SEX STEROIDS AND MACULAR TELANGIECTASIA TYPE 2

Purpose: To investigate the relationship between macular telangiectasia Type 2 and systemic levels of sex steroids or their antagonization. Methods: In a prospective single-center study, 90 patients with macular telangiectasia Type 2 were investigated. Female patients were evaluated for previous surgical (e.g., ovariectomy) and/or pharmacological (e.g., aromatase inhibitors, tamoxifen) therapy resulting in reduced action of sex steroids. In males, free serum testosterone levels were assessed in patients and controls. Results: Fourteen of 49 (29%) female patients had a history of pharmacological suppression of sex steroids and/or ovariectomy. These patients were younger at disease onset when compared with those without such medical history (mean +/- SD: 47.1 +/- 7.8, range: 38-59, versus 60.1 +/- 7.6, range: 45-76; P < 0.0001). Male patients showed significantly lower free serum testosterone levels compared with controls at younger age (P < 0.0001 and 0.04 in the first and second age quartiles, respectively), as opposed to nonsignificant differences in older patients. In men <= 60 years of age, a biochemical hypogonadism (free serum testosterone, 0.05 ng/mL) was present in 53% (8/15) and 4% (2/49) of patients and controls, respectively (P < 0.0001). Conclusion: The results indicate that steroidal sex hormones might be involved in the presumably multifactorial pathophysiology of macular telangiectasia Type 2.