title: Effects of Hormone Therapy on Intraocular Pressure: The Women's Health Initiative-Sight Exam Study.
abstract: OBJECTIVE
  Previous studies suggest that hormone therapy favorably affects intraocular pressure (IOP). Here, we examined the association between hormone therapy use and IOP in the context of a large randomized trial.
  
  
  METHODS
  Secondary data analysis from a randomized controlled trial.
  
  
  METHODS
  We used data from the Women's Health Initiative-Sight Exam (WHISE). Women with prior hysterectomy received oral conjugated equine estrogen (0.625 mg/day) or placebo. Women with a uterus received estrogen plus progestin (medroxyprogesterone acetate 2.5 mg/day) or placebo. IOP was measured 5 years after randomization. Adjusted linear regression models were used to assess the association between hormone therapy and IOP.
  
  
  RESULTS
  The WHISE included 1668 women in the estrogen-alone trial (aged 63-86, mean 72 years) and 2679 women in the estrogen-plus-progestin trial (aged 63-87, mean 72 years). In multivariate analyses, compared to placebo treatment, treatment with estrogen alone was associated with a 0.5 mm Hg reduction of the IOP in the right eye (95% CI: -0.8, -0.1, P = .005) and a 0.6 mm Hg (95% CI: -0.9, -0.3, P < .001) reduction of the IOP in the left eye. In the estrogen-plus-progestin trial, there was no significant difference in IOP between the treatment and placebo groups (P = .30 right eye and P = .43 left eye).
  
  
  CONCLUSIONS
  This study represents an IOP analysis in the largest hormone trial available. Estrogen-alone therapy in postmenopausal women is associated with a small but significant IOP reduction of 0.5 mm Hg. The clinical significance of this small decrease remains to be determined.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois. Electronic address: thasarat@uic.edu.
authors.forename: Thasarat S
authors.initials: TS
authors.lastname: Vajaranant
authors.affiliation: Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Pauline M
authors.initials: PM
authors.lastname: Maki
authors.affiliation: Department of Ophthalmology, Mass Eye and Ear, Harvard Medical School, Boston, Massachusetts; Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Louis R
authors.initials: LR
authors.lastname: Pasquale
authors.affiliation: Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.
authors.forename: Anne
authors.initials: A
authors.lastname: Lee
authors.affiliation: Center for Clinical and Translational Science, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Hajwa
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.
authors.forename: Mary N
authors.initials: MN
authors.lastname: Haan
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage*; D004338:Drug Combinations; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000008:administration & dosage*; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D014065:Tonometry, Ocular; D016387:Women's Health
chemical_list: D018931:Antineoplastic Agents, Hormonal; D004338:Drug Combinations; D004967:Estrogens; D004966:Estrogens, Conjugated (USP); D017258:Medroxyprogesterone Acetate