Impact of oral contraceptive pills on central corneal thickness in young women

What intrinsic factors affect the central corneal thickness?

The cornea is one of the tissues responsible for covering and protecting the inner structures of the eye. Central corneal thickness (CCT) is defined as the distance between the anterior epithelial surface and the posterior surface of the endothelial layer. This parameter plays a very important role regarding intraocular pressure (IOP) measurement, evaluation of corneal uniformity, selection of a suitable technique for corneal refractive surgery and the planning of surgical procedures to overcome corneal disease. This comprehensive review elucidates the multifaceted factors influencing the central corneal thickness. Recognising the impact of these factors not only enhances our understanding of corneal dynamics but also contributes significantly to the refinement of diagnostic and therapeutic strategies in ophthalmology.

Myopia and its associated factors among pregnant women at health institutions in Gondar District, Northwest Ethiopia: A multi-center cross-sectional study

Background

Myopia is the most common form of uncorrected refractive error with a growing burden worldwide. It is the principal complaint of most women during pregnancy. Although myopia has led to several consequences across the standard life of pregnant women, there is no previous study in Ethiopia regarding this topic. Thus, this study determined the prevalence of myopia and identifies its associated factors among pregnant women attending antenatal care units at governmental health institutions in Gondar City District, Northwest Ethiopia.

Methods

An institution-based cross-sectional study design was conducted from 08 February to 08 April 2021. From the selected health centres, study participants were recruited by systematic random sampling technique. A pre-tested, structured-interviewer-administered questionnaire consisting of socio-demographic variables, obstetric and clinical-related variables was used to collect the required data. Non-cycloplegic refraction was performed using trial lenses, trial frames, and retinoscopy in a semi-dark examination room. EpiData 3 and STATA 14 were used for data entry and statistical analysis respectively. Both bivariable and multivariable binary logistic regression analyses were executed to identify associated factors of myopia. Variables with a p-value ≤0.05 in the multivariable logistic regression analysis were declared as statistically significant with myopia. Model fitness was checked by Hosmer and Lemeshow goodness of test (at p > 0.05).

Results

A total of four-hundred and twenty-three pregnant women participated with a 100% response rate in this study. The overall prevalence of myopia among pregnant women was 26.48% (95% CI: 22.48-30.91). Eighty-Eight (20.81%) and Eighty-Four (19.85%) of the study participants had myopia in their right and left eyes respectively. The prevalence of myopia was significantly associated with age (AOR = 1.17; 95% CI: 1.09-1.28), the third trimester of gestation (AOR = 2.05, 95% CI: 1.08-3.90), multi & grand multipara (AOR = 3.15; 95% CI: 1.59-6.25), and history of contraceptive use (AOR = 3.30; 95% CI: 1. 50-7.28).

Conclusion

The finding of our study shows that there is a higher prevalence of myopia among pregnant women in our study area. Further prospective analytical studies regarding visual systems among pregnant women, particularly as a result of pregnancy, are strongly recommended.

Visual impairment and associated factors among pregnant women attending antenatal care units at health institutions in Gondar City Administration, Northwest Ethiopia

Background

Visual impairment is a major public health concern among women of reproductive age groups in Ethiopia, which is getting worse during pregnancy. Though visual impairment has lots of serious consequences across the life course of pregnant women, there is no previous study on this topic in Ethiopia. Thus, this study determined the prevalence of visual impairment and identified associated factors among pregnant women attending antenatal care units at the governmental health institutions in Gondar City Administration, Northwest Ethiopia.

Methods

An institution-based cross-sectional study was conducted. A systematic random sampling technique was used to recruit the study participants. We used an interviewer-administered questionnaire comprising of socio-demographic, clinical and pregnancy-related variables to collect the required data. Snellen’s illiterate “E” chart was used to determine visual impairment. EpiData 3 and Stata 14 were used for data entry and statistical analysis, respectively. Both bivariable and multivariable binary logistic regression analyses were executed to identify associated factors of visual impairment. Variables with a p-value ≤0.05 in the multivariable logistic regression analysis were declared as statistically significant with visual impairment.

Results

A total of 417 (response rate = 98.6%) participants were involved in this study, with a median age of 27 years. The overall prevalence of visual impairment was 22.5% (95% CI: 18.5–26.6). Thirty (7.2%) and thirty-two (7.7%) of the study participants had moderate to severe visual impairments in their right and left eyes, respectively. Participants aged from 31 to 49 years (AOR = 2.1; 95% CI: 1.1–4.0), being 3rd trimester (AOR = 2.4; 95% CI: 1.3–4.5), multi & grand multipara (AOR = 2.3; 95% CI: 1.2–4.6), and history of contraceptive use (AOR = 2.7; 95% CI: 1.2–6.3) had higher chance of visual impairment.

Conclusion

The magnitude of visual impairment among pregnant women was high in the study area. Therefore, routine screening and evaluation of pregnant women for visual condition during antenatal care visits is recommended. Further investigations of visual changes, particularly as a result of pregnancy, are warranted.

The Effects of Sex, Oral Contraception, and Menstrual Cycle Phase on Intraocular Pressure, Central Corneal Thickness, and Foveal Thickness: A Descriptive Analysis

The primary goal of this study was to investigate the effects of sex, oral contraceptive (OC) use, and menstrual cycle phase on common ocular parameters assessed during ophthalmic evaluations, namely intraocular pressure (IOP), central corneal thickness (CCT), and foveal thickness (FT), in young healthy adults. We measured IOP, CCT, and FT in 60 participants (16 men, 16 contraceptive users, and 28 cycling women) over two sessions that characterized the menstrual cycle phase in women. For men in our study, two sessions were separated by two weeks. For women, the two sessions were scheduled during the follicular and luteal phases of the menstrual cycle. There was a trend towards higher IOP in men, and the difference was significant for white, non-Hispanic subjects and for white subjects considered separately. There was also a trend for thicker corneas in women, but men had significantly thicker foveae. CCT and FT were not different between men and OC-users, hinting at a moderating hormonal effect of oral contraceptive use. We found that IOP, CCT, and FT were equivalent between the follicular and luteal phases, which may be owing to the timing of our sessions. However, our findings strongly suggest that clinicians should consider contraceptive use during routine ophthalmic evaluations, as it could inform glaucomatous risk in women.

Variations in the central corneal thickness during the menstrual cycle in Indian women

Purpose:

To determine the changes in central corneal thickness (CCT) during the menstrual cycle in Indian women.

Methods:

A prospective observational clinical study at a tertiary care center between December 2015 and December 2018. One hundred and twenty sixty women between 18 and 45 years were included. The CCT was measured using an ultrasound pachymeter at three specific timelines of the menstrual cycle: at the beginning (1^st to 3^rd day), during ovulation time (14^th to 16^th day), and at the end of the cycle (28^th to 33^rd day). Phases of the cycle were confirmed by the urine luteinizing hormone level.

Results:

The mean CCT of both eyes was 541.76 ± 4.21 μm, 559.21 ± 4.50 μm, and 544.52 ± 8.06 μm at the beginning, mid, and end of cycle, respectively. The mean CCT of the right eye was 541.68 ± 4.15 μm, 559.08 ± 4.50 μm, and 544.44 ± 8.06 μm and of the left eye was 541.84 ± 4.27 μm, 559.35 ± 4.50 μm, and 544.61 ± 8.06 μm at the beginning, mid, and end of cycle, respectively.

Conclusion:

The CCT value was significantly (P < 0.001) higher during ovulation compared to the beginning and end of the menstrual cycle. Our study recommends adding menstrual history in the workup of women undergoing refractive surgery as physiological variations in the CCT may result in unexpected surgical outcomes.

The effect of oral contraceptive pills on the macula, the retinal nerve fiber layer, the ganglion cell layer and the choroidal thickness

Backgroun

To evaluate the effect of oral contraceptive pills (OCP) on the macula, the retinal nerve fiber layer (RNFL), the ganglion cell layer (GCL), and the choroidal thickness (CT).

Methods

In this prospective observational cross-sectional study, 60 eyes of 30 healthy women taking monophasic OCP (0.03 mg ethinylestradiol and 0.15 mg levonorgestrel) for contraception for at least 1 year were compared with 60 eyes of a control group of 30 healthy women who were not taking any OCP. Spectral-Domain Optical Coherence Tomography (SD-OCT) was used to evaluate the macula, the RNFL, the GCL, and the CT. Measurements were taken in the follicular phase (day 3) of the last menstrual cycle in all women. The body mass index (BMI) scores of all participants were also recorded.

Results

No disparity in terms of age and BMI between both groups was observed (p = 0.444, p = 0.074, respectively). All the macular parameters measurements were considerably lower in the OCP group compared to the control group (p < 0.001). Also, the RNFL thickness, the GCL thickness, and the CT were all significantly thinner in the OCP group (p < 0.001).

Conclusions

The use of OCP can cause significant changes in the retina and choroid thickness over 1 year period. The women who are using OCP for a longer duration could have some eye problems. OCT should be routinely done for follow up. Further long term studies are required, using different preparations of OCP. It is important to find out when this thickness alterations can be clinically significant or symptomatic and if these changes are reversible or not.

Effect of age, sex, and refractive errors on central corneal thickness measured by Oculus Pentacam®

BACKGROUND

Central corneal thickness (CCT) can be used to assess the corneal physiological condition as well as the pathological changes associated with ocular diseases. It has an influence on the measurement of intraocular pressure and is being used as a screening tool for refractive surgery candidates. The aim of this study was to determine the median CCT among normal Pakistani population and to correlate CCT with age, sex, and refractive errors.

METHODS

We conducted a retrospective analysis of 5,171 healthy eyes in 2,598 patients who came to Hashmanis Hospital, Karachi, Pakistan. The age of the patients ranged from 6 to 70 years. The refractive error was gauged by an auto-refractometer, and CCT was measured using Oculus Pentacam^®.

RESULTS

The median CCT of our study was 541.0 μm with an interquartile range (IQR) of 44.0 μm. The median age was 26.0 years (IQR: 8.0). Median spherical equivalent (SE) of the patients was -4.3 D (IQR: 3.3) with the median sphere value as -4.0 D (IQR: 3.8). Lastly, the median cylinder was -1.0 D (IQR: 1.3). Age has a weak negative correlation with CCT (r=-0.058) and shows statistical significance (P<0.001). Additionally, males had thinner CCT readings than females (P=0.001). The cylinder values, on the other hand, had a significant (P=0.004) and positive correlation (r=0.154). Three values showed no significant correlation: sphere (P=0.100), SE (P=0.782), and the left or right eye (P=0.151).

CONCLUSION

Among the Pakistani population, CCT was significantly affected by three variables: sex, age, and cylinder. No relationship of CCT was observed with the left or right eye, sphere, and SE.