Transgenders on feminizing hormone therapy
may have a higher risk of venous thromboembolism.
25 Nonetheless, the literature on ocular vascular occlusive disorders is limited to a few reports.
26,
27,
28,
29 We identified two MTF patients with unilateral BRVO, one at her initial visit and the other at a follow-up appointment for chorioretinitis in her contralateral eye. In accordance with the literature, our patients had multiple risk factors, such as systemic hypertension, high body mass index, and smoking history. Therefore, it could be possible that these comorbidities could have influenced the prevalence of these events, yet more studies are needed to evaluate any possible association.
Sex steroid hormones can also influence intraocular inflammation.
30 In general, testosterone acts as an immunosuppressant, while estrogen is mostly proinflammatory, yet the latter can vary.
30 Therefore, it has been proposed that transgenders might also be at an increased risk of inflammatory eye diseases,
10 though this remains purely speculative. In our study, two MTF transgenders presented with idiopathic chorioretinitis. In both cases, no etiology was identified despite extensive diagnostic work-up, and no cause-and-effect association with gender-affirming hormone therapy was identified.