The potential association between postmenopausal hormone use and primary open-angle glaucoma.
OBJECTIVE
Retinal ganglion cells are known to express estrogen receptors and prior studies have suggested an association between postmenopausal hormone (PMH) use and decreased intraocular pressure, suggesting that PMH use may decrease the risk for primary open-angle glaucoma (POAG).


OBJECTIVE
To determine whether the use of 3 different classes of PMH affects the risk for POAG.


METHODS
Retrospective longitudinal cohort analysis of claims data from women 50 years or older enrolled in a US managed-care plan for at least 4 years in which enrollees had at least 2 visits to an eye care provider during the period 2001 through 2009.


METHODS
Postmenopausal hormone medications containing estrogen only, estrogen + progesterone, and estrogen + androgen, as captured from outpatient pharmacy claims over a 4-year period.


METHODS
Hazard ratios (HRs) for developing incident POAG.


RESULTS
Of 152,163 eligible enrollees, 2925 (1.9%) developed POAG. After adjustment for confounding factors, each additional month of use of PMH containing estrogen only was associated with a 0.4% reduced risk for POAG (HR, 0.996 [95% CI, 0.993-0.999]; P = .02). The risk for POAG did not differ with each additional month of use of estrogen + progesterone (HR, 0.994 [95% CI, 0.987-1.001]; P = .08) or estrogen + androgen (HR, 0.999 [95% CI, 0.988-1.011]; P = .89).


CONCLUSIONS
Use of PMH preparations containing estrogen may help reduce the risk for POAG. If prospective studies confirm the findings of this analysis, novel treatments for this sight-threatening condition may follow.
Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor.
Paula Anne
PA
Newman-Casey
Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor.
Nidhi
N
Talwar
Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor.
Bin
B
Nan
Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor3Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor.
David C
DC
Musch
Department of Ophthalmology, Harvard Medical School, Cambridge, Massachusetts5Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, Massachusetts.
Louis R
LR
Pasquale
Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor.
Joshua D
JD
Stein
D000368:Aged; D000728:Androgens / Q000008:administration & dosage; D004338:Drug Combinations; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data*; D004967:Estrogens / Q000008:administration & dosage; D005260:Female; D005902:Glaucoma, Open-Angle / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D008329:Managed Care Programs / Q000706:statistics & numerical data; D008875:Middle Aged; D011374:Progesterone / Q000008:administration & dosage; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D014065:Tonometry, Ocular; D014481:United States / Q000453:epidemiology
D000728:Androgens; D004338:Drug Combinations; D004967:Estrogens; D011374:Progesterone