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Abstract：
Purpose: To report the ocular surface and meibomian gland changes in polycystic ovarian syndrome (PCOS) women taking hormone supplementation. Methods: Case series. Results: Three women (27 ± 11 years) already diagnosed with PCOS presented with dry eye symptoms (mean OSDI, 37.5) for a mean duration of 13 months and were taking hormonal supplements for a mean duration of 60 ± 11 months. The hormonal supplements included oral estrogen (n=3), oral progesterone (n=3), antiandrogen cyproterone (n=1) and isotretinoin (n=1). Ocular surface evaluation revealed mean NIBUT of 9.9 ± 1.6 seconds and mean TMH of 0.27 ± 0.05 mm, assessed non-invasively using Oculus keratograph 5M (K5M). Meibography (K5M) showed near total loss of all meibomian glands (n=8/12 eyelids) with residual ghost glands in all four eyelids of two patients, and gland shortening alone in one patient. The gland morphology did not change following intense thermal pulsation treatment or cessation of hormonal therapy. Conclusions: Near-total irreversible meibomian gland loss was seen in two young PCOS women taking hormonal supplements. Collaboration between ophthalmologists and gynecologists is advisable for early detection and better understanding of dry eye disease (DED) progression in these patients.
摘要：
目的：报道服用激素补充的多囊卵巢综合征（PCOS）妇女的眼表和睑板腺变化。方法：案例系列。结果：3名（27±11岁）已诊断为PCOS的女性表现为干眼症状（平均OSDI，37.5），平均持续时间为13个月，并且正在服用激素补充剂，平均持续时间为60±11个月。激素补充剂包括口服雌激素（n=3），口服孕酮（n=3），抗雄激素环丙孕酮（n=1）和异维A酸（n=1）。眼表评估显示平均NIBUT为9.9±1.6秒，平均TMH为0.27±0.05mm，使用Oculus角膜描记器5M（K5M）进行非侵入性评估。眼图（K5M）显示两名患者的所有睑板腺（n=8/12眼睑）几乎完全消失，所有四个眼睑均残留鬼腺，一名患者仅腺体缩短。强烈的热脉动治疗或停止激素治疗后，腺体形态没有改变。结论：在两名服用激素补充剂的年轻PCOS女性中发现了几乎完全不可逆的睑板腺损失。建议眼科医生和妇科医生之间的合作，以便早期发现和更好地了解这些患者的干眼病（DED）进展。
