Risk of glaucoma after early bilateral oophorectomy.
OBJECTIVE
Because early estrogen deficiency may increase the susceptibility of the optic nerve to glaucoma, we studied the association of early bilateral oophorectomy with glaucoma.


METHODS
In the Mayo Clinic Cohort Study of Oophorectomy and Aging, we studied the risk of glaucoma by comparing women who underwent bilateral oophorectomy from 1950 to 1987 with age-matched referent women who did not undergo unilateral or bilateral oophorectomy. Glaucoma diagnostic codes were identified in the records linkage system of the Rochester Epidemiology Project. Hazard ratios (HRs) were calculated during a median follow-up of 25.5 years. Analyses were stratified by age at the time of bilateral oophorectomy (in tertiles).


RESULTS
Of 1,044 women who underwent bilateral oophorectomy before menopause, 147 developed glaucoma. Of 1,070 referent women, 133 developed glaucoma. Women who underwent bilateral oophorectomy showed no increased risk of glaucoma in the overall group (HR, 1.12; 95% CI, 0.89-1.42). However, women who underwent oophorectomy before the age of 43 years (n = 344; first tertile) had a significantly increased risk of glaucoma (HR, 1.60; 95% CI, 1.15-2.23). The results did not change after adjustment for hypertension, obesity, diabetes, or disorders of lipid metabolism at baseline. Approximately 11% of women who had undergone bilateral oophorectomy before the age of 43 years were treated with estrogen up to the age of 50 years; however, treatment did not reduce the association (HR, 1.59; 95% CI, 0.81-3.13).


CONCLUSIONS
Bilateral oophorectomy before the age of 43 years may increase the risk of glaucoma, and estrogen treatment does not seem to attenuate the risk.
From the 1Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL; Divisions of 2Epidemiology and 3Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN; 4Department of Psychiatry, University of Illinois at Chicago, Chicago, IL; 5Department of Ophthalmology and Channing Division of Network Medicine, Harvard Medical School, Boston, MA; and Departments of 6Ophthalmology, 7Internal Medicine, and 8Neurology, Mayo Clinic, Rochester, MN.
Thasarat S
TS
Vajaranant
Brandon R
BR
Grossardt
Pauline M
PM
Maki
Louis R
LR
Pasquale
Arthur J
AJ
Sit
Lynne T
LT
Shuster
Walter A
WA
Rocca
D000328:Adult; D000367:Age Factors; D000375:Aging; D015331:Cohort Studies; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000008:administration & dosage / Q000172:deficiency; D005260:Female; D005901:Glaucoma / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D010052:Ovariectomy / Q000009:adverse effects*; D016016:Proportional Hazards Models; D012307:Risk Factors
D004967:Estrogens