COMMENTARY

The Hormone-Glaucoma Connection

Shuchi B. Patel, MD

Disclosures

April 04, 2014

The Potential Association Between Postmenopausal Hormone Use and Primary Open-Angle Glaucoma

Newman-Casey PA, Talwar N, Nan B, Musch DC, Pasquale LR, Stein JD
JAMA Ophthalmol. 2014;132:298-303

Study Summary

Newman-Casey and colleagues addressed an interesting question in the retrospective longitudinal cohort analysis of claims data. They sought to correlate the use of postmenopausal hormone therapy (PMH) and primary open-angle glaucoma (POAG).

Patients were included in the analysis if they met the following criteria: female sex, age 50 years or older, continuous enrollment in the medical plan for at least 4 years, and at least 2 visits to an eye care provider. A total of 152,163 women met the inclusion criteria. Their mean age (standard deviation) was 65.1 (8.9) years, and their racial distribution included white, black, Latina (8.8%), Asian American, and other populations that were unidentified. Among enrollees with PMH prescriptions, 59,847 (39.3%) had a prescription for estrogen alone (E), 15,288 (10.1%) for PMH with estrogen and progesterone (E+P), and 4441 (2.9%) for estrogen and androgen (E+A) during their time in the plan.

The proportions of women taking E, E+P, and E+A who developed POAG were 1.7%, 1.9%, and 1.4%, respectively. By comparison, 2.1% of women using no PMH developed POAG. After adjustment for age plus other sociodemographic factors and ocular and systemic comorbid conditions, the association between E use and development of POAG was statistically significant. Every additional month of E use reduced the hazard for POAG by 0.4%, but there was no association between E+P or E+A use and POAG.

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