[Ocular complications of hormonal treatments: oral contraception and menopausal hormonal replacement therapy]

Numerous reports have described ocular complications of sex hormone preparations, particularly after the appearance of the oral contraceptive pill. The most serious complications are vascular occlusions such as central retinal vein or artery occlusion and acute ischemic optic neuropathy. In these cases, permanent visual loss may occur. Combined oral contraceptives have been reported to increase the incidence of these complications but it remains very low. It seems to lessen with the decrease in the estrogen dosage and the use of third-generation progestins. Conversely, post-menopausal hormone replacement therapy seems to have a protective effect for retinal vascular complications. Other ocular involvements have been described with sex hormone preparations but remain not yet confirmed, such as the effect on cataract, lacrymal secretion, diabetic retinopathy, age-related macular degeneration.