Androgen skin patch improves signs, symptoms of dry eye disease

Investigators from Thailand prospectively evaluated the efficacy of transdermal androgen therapy for treating dry eye in patients with androgen deficiency.

Study design

This single center, double-masked, randomized, placebo-controlled trial involved 34 postmenopausal females and 12 andropausal males with aqueous deficient dry eye syndrome. Twenty-five patients received a transdermal androgen patch, while 21 controls received urea patches. Patients received baseline ocular examination and quality of life surveys, followed by endpoint examination and surveys after 4 weeks of treatment.

Outcomes

The OSDI score, corneal fluorescein staining, tear meniscus height, tear break-up time, basic tear secretion test and ocular protective index all significantly improved in the transdermal androgen treatment group. The treatment group showed a significantly decreased frequency of artificial tear administration and an improvement in menopausal rating scores, whereas aging male symptoms were similar between groups.

Limitations

The study was limited by a small sample size. The use of measures such as Schirmer and tear break-up time could confound the results. The study looked only at right eyes which could bias the findings. Finally, the treatment and placebo transdermal patches had enough dissimilarity as to possibly negate masking.

Clinical significance

The authors present a novel treatment for dry eye syndrome that is based on previous literature linking the decline in systemic androgen to worsening dry eye disease. While further study is needed, the use of androgen supplementation could play a role in future treatments for dry eye.