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Ye Elaine Wang, Caitlin Kakigi, Diego Tebaldi de Queiroz Barbosa, Sophia Ying Wang, Rebecca I Chen, Shan C Lin; Association between oral contraceptives use and glaucoma in United States . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5015.
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To investigate the association between oral contraceptives (OCPs) use and the prevalence of glaucoma.
This cross-sectional study included female participants 40 years or older, from the 2005-2008 National Health and Nutrition Examination Survey, who completed the vision and reproductive health questionnaire and underwent eye exams. The predictor was >3 years history of OCs usage. The primary outcome was self-reported glaucoma. Secondary outcome was FDT visual field defects in either eye and vertical cup to disc ratios.
After adjusting for confounders including age, gender, ethnicity, income level, education level, general health condition, history of stroke, hypertension, and diabetes; ocular health condition including history of cataract surgery, history of diabetic retinopathy; reproductive health factors including age at menarche, number of pregnancies, menopausal status, history of hormone replacement therapy; history of gynecological surgeries such as hysterectomy and bilateral oophorectomy; and history of breast, ovary or uterine cancer; those women with greater than 3 years of OCPs use had odds ratio of 2.17 of having self-reported glaucoma (P=0.0028). Other factors associated with increased risk of glaucoma include older age, African American race, and later age of menarche, history of bilateral oophorectomy (all p<0.01). Secondary outcomes, namely FDT visual field defect (in either eye) or vertical cup to disc ratio, was not found to be significantly associated with longer term (greater than three years) use of OCPs, after adjusting for the same sets of confounders.
Greater than three years use of OCPs is possibly associated with increased risk of glaucoma, further supporting the role of circulating estrogen in the pathogenesis of glaucoma in older women.
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