Who would have thought that birth control pills could affect the eyes? Well, that is precisely what a study from Turkey reported recently.
Weight gain and nausea are just some of the well-known side effects of oral contraceptive pills (OCP), but according to this recent study, they can also mimic age-related changes in the eye, potentially affecting the central vision which is essential for daily activities such as driving, reading and watching television.
Conducted at the Department of Obstetrics and Gynecology, Health Sciences University Kayseri Education and Research Hospital, Kayseri, Turkey, between January 2014 and April 2016, the study by Dr. Ahter Tanay Tayyar and colleagues compared a total of 24 healthy women taking monophasic OCP (3 mg drospirenone and 0.03 mg ethinylestradiol) for contraception only for at least one year with a control group of 24 healthy women who were not taking an OCP.
The aim of the study was to evaluate the effect of OCP on the macula, the retinal nerve fiber layer (RNFL), and choroidal thickness (CT).
Optical coherence tomography (OCT) was used to evaluate the posterior ocular segments, and measurements were taken in the follicular phase (day 3) of the cycle in all women, who were between 25-40 years old.
“In comparison of the macular region and CT between groups, we found that all variables except foveal center thickness and CT were significantly thinner in the OCP group. Nasal and temporal inferior parts of the RNFL and average RNFL were significantly slimmer in the study group versus the control group,” reported Dr. Tayyar and colleagues, explaining the results.
Therefore, women who use OCP for more than one year may experience eye problems and should get their eyes routinely checked with OCT. Further clinical trials researching the long-period effect of OCP on the eyes are needed, the investigators emphasized.
The paper noted that OCP does have some risks and side effects with regard to several organs, one of which is the eye. Eye complications in users of OCP include retinal vascular occlusion, optic neuritis and proptosis; in addition, retinal edema, glaucoma and hemorrhagic retinopathy have also been reported previously.
Because of extensive evidence that OCP can cause vascular events elsewhere in the body, this is of particular interest for closer analysis, the study said. Furthermore, these effects have been shown to change depending on the type of progesterone used.
Several earlier studies have looked at the effect of sex steroid hormone fluctuations in the menstrual cycle on the eye; and some researchers have shown that these hormone fluctuations exhibited correlations with changes in ocular tissue. Age-related hormonal changes may also affect the ocular tissues, causing thickening due to edema or slimming due to atrophy in the macula and atrophy in the RNFL.
Dr. Vishali Gupta, professor of ophthalmology at the Postgraduate Institute of Medical Education and Research (PGIMER) in Chandigarh, India, and PIE Magazine advisory board member, said of the Turkish paper: “This is a very interesting observation indeed – an observation that merits to be studied in detail to look at the effect of OCPs on retinal health.”
“We do know that drugs like Spironolactone and Eplerenone help in reducing the fluid from the retina in eyes with chronic central serous chorioretinopathy. However the possible effect of OCP in normal retina is something that is very fascinating and needs further large studies,” explained Dr. Gupta.
Editor’s Note: Dr. Vishali was generous enough to contribute on this story, but she was not a participant of the mentioned study.
Reference:
Madendag Y, Acmaz G, Atas M, Sahin E, Tayyar AT, et al. The Effect of Oral Contraceptive Pills on the Macula, the Retinal Nerve Fiber Layer, and Choroidal Thickness. Med Sci Monit. 2017;23:5657-5661.
