Are sex hormones associated with age-related maculopathy in women? The Beaver Dam Eye Study.

AGE-RELATED MACULOPATHY (ARM) IN ITS MOST SEVERE FORM IS OFTEN associated with legal blindness.1-3 The lesions characterizing this condition are geographic atrophy and neovascularization of the macula. This latter manifestation of macular degeneration appears to occur more commonly in women.4 A recent case-control study found a protective effect of reported use of estrogen replacement therapy.5 In the Beaver Dam Eye Study, current estrogen replacement therapy was associated with less severe nuclear sclerosis.6 Other markers of estrogen exposure were also associated with decreased frequencies of lens opacities. Therefore, because of the biologic plausibility of an association of estrogens and maculopathy and the availability of a unique data set from the Beaver Dam Eye Study, we explored the relationship of the range of maculopathy as it occurs in an unselected population of women and a variety of lifetime estrogen exposures.