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Visual function in menopause: the role of hormone replacement therapy

Guaschino, Secondo MD1; Grimaldi, Eva MD1; Sartore, Andrea MD1; Mugittu, Raffaela MD1; Mangino, Francesco MD1; Bortoli, Paolo2; Pensiero, Stefano MD3; Vinciguerra, Agatino MD3; Perissutti, Paolo MD3


Objective To assess the effects of hormone replacement therapy (HRT) on visual function after menopause.

Design This study was conducted on 80 postmenopausal women aged 52 to 70 years. Women were randomly divided into two groups: 40 women were treated by oral HRT (equine conjugated estrogens 0.625 mg/day + dydrogesterone 5 mg/day in a continuous combined regimen), and 40 women were not treated with hormones (control group). Each woman underwent a contrast sensitivity test, a Schirmer test, and an evaluation of intraocular pressure before starting the study and 1 year after the beginning of the study. Statistical analysis was performed by Student's t test and Fisher's exact test.

Results Contrast sensitivity function was significantly improved in all spatial frequencies (1.5, 3, 6, and 12 cycles per degree) with the exception of 18 cycles per degree in the HRT group 1 year after the beginning of treatment, whereas the control group demonstrated significant impairment at the lowest spatial frequencies (1.5, 3, and 6 cycles per degree). Tear production was significantly improved in the HRT group 1 year after the beginning of treatment, and intraocular pressure was similar in the two groups before and after the beginning of the study.

Conclusions HRT improves visual function, promoting a better contrast sensitivity and a higher tear production, but does not modify intraocular pressure.

From the 1Department of Obstetrics and Gynecology, 2Epidemiology Unit, and 3Department of Ophthalmology, University of Trieste, IRCCS Burlo Garofolo, Italy.

Received March 15, 2002; revised and accepted July 10, 2002.

Address reprint requests to Andrea Sartore, MD, Department of Obstetrics and Gynecology, IRCCS Burlo Garofolo, University of Trieste, Via dell'Istria 65/1-34137 Trieste, Italy. E-mail:

©2003The North American Menopause Society