Erdem DURSUN, Selim YALÇIN, Oğuzhan AKÇA, Seval ÇOBANOĞLU ÖZTÜRK, Zafer ONARAN, Nuray BAYAR MULUK
Anatolian Current Medical Journal - 2026;8(1):61-65
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 age-matched 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.
