September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Sex hormone levels and risk of primary open-angle glaucoma in postmenopausal women
Author Affiliations & Notes
  • Jae H Kang
    Medicine, Brigham and Women's Hospital / Harvard Medical School, Boston, Massachusetts, United States
  • Janey L Wiggs
    Department of Ophthalmology, Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Louis R Pasquale
    Department of Ophthalmology, Brigham and Women's Hospital, Boston, Massachusetts, United States
    Medicine, Brigham and Women's Hospital / Harvard Medical School, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Jae Kang, None; Janey Wiggs, None; Louis Pasquale, None
  • Footnotes
    Support  NIH Grant EY015473
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Jae H Kang, Janey L Wiggs, Louis R Pasquale; Sex hormone levels and risk of primary open-angle glaucoma in postmenopausal women. Invest. Ophthalmol. Vis. Sci. 201657(12):.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate pre-diagnostic sex hormone levels in postmenopausal women in relation to primary open-angle glaucoma (POAG).

Methods : Blood samples were collected in 1989-1990 in the Nurses’ Health Study, and medical-record confirmed incident POAG cases were identified (252 cases and 1815 controls; date of diagnosis from after blood draw to 2012) among postmenopausal women not on postmenopausal hormone therapy at blood draw. Plasma concentrations of estrone sulfate, estradiol and testosterone were assessed. Multivariable logistic regression was used to evaluate tertiles of biomarker levels, adjusting for various potential confounders including age, race, family history of glaucoma, cigarette smoking, hypertension, diabetes and body mass index. The primary outcome was POAG; in secondary analyses, we evaluated subtypes defined by maximum intraocular pressure (IOP) at diagnosis.

Results : The median levels of sex hormones among controls were 23.9 pg/mL for estrone, 5.7 pg/mL for estradiol and 18.9 ng/dL for testosterone. We observed no associations with estrone (p for trend [p-trend]=0.25) or estradiol (p-trend=0.48) and POAG. For testosterone, compared to the lowest tertile (median=18.5 ng/dL), the highest tertile (median= 30.7 ng/dL) showed a significant increased risk of POAG (multivariable odds ratio [OR]=1.76, 95% CI=1.18-2.62; p-trend=0.01). Also, the adverse association with testosterone was stronger with high tension glaucoma (maximum IOP > 21 mmHg at diagnosis) with highest versus lowest tertile comparison of OR= 2.10 (95% CI=1.24-3.56; p-trend=0.01) versus OR= 1.20 (95%CI=0.62-2.34; p-trend=0.58) for normal tension glaucoma (maximum IOP ≤ 21 mmHg at diagnosis).

Conclusions : Higher testosterone levels in postmenopausal women were adversely associated with POAG, particularly for high tension glaucoma.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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