Intraocular pressure and central corneal thickness in premenopausal and postmenopausal women: a systematic review and meta-analysis.

OBJECTIVE

This study aimed to systematically evaluate and quantify the impact of menopausal status on intraocular pressure (IOP) and central corneal thickness (CCT) in women, through a comparative meta-analysis.

METHOD: A systematic search was conducted across PubMed, Scopus, Web of Science and the Cochrane Library up to 15 April 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies included original research comparing IOP and/or CCT between premenopausal and postmenopausal women. Meta-analysis was conducted using a random-effects model, and heterogeneity was assessed via I2, τ2 and H2 statistics.

RESULTS

Ten studies were analyzed in this meta-analysis, including data from premenopausal and postmenopausal women (totaling 999 eyes). The pooled results indicated that postmenopausal women had significantly higher IOP and reduced CCT compared to premenopausal women. Despite high heterogeneity (I2 = 97.17% for CCT, I2 = 84.20% for IOP), the direction of effect was consistent across most studies. The hormonal decline associated with menopause, particularly reduced estrogen levels, appears to affect corneal structure.

CONCLUSION

Menopause is associated with elevated IOP and decreased CCT, likely due to hormonal alterations, notably estrogen deficiency. Menopausal status may be a relevant factor in ocular assessments and could have implications for risk assessment in conditions such as glaucoma.