Menopausal and reproductive factors and risk of age-related macular degeneration.
OBJECTIVE
To investigate whether estrogen exposures are associated with lower risks of age-related macular degeneration (AMD).


METHODS
Postmenopausal hormone (PMH) use, past use of oral contraceptives (OCs), ages at menarche and menopause, and parity were assessed among 74,996 postmenopausal women. Over 22 years, cases of early (n = 554) and neovascular (n = 334) AMD with a visual acuity of 20/30 or worse were identified. Cox models were used to calculate the relative risk for each exposure, adjusted for smoking and other factors.


RESULTS
Current PMH users had a notable 48% lower risk of neovascular AMD compared with those who had never used PMH, although risk did not decline linearly with longer durations of use. Risk was lowest for PMH users who had used OCs in the past (P value for interaction, .03). In contrast, risk of early AMD was a notable 34% higher among current PMH users and OC use was unassociated with risk. The only remarkable finding for the endogenous estrogenic factors was a 26% lower risk of early AMD for parous women.


CONCLUSIONS
Although PMH and OC use were associated with a lower risk of neovascular AMD, no benefit was observed for early AMD. Factors influencing lifetime exposure to estrogens were not consistently associated with the disease.
Feskanich
Diane
D
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA. diane.feskanich@channing.harvard.edu
Cho
Eunyoung
E
Schaumberg
Debra A
DA
Colditz
Graham A
GA
Hankinson
Susan E
SE
D000328:Adult; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage*; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000453:epidemiology*; D008572:Menarche; D008593:Menopause; D008875:Middle Aged; D011446:Prospective Studies; D017584:Reproductive History; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014792:Visual Acuity; D016387:Women's Health
D003278:Contraceptives, Oral, Hormonal