institute, 20 Staniford Street, Boston, Massachusetts 02114. E-mail: sullivan{at}vision.eri.harvard.edu

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.

This article has been cited by other articles:

				I. A. Butovich, E. Uchiyama, and J. P. McCulley Lipids of human meibum: mass-spectrometric analysis and structural elucidation J. Lipid Res., October 1, 2007; 48(10): 2220 - 2235. [Abstract] [Full Text] [PDF]

				B. D. Sullivan, J. E. Evans, M. R. Dana, and D. A. Sullivan Influence of aging on the polar and neutral lipid profiles in human meibomian gland secretions. Arch Ophthalmol, September 1, 2006; 124(9): 1286 - 1292. [Abstract] [Full Text] [PDF]

				P S Tsai, J E Evans, K M Green, R M Sullivan, D A Schaumberg, S M Richards, M R Dana, and D A Sullivan Proteomic analysis of human meibomian gland secretions. Br. J. Ophthalmol., March 1, 2006; 90(3): 372 - 377. [Abstract] [Full Text] [PDF]

				F. Schirra, T. Suzuki, S. M. Richards, R. V. Jensen, M. Liu, M. J. Lombardi, P. Rowley, N. S. Treister, and D. A. Sullivan Androgen Control of Gene Expression in the Mouse Meibomian Gland Invest. Ophthalmol. Vis. Sci., October 1, 2005; 46(10): 3666 - 3675. [Abstract] [Full Text] [PDF]

				J. A. Smith, S. Vitale, G. F. Reed, S. A. Grieshaber, L. A. Goodman, V. H. Vanderhoof, K. A. Calis, and L. M. Nelson Dry Eye Signs and Symptoms in Women With Premature Ovarian Failure Arch Ophthalmol, February 1, 2004; 122(2): 151 - 156. [Abstract] [Full Text] [PDF]

				S. C. Pflugfelder Hormonal Deficiencies and Dry Eye Arch Ophthalmol, February 1, 2004; 122(2): 273 - 274. [Full Text] [PDF]

				B. D. Sullivan, J. E. Evans, J. M. Cermak, K. L. Krenzer, M. R. Dana, and D. A. Sullivan Complete Androgen Insensitivity Syndrome: Effect on Human Meibomian Gland Secretions Arch Ophthalmol, December 1, 2002; 120(12): 1689 - 1699. [Abstract] [Full Text] [PDF]

				M. S. LeDoux, Q. Zhou, R. B. Murphy, M. L. Greene, and P. Ryan Parasympathetic Innervation of the Meibomian Glands in Rats Invest. Ophthalmol. Vis. Sci., October 1, 2001; 42(11): 2434 - 2441. [Abstract] [Full Text] [PDF]