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¹Numune Eğitim ve Araştırma Hastanesi, 1. Göz Kliniği, Ankara, Uzm. Dr.
²Sağlık Bakanlığı Niğde Devlet Hastanesi, Niğde, Uzm. Dr.
³Numune Eğitim ve Araştırma Hastanesi, Radyoloji Kliniği, Ankara, Uzm. Dr.
⁴Numune Eğitim ve Araştırma Hastanesi, 1. Göz Kliniği Şefi, Ankara, Uzm. Dr. Purpose: To investigate the effect of menopause and hormone replacement therapy (HRT) on ocular blood flow.
Materials and Methods: Colour Doppler ultrasonography (CDU) was used to determine peak systolic (PSV) and end diastolic (EDV) flow velocities and the resistivity index (RI) in the ophthalmic (OA) and the central retinal (CRA) arteries in 31 postmenopausal women who had never received HRT (mean age 50.6±6.1 years), 40 postmenopausal women receiving HRT (mean age 56.6±7.5 years), and 18 premenopausal women as controls (mean age 32.2±10.4 years). Twenty-five postmenopausal women who had never received HRT were re-evaluated by CDU, 6 months after the initiation of HRT.
Results: Mean age and duration of menopause of postmenopausal women without HRT were significantly lower than those of postmenopausal women with HRT (p=0.005 and p=0.047, respectively). PSV (p<0.001, for both groups) and EDV (p=0.015 and p=0.002, respectively) in the CRA were significantly higher in postmenopausal women without and with HRT as compared to premenopausal women. RI in the CRA of postmenopausal women without HRT was significantly higher than that of control subjects (p=0.005). Six months after the initiation of HRT, EDV (p=0.019) and RI (p=0.010) in the CRA in 25 postmenopausal women who had never received HRT previously were found to be significantly increased and decreased, respectively. Although, PSV (p<0.001 and p=0.001, respectively) and EDV (p<0.001 and p=0.008 respectively) in the CRA were significantly higher in postmenopausal women with HRT and those who received HRT only for six months as compared to premenopausal women, RI in the CRA was not statistically different. Being independent from hormonal state, there was a positive correlation between age and each of PSV, EDV, and RI in the CRA (p=0.018, r=0.309; p=0.047, r=0.262, and p=0.045, r=0.265, respectively).
Conclusion: Age related changes in blood flow parameters of the CRA were enhanced by menopause. HRT may play a role in the prevention of alterations in blood flow parameters of the CRA, which are related to aging and menopause, probably by causing a vasodilation and decreasing distal vascular resistance in the CRA. Since this effect on blood flow is not permanent and decreases with age and duration of menopause, HRT must be considered as a therapy that delays the occurrence of age and/or menopause related alterations in ocular blood flow. Keywords : Colour doppler ultrasonography, hormone replacement therapy, menopause, ocular blood flow