Female Reproductive Factors and Major Eye Diseases in Asian Women - The Singapore Malay Eye Study

Abstract

 

Purpose

 

To examine the association of reproductive factors and major eye diseases, including glaucoma, age-related macular degeneration (AMD), diabetic retinopathy and cataract in Asian women.

 

Methods

 

The Singapore Malay Eye Study is a population-based cross-sectional epidemiological study which examined 3280 (78.7% response) persons of Malay ethnicity aged 40 to 79 years, of which 1,704 were women. Information on reproductive factors and use of hormone replacement therapy was collected using an interviewer-administered questionnaire. Glaucoma was defined according to International Society for Geographical and Epidemiological Ophthalmology criteria. Retinal photographs were taken from both eyes, graded for AMD following the Wisconsin grading system and diabetic retinopathy according to the modified Airlie House classification system. Cataract was assessed by slit-lamp examination and graded according to the Lens Opacity Classification System III (LOCS III).

 

Results

 

Of the 1704 women in this study, 1176 (69%) reported having experienced menopause by the time of the study, of which 1073 (91%) had natural menopause, 88 (7.5%) had hysterectomy and 9 (0.8%) due to other reasons. Hormone replacement therapy was used by 70 (6%) of the women. Age of menopause was associated with glaucoma; women who had menopause at 52 years or younger were 3.5 times more likely to have glaucoma (95% CI 1.23-9.98, p-value =0.02) than those with age of menopause 53 years and older. Age of menopause was not associated with AMD (age-adjusted OR = 1.22, 95% CI 0.65 to 2.31), diabetic retinopathy (age-adjusted OR = 1.01, 95% CI 0.66 to 1.54) or cataract (age-adjusted OR = 1.38, 95% CI 0.95 to 2.00). Use of hormone replacement therapy was not associated with any of these four major eye diseases.

 

Conclusions

 

Women who had menopause at a younger age were more likely to have glaucoma.

 

Keywords: 464 clinical (human) or epidemiologic studies: risk factor assessment • 463 clinical (human) or epidemiologic studies: prevalence/incidence