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J Glaucoma. 2007 Oct-Nov;16(7):598-605.

Attributes of female reproductive aging and their relation to primary open-angle glaucoma: a prospective study.

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Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA.



We investigated the relation between age at menopause, postmenopausal hormone (PMH) use, and incident primary open-angle glaucoma (POAG).


We followed 66,417 women in the Nurses' Health Study prospectively from 1980 to 2002. Eligible participants were > or =40 years old, free of POAG at baseline, provided information on menopausal status, and reported receiving eye examinations during follow-up. Relevant exposure data and POAG risk factors were updated using biennial questionnaires. We identified 447 POAG cases during follow-up. We used proportional hazards models to calculate multivariable rate ratios (MVRR) of POAG and 95% confidence intervals.


Among postmenopausal women overall, entering menopause before age 45 [MVRR=0.85 (0.63 to 1.14)] or at age > or =54 [MVRR=0.84 (0.60 to 1.18)] was not significantly associated with POAG compared with entering menopause at age 50 to 54. However, in secondary analysis, among postmenopausal women aged > or =65 years, entering menopause at age > or =54 years was associated with reduced risk of POAG compared with entering menopause at age 50 to 54 [MVRR=0.53 (0.32 to 0.89)]. Overall, compared with never use of PMH, past PMH use [MVRR=0.84 (0.61 to 1.18)], and current PMH use [MVRR=0.89 (0.70 to 1.13)] was not significantly associated with POAG. In secondary analysis, compared with never use of PMH, current use of estrogen with progestin [MVRR=0.58 (0.36 to 0.94)] was associated with a reduced risk of POAG characterized by intraocular pressure >21 mm Hg before visual field loss; current use estrogen alone [MVRR=0.93 (0.63 to 1.35)] was not significantly associated.


These data suggest a possible role for declining sex hormones in POAG pathogenesis.

[Indexed for MEDLINE]

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