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Macular Abnormalities Associated With 5α-Reductase Inhibitor
Yong Kyun Shin1, Geun Woo Lee1, Se Woong Kang1
1Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
JAMA Ophthalmology
|May 8, 2020
Summary
Men using 5-alpha-reductase inhibitors (5-ARIs) for prostate or hair loss conditions showed a higher incidence of macular abnormalities, including foveal cavitation. Further research is needed to confirm this association between 5-ARIs and vision changes.
Area of Science:
- Ophthalmology
- Endocrinology
- Pharmacology
Background:
- Sex hormones play a neuroprotective role.
- Data linking 5-alpha-reductase inhibitors (5-ARIs), which antagonize male sex hormones, to macular abnormalities are limited.
- 5-ARIs are commonly prescribed for benign prostate hypertrophy and androgenic alopecia.
Purpose of the Study:
- To investigate the association between 5-ARI use and macular abnormalities in men.
- To analyze optical coherence tomography (OCT) findings in patients using 5-ARIs.
Main Methods:
- Retrospective case-control, cross-sectional study.
- Included 31 male patients with foveal cavitation on spectral-domain OCT.
- Data collected from January 1, 2016, to June 30, 2019.
- Analyzed electronic health records, clinical data, and multimodal imaging.
Main Results:
- 10 of 14 patients (71.4%) with macular abnormalities of unknown origin used 5-ARIs, compared to 2 of 17 patients (11.8%) with known macular conditions (P=.001).
- In patients using 5-ARIs, OCT revealed cystoid abnormalities and foveal cavitation, progressing to outer foveal defects and macular holes.
- Most affected patients (80%) were asymptomatic.
Conclusions:
- 5-ARI use is associated with specific macular abnormalities in men, characterized by cystoid changes and foveal cavitation.
- These abnormalities may progress to macular holes.
- Further investigation is warranted to confirm the link between 5-ARIs and these ocular findings.
