Abstract
Purpose :
Glaucoma is the leading cause of irreversible blindness worldwide and females constitute nearly 60% of the glaucomatous population (French et al. 2010). Recent studies suggest that the age of menopause affects the risk of developing glaucoma (Pasquale et al. 2007). We performed a retrospective study of U.S. Veterans to further examine the relationship between the age of menopause and the onset of glaucoma.
Methods :
Our criteria required female patients to have a negative ophthalmological and menopausal screening prior to a glaucoma diagnosis (including prescription of medication) and a menopause diagnosis. Patients with a history of hormone replacement therapy or other ocular pathologies were excluded. Covariates included race and ethnic background, body mass index, blood pressure, systemic anti-hypertensive medication usage, and co-morbidity index. We performed propensity score matching and created two separately matched populations. These populations were the (1) early-to-control population, consisting of an early menopause group (menopause age: 35-45 years, n=221) matched against a control menopause group (45-55 years, n=663), and (2) late-to-control population, made up of a late menopause group (55-65 years, n=488) matched against a control menopause group (45-55 years, n=488). We then developed multivariate linear regressions with the age of glaucoma diagnosis as the outcome variable for each dataset.
Results :
Women in the early menopause group developed glaucoma on average 5.5 years earlier than their matched control group, while women in the late menopause group developed glaucoma 5.3 years later compared to their matched control group. For both matched datasets, the age of menopause diagnosis was the strongest predictor of the onset of glaucoma. These models predicted that for each year later a woman went into menopause there was a 0.67-year and 0.68-year delay in developing glaucoma for the early-to-control and late-to-control populations, respectively.
Conclusions :
Our study is the first to demonstrate a direct association between the age of menopause and the onset of glaucoma. Notably, women experiencing early menopause are predicted to develop glaucoma earlier, which is critical for long-term vision outcomes. Future work will look at the impact of menopause on glaucoma incidence and the role of HRT on the onset of glaucoma.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.