Abstract
Hormone replacement therapy (HRT) is used by women to get relief from menopausal symptoms,
including dry eyes. However, it is not entirely certain that HRT helps relieve dry
eye disease (DED). The focus of this study is to systematically review the literature
of the relevant studies to understand and determine the correlation between HRT and
DED. Literature was systematically reviewed using Distiller SR. Meta-analysis was
conducted using STATA 15.0. Standardized mean difference (SMD) and 95% confidence
interval (CI) were calculated, and heterogeneity was assessed using statistics. Fixed-effect
and random-effects models were computed based on heterogeneity. Subgroups analysis
was done by follow-up. Our meta-analysis results indicated significant reduction in
dry eye with HRT treatment at 1-month follow-up (SMD = −1.97; CI: −3.83, −0.11), a
nonsignificant increase in tear breakup time at 3-month (SMD = −0.91; CI: −3.26, 1.44)
and 6-month (SMD = −1.05; CI: −3.91, 1.82) follow-ups. Our meta-analysis results indicated
a nonsignificant improvement in DED with HRT treatment at 1-month (SMD = −0.97; CI:
−2.35, 0.4), 3-month (SMD = 0.19; CI: −0.91, 1.29), and 6-month (SMD = −0.48; CI:
−1.39, 0.43) follow-ups.Overall, nonsignificant improvement in postoperative tear
production, as well as tear breakup time, was seen after HRT treatment at follow-ups
in dry eye patients. More good-quality randomized control trials are needed to make
accurate conclusions.
Résumé
L'hormonothérapie substitutive (HTS) est utilisée pour soulager les symptômes de la
ménopause, notamment la sécheresse oculaire. Or, on ne sait pas avec certitude si
l'HTS soulage véritablement la sécheresse oculaire. On a donc procédé à une revue
systématique de la littérature médicale, à l'aide du logiciel Distiller SR, pour extraire
les études pertinentes qui permettraient de comprendre et de déterminer le lien qui
unit l'HTS et la sécheresse oculaire. Une méta-analyse a ainsi été réalisée au moyen
du logiciel STATA 15.0. On a calculé la différence moyenne standardisée (DMS) et l'intervalle
de confiance (IC) à 95 %. L'hétérogénéité a été mesurée au moyen de paramètres statistiques
et a servi à générer des modèles à effets fixes et à effets aléatoires. L'analyse
des sous-groupes a été réalisée en fonction de la durée du suivi. Selon notre méta-analyse,
on note une diminution significative de la sécheresse oculaire grâce à l'HTS après
un suivi de 1 mois (DMS = −1,97; IC de −3,83 à −0,11) de même qu'une augmentation
non significative du temps de rupture du film lacrymal à 3 mois (DMS = −0,91; IC de
−3,26 à 1,44) et à 6 mois (DMS = −1,05; IC de −3,91 à 1,82). Si l'on en croit les
résultats de notre méta-analyse, la sécheresse oculaire bénéficie d'un soulagement
non significatif sous l'effet de l'HTS à 1 mois (DMS = −0,97; IC de −2,35 à 0,4),
à 3 mois (DMS = 0,19; IC de −0,91 à 1,29) et à 6 mois (DMS = −0,48; IC de −1,39 à
0,43). Dans l'ensemble, on a enregistré une amélioration non significative de la production
lacrymale et du temps de rupture du film lacrymal après la mise en route d'une HTS
lors de suivis de patientes présentant une sécheresse oculaire. La tenue d'autres
études comparatives randomisées de grande qualité permettra de tirer des conclusions
plus précises.
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Article info
Publication history
Published online: July 06, 2019
Accepted:
May 30,
2019
Received in revised form:
May 29,
2019
Received:
May 1,
2019
Identification
Copyright
© 2019 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
