Eye (Lond)January 20251 citations

Macular, choroidal and disc associations across women's reproductive life stages: a scoping review from menarche to post-menopause.

Ribeiro Reis Ana Paula, Ioannidou Estelle, Stuart Kelsey V, Wagner Siegfried K, Foster Paul J, Khawaja Anthony P, Petzold Axel, Sivaprasad Sobha, Pontikos Nikolas, Keane Pearse A

View on PubMed DOI: 10.1038/s41433-025-03592-w

AI Summary

This review found limited, inconsistent data on how women's hormonal cycles affect eye structures, though choroidal thinning was noted during the luteal phase. More research is needed to understand sex differences in eye diseases.

Abstract

Oestrogen and progesterone fluctuate cyclically in women throughout their adult lives. Although these hormones cross the blood-retinal barrier and bind to intraocular receptors, their effects remain unclear. We present the first review to date on associations between posterior pole structures-specifically the macula, choroid, and optic disc-and both the menstrual cycle and post-menopausal period, utilising multimodal imaging techniques in healthy adult non-pregnant women. We excluded studies on contraception and hormonal replacement therapy, focusing solely on physiological associations. Despite the comprehensive scope of our review, limited data and inconsistent reporting among studies prevented the establishment of meaningful trends. Across menstrual cycle phases, choroidal thickness (CHT) was the most consistently reported parameter, with thinning during the luteal phase compared to the follicular phase. Conversely, no significant differences were observed in macular or disc morphology across the cycle, likely reflecting a preserved structure despite potential fluctuations in blood flow and perfusion. Studies comparing pre- and post-menopausal associations, after adjusting for age or body mass index (BMI), failed to reveal meaningful trends, highlighting the difficulty in separating the effect of age from hormonal declines in older women. Understanding how hormonal cycles impact the posterior pole in women is crucial for addressing sex differences in various ocular pathologies. Research on female-specific factors is still sparse, and interestingly, the majority of affiliations in the reviewed articles did not originate from regions with the highest biomedical research funding and publication rates. We encourage further studies focusing on female-specific variables and provide recommendations for future designs.

MeSH Terms

HumansFemaleChoroidOptic DiskPostmenopauseMenarcheTomography, Optical CoherenceMenstrual CycleMacula LuteaMiddle AgedAdultMenopause

Shields Classification

Ch. 4Optic Nerve, Retina, and Choroid

Key Concepts4

In healthy adult non-pregnant women, across menstrual cycle phases, choroidal thickness (CHT) was the most consistently reported parameter, with thinning observed during the luteal phase compared to the follicular phase.

MechanismReviewScoping Reviewn=multiple studiesCh5

In healthy adult non-pregnant women, no significant differences were observed in macular or disc morphology across the menstrual cycle, likely reflecting a preserved structure despite potential fluctuations in blood flow and perfusion.

MechanismReviewScoping Reviewn=multiple studiesCh5

Studies comparing pre- and post-menopausal associations of posterior pole structures (macula, choroid, and optic disc) in women, after adjusting for age or body mass index (BMI), failed to reveal meaningful trends, highlighting the difficulty in separating the effect of age from hormonal declines in older women.

MethodologyReviewScoping Reviewn=multiple studiesCh5Ch10

A scoping review of associations between posterior pole structures (macula, choroid, and optic disc) and both the menstrual cycle and post-menopausal period in healthy adult non-pregnant women, utilising multimodal imaging techniques, found limited data and inconsistent reporting, preventing the establishment of meaningful trends.