Ocular effects of oral contraceptives. I. Studies in the dog

The impact of combined oral contraceptives on ocular tissues: a review of ocular effects

The aim of this manuscript is to review the action and adverse effects of combined oral contraceptives (COCs) on ocular tissues. The percentage of unwanted pregnancies and the subsequent abortions make contraception crucial worldwide. Over 100 million women around the world use common contraceptive methods, including intrauterine devices, combined estrogen and progestin oral contraceptives, as well as progestin only preparations (oral contraceptives, implants or injections). COCs are widely used for contraception, but they are also indicated in menorrhagia, endometriosis, acne and hirsutism, fibroid uterus and premenstrual syndrome. However, they have been associated with high rates of cardiovascular events, venous thromboembolic disease, ischemic strokes and breast cancer. The incidence of COCs-related ocular complications is estimated to be 1 in 230 000, including dry eye symptoms, corneal edema, lens opacities and retinal neuro-ophthalmologic or vascular complications. We may infer that the serious ocular complications of COCs can be prevented by eliminating the estrogen dosage and choosing third-generation progestins. In any case, doctors should take into consideration the systemic and ocular history of the patients before selecting any method of contraception.

Ocular effects of oral contraceptives. II. Studies in the rhesus monkey

Oral contraceptives were administered cyclically to 96 female rhesus monkeys for 5 years. Forty-eight animals received Enovid-E and 48 were treated with Ovulen at doses 1, 10, and 50 times the human dose. Ophthalmic lesions did not occur at any of the dose levels employed. Significant fundic lesions, including papilledema, venous dilatation, venous retinal thrombosis, or arterial retinal thrombosis, did not develop in any of the treated animals.