Abstract:
Purpose. To explore the relationship between serum prolactin, testosterone level, and tear film parameters. The potential impact of
these hormones on the health of the ocular surface in pregnant women was evaluated. Methods. This was a hospital-based cross-
sectional study in which ocular symptoms (Ocular Surface Disease Index (OSDI)), tear function (fluorescein tear breakup time,
Schirmer’s test 1), corneal and conjunctival staining, meibomian gland (MG) expressibility, and quality of secretion were
measured. Lid margin findings including lid notching, thickness, and lid margin telangiectasia were also recorded. Venous blood
was collected and the serum concentrations of prolactin and testosterone were determined using ELISA kits. Correlation and
multiple linear regression analyses were used to examine predictors of dry eye symptoms and signs. Results. A total of 160
pregnant women participated in the study and their mean age was 30.1 ± 4.6 years (range 18–42 years). The correlation analysis
indicated that testosterone concentration did not significantly correlate with any of the clinical parameters hence it was not
included in the linear regression analysis. However, prolactin serum concentration correlated significantly with Schirmer’s test 1.
Multiple linear regression was done to predict participants’ Schirmer’s test 1 score based upon their ocular surface staining score
(oxford grading scale), meibomian gland expressibility, meibomian secretion quality, and serum concentration of prolactin. Only
predictors that significantly correlated with Schirmer’s test 1 in the correlation analysis were included in the linear regression
analysis. A significant regression equation was obtained (F (2, 157) � 5.119, p � 0.007) with an R square of 0.05. Multiple linear
regression analysis revealed that concentration of prolactin (ß coefficient � 0.032, p � 0.044) and meibomian gland expressibility
scores (ß coefficient � 2.14, p � 0.016) were associated with Schirmer’s test 1 scores when adjusted for duration of pregnancy.
Conclusion. The study showed that increased serum prolactin levels have a weak but positive impact on Schirmer’s test 1 scores
whilst serum testosterone level has no association with the clinical parameters of dry eye in pregnant women.
