After Menopause, Hormones May Lower Glaucoma Risk

Glaucoma risk in postmenopausal women may be reduced with hormone therapy containing estrogen

(RxWiki News) Some women take hormone medications to help with menopausal symptoms. It's possible that these medications protect their eyesight as well.

A recent study found that postmenopausal hormone medication (PMH) containing estrogen may reduce the risk of glaucoma in postmenopausal women.

The researchers believe that more research is needed on this association and on the effects of specific combinations of PMH medications on the risk of glaucoma.

"Ask your doctor about the side effects of your hormone therapy."

The lead author of this study was Joshua D. Stein, MD, MS, from the Department of Ophthalmology and Visual Sciences at the University of Michigan Medical School in Ann Arbor, Michigan.

The study included 152,163 women, 50 years of age and older, with an eye-related diagnosis who saw an eye doctor at least twice between 2001 and 2009. Most (81 percent) of the participants were white.

The researchers looked through insurance claim records for cases of primary open-angle glaucoma (POAG) among the study's participants.

POAG is the most common form of glaucoma, and is characterized by a rise in inner eye pressure because the correct amount of fluid can’t drain out of the eye.

The findings showed that 70,292 women (46 percent) had a prescription for at least one type of PMH. A total of 59,847 women used a PMH with estrogen-only, 15,288 used a PMH with estrogen plus progesterone and 4,441 participants used a PMH with estrogen plus androgen.

Cases of incident POAG accounted for 2,925 (2 percent) participants. Only 2 percent of the participants not using PMH developed POAG.

The women who used estrogen-only PMH were prescribed the medication for an average of 753 days. Those who used estrogen plus progesterone PMH were prescribed the medication for an average of 670 days, and those who used estrogen plus androgen PMH were prescribed the medication for an average of 708 days.

The researchers determined that the women who were prescribed estrogen-only PMH had a 0.4 percent reduced relative risk of POAG for every month of PMH use compared to a non-user.

The women who were prescribed estrogen plus progesterone PMH had a 0.6 percent reduced relative risk of POAG for every month of PMH use compared to a non-user.

Use of estrogen plus androgen PMH did not affect the risk of POAG.

The researchers found that black participants had a 72 percent increased risk, and Latina participants had a 41 percent increased risk of developing POAG compared to the white participants.

The authors noted a few limitations of their study. First, the researchers relied on data from insurance claims. Second, the study only used insured participants, so the findings may not be applicable to those without insurance. Third, the researchers did not consider the possibility of participants not sticking to their medication regimen. Fourth, PMH users may pay more attention to their health than other people enrolled in an insurance plan.

This study was published on January 30 in JAMA Ophthalmology.

The National Eye Institute, the American Glaucoma Society, Blue Cross Blue Shield of Michigan Foundation, Research to Prevent Blindness, the Heed Foundation, the Harvard Glaucoma Center of Excellence and the Arthur Ashley Foundation provided funding.

Review Date: 
January 30, 2014