Does Postmenopausal Hormone Replacement Therapy Affect Intraocular Pressure?

Abstract

Hormone replacement therapy and lifetime estrogen and progesterone exposure do not seem to affect IOP or the risk for increased IOP. A personal history of ischemic heart disease may be associated with a higher risk for this disorder.

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

“…Consistent with this hypothesis, a study of 263 women with an average age of 53 years showed a significant effect of hormone therapy on IOP, whereas a study of 214 women with an average age of 66 years showed no effect. 16,18 Similarly, in our study, even with a very large sample (n = 4347), there was only a 0.5–0.6-mmHg reduction in IOP among older women (average age, 72 years). The magnitude of the IOP reduction in our study may reflect the declining number of estrogen receptors in ocular tissues with aging, 13 potentially less compliant aged tissue (trabecular meshwork and vessels), or a decreased responsiveness to hormone therapy.…”

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

“…Consistent with this hypothesis, a study of 263 women with an average age of 53 years showed a significant effect of hormone therapy on IOP, whereas a study of 214 women with an average age of 66 years showed no effect. 16,18 Similarly, in our study, even with a very large sample (n = 4347), there was only a 0.5–0.6-mmHg reduction in IOP among older women (average age, 72 years). The magnitude of the IOP reduction in our study may reflect the declining number of estrogen receptors in ocular tissues with aging, 13 potentially less compliant aged tissue (trabecular meshwork and vessels), or a decreased responsiveness to hormone therapy.…”

The Association of Female Reproductive Factors with Glaucoma and Related Traits

“…Fifteen studies assessing the associations between PMH use and IOP were identified ( Tables 11 – 13 ). 4 , 6 , 8 , 25 – 30 , 36 – 41 Five studies were controlled studies 8 , 25 , 27 , 36 , 37 ( Table 11 ), 6 studies were uncontrolled cross-sectional studies 6 , 30 , 38 – 41 ( Table 12 ), and 4 were uncontrolled before-and-after studies measuring IOP values within participants at baseline and then following a period of PMH use. 4 , 26 , 28 , 42 …”

“…Four studies evaluated a combined estrogen-plus-progesterone PMH user group against a control group. 8 , 27 , 36 , 37 A total of 1584 eyes of individuals receiving a combined estrogen-plus-progesterone PMH were compared against a total 1469 control eyes. Two studies identified lower IOP values in the combined PMH group than in the control group 25 , 27 (14.1 ± 2.0 vs. 16.6 ± 2.4, respectively; −1.8 mmHg; 95% CI, −2.2 and −1.4 mmHg).…”

Is Estrogen a Therapeutic Target for Glaucoma?

“…42,43,44,45, 46,47,48 Interesting, there are a few studies that show PMH use has no effect on IOP. 49,50,51 …”

“…al. found topical administration of 17-β-estradiol lead to systemic side effects in the animal model studied, 49 further investigations may lead to the development of topical preparations with specific vehicles of delivery that may avoid systemic issues. Furthermore, such estrogen therapy may have protective effects on other ocular pathology such as age related cataract, 70 diabetic retinopathy 71 and age-related macular degeneration.…”

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

“…Consistent with this hypothesis, a study of 263 women with an average age of 53 years showed a significant effect of hormone therapy on IOP, whereas a study of 214 women with an average age of 66 years showed no effect. 16,18 Similarly, in our study, even with a very large sample (n = 4347), there was only a 0.5–0.6-mmHg reduction in IOP among older women (average age, 72 years). The magnitude of the IOP reduction in our study may reflect the declining number of estrogen receptors in ocular tissues with aging, 13 potentially less compliant aged tissue (trabecular meshwork and vessels), or a decreased responsiveness to hormone therapy.…”

The Association of Female Reproductive Factors with Glaucoma and Related Traits

“…Fifteen studies assessing the associations between PMH use and IOP were identified ( Tables 11 – 13 ). 4 , 6 , 8 , 25 – 30 , 36 – 41 Five studies were controlled studies 8 , 25 , 27 , 36 , 37 ( Table 11 ), 6 studies were uncontrolled cross-sectional studies 6 , 30 , 38 – 41 ( Table 12 ), and 4 were uncontrolled before-and-after studies measuring IOP values within participants at baseline and then following a period of PMH use. 4 , 26 , 28 , 42 …”

“…Four studies evaluated a combined estrogen-plus-progesterone PMH user group against a control group. 8 , 27 , 36 , 37 A total of 1584 eyes of individuals receiving a combined estrogen-plus-progesterone PMH were compared against a total 1469 control eyes. Two studies identified lower IOP values in the combined PMH group than in the control group 25 , 27 (14.1 ± 2.0 vs. 16.6 ± 2.4, respectively; −1.8 mmHg; 95% CI, −2.2 and −1.4 mmHg).…”

Is Estrogen a Therapeutic Target for Glaucoma?

“…42,43,44,45, 46,47,48 Interesting, there are a few studies that show PMH use has no effect on IOP. 49,50,51 …”

“…al. found topical administration of 17-β-estradiol lead to systemic side effects in the animal model studied, 49 further investigations may lead to the development of topical preparations with specific vehicles of delivery that may avoid systemic issues. Furthermore, such estrogen therapy may have protective effects on other ocular pathology such as age related cataract, 70 diabetic retinopathy 71 and age-related macular degeneration.…”

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

“…Consistent with this hypothesis, a study of 263 women with an average age of 53 years showed a significant effect of hormone therapy on IOP, whereas a study of 214 women with an average age of 66 years showed no effect. 16,18 Similarly, in our study, even with a very large sample (n = 4347), there was only a 0.5–0.6-mmHg reduction in IOP among older women (average age, 72 years). The magnitude of the IOP reduction in our study may reflect the declining number of estrogen receptors in ocular tissues with aging, 13 potentially less compliant aged tissue (trabecular meshwork and vessels), or a decreased responsiveness to hormone therapy.…”

The Association of Female Reproductive Factors with Glaucoma and Related Traits

“…Fifteen studies assessing the associations between PMH use and IOP were identified ( Tables 11 – 13 ). 4 , 6 , 8 , 25 – 30 , 36 – 41 Five studies were controlled studies 8 , 25 , 27 , 36 , 37 ( Table 11 ), 6 studies were uncontrolled cross-sectional studies 6 , 30 , 38 – 41 ( Table 12 ), and 4 were uncontrolled before-and-after studies measuring IOP values within participants at baseline and then following a period of PMH use. 4 , 26 , 28 , 42 …”

“…Four studies evaluated a combined estrogen-plus-progesterone PMH user group against a control group. 8 , 27 , 36 , 37 A total of 1584 eyes of individuals receiving a combined estrogen-plus-progesterone PMH were compared against a total 1469 control eyes. Two studies identified lower IOP values in the combined PMH group than in the control group 25 , 27 (14.1 ± 2.0 vs. 16.6 ± 2.4, respectively; −1.8 mmHg; 95% CI, −2.2 and −1.4 mmHg).…”

Is Estrogen a Therapeutic Target for Glaucoma?

“…42,43,44,45, 46,47,48 Interesting, there are a few studies that show PMH use has no effect on IOP. 49,50,51 …”

“…al. found topical administration of 17-β-estradiol lead to systemic side effects in the animal model studied, 49 further investigations may lead to the development of topical preparations with specific vehicles of delivery that may avoid systemic issues. Furthermore, such estrogen therapy may have protective effects on other ocular pathology such as age related cataract, 70 diabetic retinopathy 71 and age-related macular degeneration.…”