PURPOSE. Even though there are multiple causes of dry eye syndrome, therapy generally consists of artificial tears. While this treatment may provide symptomatic relief it does not provide a long term solution to the problem. Sullivan at Harvard has indicated a role for androgens in the treatment of dry eye. Androgens play a key role in regulating the function of both the lacrimal and meibomian glands. DHEA (dehydroepiandrosterone) is a steroid hormone produced naturally by the adrenal glands that has 5% of the androgenic activity of testosterone.The present study examines the efficacy of a 1% artificial tear solution of DHEA on dry eye symptoms.
METHOD. Ten subjects 9 males and 1 female with a mean age 26.4 yrs who had a subjective complaint of dry eye were enrolled in the study. The subjects were divided into two groups one group received artificial tears alone the second group used artificial tears supplemented with 1% DHEA, the subjects used the drops 4 times daily for two weeks. The groups were reversed after two weeks of drop use. Baseline TBUT(tear breakup time) and Schirmer test were done prior to the study and after the use of each the two artificial tears(control and DHEA).
RESULTS. Baseline TBUT was 5.25 +/- 2.25 sec with DHEA 7.6 +/- 1.8 sec and artificial tears 5.4 +/- 2.37sec. Schirmer results are 16.4 mm in 5 min baseline , 21 mm DHEA and 17.6 artificial tears. ANOVA with post hoc student Newman-Keuls reveals that the TBUT and Schirmer test results with 1% DHEA are different from baseline and artificial tears at p=.05 level. Patient questionnaire indicates all subjects felt the drop was irritating but 60% felt the product reduced their symptoms better than the artificial tears and 50% said the product also provided longer relief.
CONCLUSIONS. DHEA supplementation of artificial tears improves TBUT and Schirmer test results. Subjectively the patients felt the drop worked better than artificial tears.This study sugggests potential addition of androgenic hormones to artificial tears may benefit dry eye patients.