May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Reproductive Hormone Exposures and Five-Year Incidence of Age-Related Macular Degeneration in Older Women
Author Affiliations & Notes
  • R. Seitzman
    Ophthalmology, UCLA/Jules Stein Eye Institute, Los Angeles, California
  • A. L. Coleman
    Ophthalmology, UCLA/Jules Stein Eye Institute, Los Angeles, California
  • F. Yu
    Ophthalmology, UCLA/Jules Stein Eye Institute, Los Angeles, California
  • J. A. Cauley
    Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
  • K. E. Ensrud
    Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota
  • K. Stone
    San Francisco Coordinating Center, San Francisco, California
  • K. Pedula
    Kaiser Permanente Center for Health Research, Portland, Oregon
  • G. Thomas
    The Retina-Vitreous Associates Medical Group, Beverly Hills, California
  • C. Mangione
    Medicine, UCLA, Los Angeles, California
  • Study of Osteoporotic Fractures Research Group
    Ophthalmology, UCLA/Jules Stein Eye Institute, Los Angeles, California
  • Footnotes
    Commercial Relationships R. Seitzman, None; A.L. Coleman, None; F. Yu, None; J.A. Cauley, None; K.E. Ensrud, None; K. Stone, None; K. Pedula, None; G. Thomas, None; C. Mangione, None.
  • Footnotes
    Support NIH grants EY013626, AG05407, AR35582, AG05394, AR35584, AR35583, and AG08415; Research to Prevent Blindness; Emily G. Plumb Estate and Trust.
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 2095. doi:https://doi.org/
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      R. Seitzman, A. L. Coleman, F. Yu, J. A. Cauley, K. E. Ensrud, K. Stone, K. Pedula, G. Thomas, C. Mangione, Study of Osteoporotic Fractures Research Group; Reproductive Hormone Exposures and Five-Year Incidence of Age-Related Macular Degeneration in Older Women. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2095. doi: https://doi.org/.

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

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Abstract

Purpose:: To examine the associations of reproductive hormone exposures with incidence of age-related macular degeneration (AMD) in older women.

Methods:: Subjects included participants in the Study of Osteoporotic Fractures attending the year 10 and year 15 follow-up visits that had fundus photographs gradable for early or late AMD in both eyes at both visits (n=1699). Forty-five degree stereoscopic fundus photographs were graded for AMD using a modification of the Wisconsin Age-Related Maculopathy Grading System. History of postmenopausal hormone therapy use, hysterectomy and surgical menopause were determined with questionnaires. Estrogen therapy (ET) and estrogen plus progestin therapy (HT) could be distinguished for Caucasians only. Total hip BMD, a potential surrogate for lifetime endogenous estrogen exposure, was measured with dual energy x-ray absorptiometry. Logistic regression was used to test whether these risk factors were associated with incident early or late AMD. Interactions between each reproductive factor and smoking were tested.

Results:: Approximately 57% of subjects reported ET or HT use. The 5-year AMD incidence was 18.6% for early and 5.5% for late. None of the reproductive factors was associated with early AMD in the complete sample; however, HT use was associated with a lower risk of early AMD in Caucasians (OR=0.45; 95% CI: 0.22-0.92). Compared to the lowest BMD quartile, quartiles two and three combined, but not quartile four, was associated with a significantly lower risk of late AMD (OR Q2+Q3 =0.56; 95% CI: 0.33-0.97; OR Q4=0.86; 95% CI:0.44-1.67).

Conclusions:: Use of postmenopausal hormone therapy was not significantly associated with early or late AMD in the complete sample; however, HT use was associated with reduction of early AMD risk in Caucasians. This association should be examined in other subgroups. Furthermore, BMD may be associated with late AMD risk. Further research is needed to understand the biological mechanisms that underlie these associations.

Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: risk factor assessment 
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