July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
The effects of estrogen deficiency on the peripapillary retinal nerve fiber layer thickness
Author Affiliations & Notes
  • Thasarat S Vajaranant
    Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
  • Joelle Hallak
    Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
  • Joseph Baker
    Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
  • Louis Pasquale
    Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York City, New York, United States
  • Pauline M Maki
    Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Thasarat Vajaranant, None; Joelle Hallak, None; Joseph Baker, None; Louis Pasquale, None; Pauline Maki, None
  • Footnotes
    Support  K23EY022949; Research to Prevent Blindness
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 5568. doi:https://doi.org/
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      Thasarat S Vajaranant, Joelle Hallak, Joseph Baker, Louis Pasquale, Pauline M Maki; The effects of estrogen deficiency on the peripapillary retinal nerve fiber layer thickness. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5568. doi: https://doi.org/.

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

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Abstract

Purpose : To determine the association between surgery-induced estrogen deficiency and peripapillary retinal nerve fiber layer (pRNFL) thickness in postmenopausal women.

Methods : We recruited women with surgical (bilateral oophorectomy) and natural menopause without a history of cancer, chemotherapy and ocular pathologies that might have affected the pRNFL thickness. All women underwent a comprehensive eye examination to confirm the absence of media opacity and pathology of the optic nerve and retina. Main outcome measures were global pRNFL thickness by optical coherence tomography (Spectralis, Heidelberg Engineering, Heidelberg, Germany) and duration of estrogen deficiency (expected age at menopause (50) - actual age at menopause + years of hormone therapy). Multivariate regression models were used to determine the association between duration of estrogen deficiency and global pRNFL thickness, adjusting for age, race, diabetes, hypertension, intraocular pressure (IOP), axial length (AL), as well as serum estradiol, progesterone and follicular stimulating hormone (FSH). Averaged global RNFL thickness, IOP and AL from both eyes of each woman was used.

Results : The final analysis included 55 women (25 women with surgical menopause and 30 women with natural menopause), with the mean age of 62.1 ±10 years, mean age at menopause of 47.8 ±8 years, and mean estrogen deficiency of 6.1 ±13 years. The mean global RNFL thickness was 94.3 ±9 m, with the mean IOP of 14.6 ±3 mmHg and mean AL of 23.7 ±1 mm. In the final adjusted analysis, the type of menopause did not associate with global pRNFL thickness. However, the duration of estrogen deficiency regardless of the type of menopause, was statistically associated with thinner global pRNFL thickness (p = 0.03). Adjusted for age and race, every 10 years of estrogen deficiency was associated with a decrease in the global pRNFL thickness of 2.3 μ (95% Confident Interval, -0.2 to -4.3). Serum estradiol, progesterone and FSH were not associated with the global pRNFL thickness (all p values > 0.12).

Conclusions : Our analysis suggests that duration of estrogen deficiency, regardless of the type of menopause, is associated with thinning of the pRNFL beyond aging alone. Further investigations are warranted to determine the clinical significance.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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