Female reproductive factors and open angle glaucoma: the Blue Mountains Eye Study.
OBJECTIVE
To determine whether endogenous oestrogen exposures are associated with open angle glaucoma (OAG).


METHODS
The Blue Mountains Eye Study examined 2072 women aged 49-97 years during 1992-4. Questions about female reproductive factors included age at menarche and menopause, parity, and use of hormone replacement therapy. Applanation tonometry, visual field tests, and stereo-optic disc photographs were performed. OAG was diagnosed when glaucomatous visual fields matched optic disc changes. Ocular hypertension (OH) was defined in the absence of glaucoma, but with intraocular pressure >or=22 mm Hg.


RESULTS
A significantly increased OAG risk with later (>13 years) compared with earlier (<or=12 years) age of menarche was found, odds ratio (OR) = 2.0; 95% confidence interval (CI) 1.0 to 3.9, p for trend = 0.01, after adjustment for multiple confounders. Non-significant increased odds for OAG were found for early natural menopause (<45 years) compared with the reference group (>or=50 years), adjusted OR = 1.7; CI: 0.7 to 3.8, and for shorter duration of endogenous oestrogen exposure (<30 years), adjusted OR = 1.8; CI: 0.6 to 5.3. Increasing parity was associated with an increased risk of OAG (p = 0.03) and decreased risk of OH (p = 0.03).


CONCLUSIONS
The modest associations found in relation to late menarche and increased parity do not allow the exclusion of a possible role for endogenous female hormones in the pathogenesis of OAG.
Lee
A J
AJ
Department of Ophthalmology, University of Sydney, Sydney, Australia.
Mitchell
P
P
Rochtchina
E
E
Healey
P R
PR
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000502:physiology*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000209:etiology*; D006306:Health Surveys; D006801:Humans; D008572:Menarche; D008593:Menopause; D008875:Middle Aged; D009798:Ocular Hypertension / Q000209:etiology; D016017:Odds Ratio; D010298:Parity; D012306:Risk; D012307:Risk Factors
D004967:Estrogens