Sistemik aromataz inhibitörü tedavisinin gözyaşı filmi, meibomian bezleri ve kornea endoteline etkisi

Abstract

Amaç Aromataz inhibitörleri (AI'lar), hormon reseptörü pozitif meme kanseri olan postmenopozal kadınlarda adjuvan endokrin tedavide yaygın olarak kullanılmaktadır. Bu çalışmanın amacı, noninvaziv oküler yüzey tanıları ve ön segment görüntülemeyi bir arada kullanarak, AI alan hastaları yaşları eşleşen sağlıklı kontrol grubuyla karşılaştırarak, sistemik AI tedavisinin gözyaşı filmi stabilitesi, meibomian bez yapısı ve kornea endotel hücre özellikleri üzerindeki etkilerini araştırmaktır. Metod Bu kesitsel çalışma, toplam 60 postmenopozal kadın katılımcıyı içermekte olup, iki gruba ayrılmıştır: hormon reseptörü pozitif meme kanseri için sistemik aromataz inhibitörü tedavisi alan 29 hasta (AI Grubu) ve yaşları eşleştirilmiş 31 sağlıklı kontrol (Kontrol Grubu). Tüm katılımcılar tam bir oftalmolojik muayene, yarık lamba biyomikroskopi ve dilate fundus muayenesinden geçirildi. Oküler yüzey hastalığına bağlı semptom ve bulgular kaydedildi. Ayrıca, kornea endotel parametreleri de değerlendirildi. Bulgular Çalışmaya toplam 60 postmenopozal kadın katıldı. Gruplar arasında yaş açısından istatistiksel olarak anlamlı bir fark yoktu (p=0,741). Ortalama Oküler Yüzey Hastalığı İndeksi (OSDI) skoru AI grubunda 23,1 ± 11,5 (aralık: 10–46) ve kontrol grubunda 16,2 ± 6,8 (aralık: 10–34) idi ve istatistiksel olarak anlamlı bir fark gözlendi (p=0,005). Diğer oküler yüzey parametrelerini değerlendiren testlerde istatistiksel olarak anlamlı bir fark bulunmamıştır. Speküler mikroskopi analizi, ortalama varyasyon katsayısı (CV) değerlerinin AI grubunda (42,9 ± 6,6) kontrol grubuna (33,7 ± 3,4; p<0,001) kıyasla anlamlı olarak daha yüksek olduğunu ortaya koymuştur. Ek olarak, altıgen hücre oranı (HEX, %) AI grubunda (42,7 ± 4,9) kontrol grubuna (46,1 ± 5,0; p=0,014) göre anlamlı olarak daha düşüktü. Sonuç Sonuç olarak, bulgularımız sistemik AI tedavisinin, meme kanseri olan postmenopozal kadınlarda subjektif kuru göz semptomlarının artması ve kornea endotel morfolojisinde ince değişikliklerle ilişkili olduğunu göstermektedir.

Keywords

• Aromataz inhibitörleri
• meme kanseri
• oküler yüzey
• kornea
• meibografi.

The impact of systemic aromatase inhibitor therapy on the tear film, meibomian glands, and corneal endothelium

Abstract

Aims: Aromatase inhibitors (AIs) are commonly used as adjuvant endocrine therapy in postmenopausal women with hormone receptor-positive breast cancer. The aim of this study is to investigate the effects of systemic AI treatment on tear film stability, meibomian gland structure, and corneal endothelial cell characteristics by comparing patients receiving AIs with age-matched healthy controls, using a combination of noninvasive ocular surface diagnostics and anterior segment imaging. Methods: This cross-sectional study included a total of 60 postmenopausal female participants, divided into two groups: 29 patients receiving systemic aromatase inhibitor therapy for hormone receptor-positive breast cancer (AI group), and 31 agematched healthy controls (control group). All participants underwent a complete ophthalmological examination, slit-lamp biomicroscopy, and dilated fundus examination. Ocular surface disease-related symptoms and signs were recorded. In addition, corneal endothelial parameters were also evaluated. Results: A total of 60 postmenopausal women were enrolled in the study. There was no statistically significant difference in age between the groups (p=0.741). The mean Ocular Surface Disease Index (OSDI) score was 23.1±11.5 (range: 10-46) in the AI group and 16.2±6.8 (range: 10-34) in the control group, with a statistically significant difference observed (p=0.005). No statistically significant differences were found in tests evaluating other ocular surface parameters. Specular microscopy analysis revealed that the mean coefficient of variation (CV) values were significantly higher in the AI group (42.9±6.6) compared to the control group (33.7±3.4; p<0.001). Additionally, the hexagonal cell ratio (HEX, %) was significantly lower in the AI group (42.7±4.9) than in the control group (46.1±5.0; p=0.014). Conclusion: In conclusion, our findings suggest that systemic AI therapy is associated with increased subjective dry eye symptoms and subtle changes in corneal endothelial morphology in postmenopausal women with breast cancer.

Keywords

• Aromatase inhibitors
• breast cancer
• ocular surface
• cornea
• meibography

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