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Sex Hormones Related Ocular Dryness in Breast Cancer Women

Breast Unit, University Campus Bio-Medico, 00128 Rome, Italy
Ophthalmology Operative Complex Unit, University Campus Bio-Medico, 00128 Rome, Italy
Department of Ophthalmology, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
Department of Ophthalmology, School of Medicine, Juntendo University, 1130033 Tokyo, Japan
Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
Research and Development Laboratory for Biochemical, Molecular and Cellular Applications in Ophthalmological Sciences, IRCCS–Fondazione Bietti, 00198 Rome, Italy
School of Medicine, Humanitas University, 20089 Milan, Italy
Author to whom correspondence should be addressed.
Academic Editor: Kyung-Chul Yoon
J. Clin. Med. 2021, 10(12), 2620;
Received: 11 May 2021 / Revised: 9 June 2021 / Accepted: 10 June 2021 / Published: 14 June 2021
Background: Dry eye syndrome (DES) is strictly connected to systemic and topical sex hormones. Breast cancer treatment, the subsequent hormonal therapy, the subsequent hyperandrogenism and the early sudden menopause, may be responsible for ocular surface system failure and its clinical manifestation as dry eye disease. This local dryness is part of the breast cancer iatrogenic dryness, which affects overall mucosal tissue in the fragile population of those with breast cancer. Methods: A literature review regarding the role of sex hormone changes and systemic hormonal replacement treatments (SHRT) in DES available on PubMed and Web of Science was made without any restriction of language. Results: Androgens exert their role on the ocular surface supporting meibomian gland function and exerting a pro-sebaceous effect. Estrogen seems to show a pro/inflammatory role on the ocular surface, while SHRT effects on dry eye are still not well defined, determining apparently contradictory consequences on the ocular surface homeostasis. The role of sex hormones on dry eye pathogenesis is most likely the result of a strict crosstalk between the protective androgens effects and the androgen-modulating effects of estrogens on the meibomian glands. Conclusions: Patients with a pathological or iatrogenic hormonal imbalance, such as in the case of breast cancer, should be assessed for dry eye disease, as well as systemic dryness, in order to restore their social and personal quality of life. View Full-Text
Keywords: dry eye syndrome; breast cancer; sex hormones; ocular surface equilibrium dry eye syndrome; breast cancer; sex hormones; ocular surface equilibrium
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MDPI and ACS Style

Grasso, A.; Di Zazzo, A.; Giannaccare, G.; Sung, J.; Inomata, T.; Shih, K.C.; Micera, A.; Gaudenzi, D.; Spelta, S.; Romeo, M.A.; Orsaria, P.; Coassin, M.; Altomare, V. Sex Hormones Related Ocular Dryness in Breast Cancer Women. J. Clin. Med. 2021, 10, 2620.

AMA Style

Grasso A, Di Zazzo A, Giannaccare G, Sung J, Inomata T, Shih KC, Micera A, Gaudenzi D, Spelta S, Romeo MA, Orsaria P, Coassin M, Altomare V. Sex Hormones Related Ocular Dryness in Breast Cancer Women. Journal of Clinical Medicine. 2021; 10(12):2620.

Chicago/Turabian Style

Grasso, Antonella, Antonio Di Zazzo, Giuseppe Giannaccare, Jaemyoung Sung, Takenori Inomata, Kendrick C. Shih, Alessandra Micera, Daniele Gaudenzi, Sara Spelta, Maria A. Romeo, Paolo Orsaria, Marco Coassin, and Vittorio Altomare. 2021. "Sex Hormones Related Ocular Dryness in Breast Cancer Women" Journal of Clinical Medicine 10, no. 12: 2620.

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