Hormone therapy and age-related macular degeneration: the Women's Health Initiative Sight Exam Study.

OBJECTIVE To determine the effectiveness of treatment with conjugated equine estrogens (CEE) or with CEE combined with progestin (CEE + P) on age-related macular degeneration (AMD). METHODS In an ancillary study to the Women's Health Initiative clinical trial of hormone therapy, 4262 women 65 years and older underwent fundus photography for the determination of AMD. Participants were recruited from April 2000 to June 2002 at 21 clinical sites an average of 5 years after randomization. Participants were randomized to treatment with CEE, CEE + P, or placebo. Participants had been treated for an average of 5 years at the ophthalmic evaluation for AMD. RESULTS The overall prevalence of any AMD was 21.0%. No association was found between CEE + P (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.75-1.11) or CEE alone (OR, 0.98; 95% CI, 0.78-1.25) and early-stage AMD. The CEE + P was associated with a reduced risk of soft drusen (OR, 0.83; 95% CI, 0.68-1.00) after adjustment for covariates and with a reduced risk of neovascular AMD (OR, 0.29; 95% CI, 0.09-0.92). CONCLUSIONS Treatment with CEE alone or CEE + P does not affect early- or late-stage AMD. Treatment with CEE + P may reduce the risk of soft drusen or neovascular AMD.

[1]  B. Rosner,et al.  Progression of age-related macular degeneration: prospective assessment of C-reactive protein, interleukin 6, and other cardiovascular biomarkers. , 2005, Archives of ophthalmology.

[2]  R. Klein,et al.  Estrogen replacement therapy and retinal vascular caliber. , 2005, Ophthalmology.

[3]  B. Munoz,et al.  Hormone Replacement Therapy, Reproductive Factors, and Age-Related Macular Degeneration: The Salisbury Eye Evaluation Project , 2005, Ophthalmic epidemiology.

[4]  T. Peto,et al.  5-year incidence of age-related maculopathy in the Reykjavik Eye Study. , 2003, Ophthalmology.

[5]  Johanna M Seddon,et al.  Risk factors for the incidence of Advanced Age-Related Macular Degeneration in the Age-Related Eye Disease Study (AREDS) AREDS report no. 19. , 2003, Ophthalmology.

[6]  E. Farish,et al.  Effects of two continuous hormone therapy regimens on C-reactive protein and homocysteine , 2005, Menopause.

[7]  P. McElduff,et al.  Progestogens of varying androgenicity and cardiovascular risk factors in postmenopausal women receiving oestrogen replacement therapy , 2004, Clinical endocrinology.

[8]  J. Katz,et al.  Female reproductive factors and eye disease in a rural South Indian population: the Aravind Comprehensive Eye Survey. , 2004, Investigative ophthalmology & visual science.

[9]  M. Kulldorff,et al.  The effect of different doses of micronized 17beta-estradiol on C-reactive protein, interleukin-6, and lipids in older women. , 2004, The journals of gerontology. Series A, Biological sciences and medical sciences.

[10]  F. Ferris.  PROGRESSION OF AGE-RELATED MACULAR DEGENERATION ASSOCIATION WITH DIETARY FAT, TRANSUNSATURATED FAT, NUTS, AND FISH INTAKE , 2004 .

[11]  R. Klein,et al.  Prevalence of age-related macular degeneration in Latinos: the Los Angeles Latino eye study. , 2004, Ophthalmology.

[12]  H. Taylor,et al.  Five-year incidence of age-related maculopathy: the Visual Impairment Project. , 2004, Ophthalmology.

[13]  John Robbins,et al.  National cross sectional survey to determine whether the decision to delivery interval is critical in emergency caesarean section , 2004, BMJ : British Medical Journal.

[14]  P. Kertes,et al.  POTENTIAL PUBLIC HEALTH IMPACT OF AGE-RELATED EYE DISEASE STUDY RESULTS: AREDS REPORT NO. 11 , 2004 .

[15]  M. C. Leske,et al.  Prevalence of open-angle glaucoma among adults in the United States. , 2004, Archives of ophthalmology.

[16]  R. Klein,et al.  Causes and prevalence of visual impairment among adults in the United States. , 2004, Archives of ophthalmology.

[17]  C. Delcourt,et al.  Sex steroids and age-related macular degeneration in older French women: the POLA study. , 2004, Annals of epidemiology.

[18]  A. Brzezinski,et al.  The effect of hormone therapy on the risk for age-related maculopathy in postmenopausal women , 2004, Menopause.

[19]  Benita J. O’Colmain,et al.  Prevalence of age-related macular degeneration in the United States. , 2004, Archives of ophthalmology.

[20]  M. Altındiş,et al.  Hormone replacement therapy, C-reactive protein, and fibrinogen in healthy postmenopausal women. , 2003, Maturitas.

[21]  Johanna M Seddon,et al.  Potential public health impact of Age-Related Eye Disease Study results: AREDS report no. 11. , 2003, Archives of ophthalmology.

[22]  Garnet L Anderson,et al.  The Women's Health Initiative recruitment methods and results. , 2003, Annals of epidemiology.

[23]  Scott Davis,et al.  Implementation of the Women's Health Initiative study design. , 2003, Annals of epidemiology.

[24]  B. Rosner,et al.  Progression of age-related macular degeneration: association with body mass index, waist circumference, and waist-hip ratio. , 2003, Archives of ophthalmology.

[25]  R. Klein,et al.  The association of cardiovascular disease with the long-term incidence of age-related maculopathy: the Beaver Dam eye study. , 2003, Ophthalmology.

[26]  R. Klein,et al.  Early age-related maculopathy in the cardiovascular health study. , 2003, Ophthalmology.

[27]  J. Seddon,et al.  Association between reproductive and hormonal factors and age-related maculopathy in postmenopausal women. , 2002, American journal of ophthalmology.

[28]  R. Klein,et al.  Ten-year incidence and progression of age-related maculopathy: The Beaver Dam eye study. , 2002, Ophthalmology.

[29]  Charles Kooperberg,et al.  Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. , 2002, JAMA.

[30]  G. Lip,et al.  Age-related macular degeneration is associated with increased vascular endothelial growth factor, hemorheology and endothelial dysfunction. , 2001, Ophthalmology.

[31]  L Papoz,et al.  Relationships between physical activity, obesity and diabetes mellitus in a French elderly population: the POLA study , 2001, International Journal of Obesity.

[32]  C. Delcourt,et al.  Associations of cardiovascular disease and its risk factors with age-related macular degeneration: the POLA study , 2001, Ophthalmic epidemiology.

[33]  M. Boulton,et al.  The role of oxidative stress in the pathogenesis of age-related macular degeneration. , 2000, Survey of ophthalmology.

[34]  R. Klein,et al.  Reproductive exposures, incident age-related cataracts, and age-related maculopathy in women: the beaver dam eye study. , 2000, American journal of ophthalmology.

[35]  P. Kertes.  HYPERTENSION, CARDIOVASCULAR DISEASE, AND AGE-RELATED MACULAR DEGENERATION , 2000 .

[36]  M. C. Leske,et al.  Hypertension, cardiovascular disease, and age-related macular degeneration. Age-Related Macular Degeneration Risk Factors Study Group. , 2000, Archives of ophthalmology.

[37]  E. Barrett-Connor,et al.  Effect of postmenopausal hormones on inflammation-sensitive proteins: the Postmenopausal Estrogen/Progestin Interventions (PEPI) Study. , 1999, Circulation.

[38]  J. J. Wang,et al.  Gender, oestrogen, hormone replacement and age-related macular degeneration: results from the Blue Mountains Eye Study. , 1997, Australian and New Zealand journal of ophthalmology.

[39]  R. Cumming,et al.  Hormone replacement therapy, reproductive factors, and cataract. The Blue Mountains Eye Study. , 1997, American journal of epidemiology.

[40]  R. Klein,et al.  The five-year incidence and progression of age-related maculopathy: the Beaver Dam Eye Study. , 1997, Ophthalmology.

[41]  R. Klein,et al.  Are sex hormones associated with age-related maculopathy in women? The Beaver Dam Eye Study. , 1994, Transactions of the American Ophthalmological Society.

[42]  R. Klein,et al.  Prevalence of age-related maculopathy. The Beaver Dam Eye Study. , 1992, Ophthalmology.

[43]  R. Klein,et al.  The Wisconsin age-related maculopathy grading system. , 1991, Ophthalmology.