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Am J OphthalmolMarch 201638 citations

Effects of Hormone Therapy on Intraocular Pressure: The Women's Health Initiative-Sight Exam Study.

Vajaranant Thasarat S, Maki Pauline M, Pasquale Louis R, Lee Anne, Kim Hajwa, Haan Mary N


AI Summary

This study found estrogen-alone therapy slightly reduced intraocular pressure by 0.5 mmHg in postmenopausal women, but its clinical significance for glaucoma risk remains uncertain.

Abstract

Purpose

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.

Design

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.


MeSH Terms

Administration, OralAgedAged, 80 and overAntineoplastic Agents, HormonalDrug CombinationsEstrogen Replacement TherapyEstrogensEstrogens, Conjugated (USP)HumansIntraocular PressureMedroxyprogesterone AcetateMiddle AgedProportional Hazards ModelsRisk FactorsTonometry, OcularWomen's Health

Key Concepts4

In multivariate analyses, treatment with estrogen alone was associated with a 0.5 mm Hg reduction of the intraocular pressure (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, compared to placebo treatment, in postmenopausal women with prior hysterectomy.

TreatmentRCTRandomized Controlled Trialn=1668 womenCh28Ch29

In the estrogen-plus-progestin trial, there was no significant difference in intraocular pressure (IOP) between the treatment and placebo groups (P = .30 right eye and P = .43 left eye) in postmenopausal women with a uterus.

TreatmentRCTRandomized Controlled Trialn=2679 womenCh28Ch29

Estrogen-alone therapy in postmenopausal women is associated with a small but significant intraocular pressure (IOP) reduction of 0.5 mm Hg.

TreatmentRCTRandomized Controlled Trialn=1668 womenCh28Ch29

The Women's Health Initiative-Sight Exam (WHISE) study 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).

MethodologyRCTRandomized Controlled Trialn=1668 women in estrogen-alone trial, 2…Ch10

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