title: Hormone replacement therapy, reproductive factors, and the incidence of cataract and cataract surgery: the Blue Mountains Eye Study.
abstract: The authors aimed to assess the relation between endogenous and exogenous female hormones and the incidence of age-related cataract and cataract surgery. The Blue Mountains Eye Study examined 2,072 women aged 49 years or older during 1992-1994, of whom 1,343 (74.0% of survivors) were reexamined after 5 years, during 1997-1999. Information on reproductive factors and use of hormone replacement therapy was collected using an interviewer-administered questionnaire. Lens photographs were graded for the presence of cortical, nuclear, and posterior subcapsular cataract at baseline and follow-up. Women who had ever used hormone replacement therapy had a decreased incidence of cortical cataract affecting any eye compared with never users (odds ratio = 0.7, 95% confidence interval: 0.4, 1.0). However, this was not statistically significant (odds ratio = 0.7, 95% confidence interval: 0.4, 1.1) when using the first affected eye. Older age at menarche was associated with an increased incidence of cataract surgery (odds ratio = 2.6, 95% confidence interval: 1.2, 5.7) and a significant trend for increasing incidence of nuclear cataract (p = 0.04). There was also a significant trend for decreasing incidence of cataract surgery with increasing duration of reproductive years (p = 0.009). These epidemiologic data provide some evidence that estrogen may play a protective role in reducing the incidence of age-related cataract and cataract surgery.
authors.affiliation: Department of Ophthalmology, University of Sydney, Westmead, New South Wales, Australia.
authors.forename: Christine
authors.initials: C
authors.lastname: Younan
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
authors.forename: Jai
authors.initials: J
authors.lastname: Panchapakesan
authors.forename: Elena
authors.initials: E
authors.lastname: Rochtchina
authors.forename: Angela M
authors.initials: AM
authors.lastname: Hales
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000145:classification / Q000453:epidemiology / Q000209:etiology*; D002387:Cataract Extraction / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D012098:Reproduction; D011795:Surveys and Questionnaires; D014505:Urban Population