Racial Differences in the Effects of Hormone Therapy on Incident Open-Angle Glaucoma in a Randomized Trial

Vajaranant, Thasarat S.; Ray, Roberta M.; Pasquale, Louis R.; Mares, Julie A.; Ritch, Robert; Gower, Emily W.; Haan, Mary N.; Jackson, Rebecca D.; Maki, Pauline M.

doi:10.1016/j.ajo.2018.07.035

Cited by 16 publications

(18 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the WHI, ET reduced intraocular pressure in postmenopausal women and mitigated the risk for open-angle glaucoma in Black women 146,147 . Similar effects were not seen for EPT 148 .…”

Section: Skin Hair and Special Sensesmentioning

confidence: 78%

The 2022 hormone therapy position statement of The North American Menopause Society

2022

Menopause

283

219

View full text Add to dashboard Cite

and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2017 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence. The Advisory Panel's recommendations were reviewed and approved by the NAMS Board of Trustees.Hormone therapy remains the most effective treatment for vasomotor symptoms (VMS) and the genitourinary syndrome of menopause and has been shown to prevent bone loss and fracture. The risks of hormone therapy differ depending on type, dose, duration of use, route of administration, timing of initiation, and whether a progestogen is used. Treatment should be individualized using the best available evidence to maximize benefits and minimize risks, with periodic reevaluation of the benefits and risks of continuing therapy.For women aged younger than 60 years or who are within 10 years of menopause onset and have no contraindications, the benefit-risk ratio is favorable for treatment of bothersome VMS and prevention of bone loss. For women who initiate hormone therapy more than 10 years from menopause onset or who are aged older than 60 years, the benefit-risk ratio appears less favorable because of the greater absolute risks of coronary heart disease, stroke, venous thromboembolism, and dementia. Longer durations of therapy should be for documented indications such as persistent VMS, with shared decision-making and periodic reevaluation. For bothersome genitourinary syndrome of menopause symptoms not relieved with over-the-counter therapies in women without indications for use of systemic hormone therapy, low-dose vaginal estrogen therapy or other therapies (eg, vaginal dehydroepiandrosterone or oral ospemifene) are recommended.

show abstract

“…In the WHI, ET reduced intraocular pressure in postmenopausal women and mitigated the risk for open-angle glaucoma in Black women 146,147 . Similar effects were not seen for EPT 148 .…”

Section: Skin Hair and Special Sensesmentioning

confidence: 78%

The 2022 hormone therapy position statement of The North American Menopause Society

2022

Menopause

283

219

View full text Add to dashboard Cite

show abstract

“…Recently, several lines of evidence have indicated that E2 influences the onset of POAG in women (Hulsman et al, 2001;Vajaranant et al, 2018). In the population-based Rotterdam Study, it was found that women who experienced menopause at <45 years of age had a significantly higher risk of POAG than women who experienced menopause at >50 years of age (Hulsman et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

“…In the population-based Rotterdam Study, it was found that women who experienced menopause at <45 years of age had a significantly higher risk of POAG than women who experienced menopause at >50 years of age (Hulsman et al, 2001). In addition, a randomized trial of hormone therapy with 25,535 women and a retrospective longitudinal cohort study that enrolled 152,163 postmenopausal women suggested that hormone therapy consisting of E2 only reduced the incidence of open-angle glaucoma (Newman-Casey et al, 2014;Vajaranant et al, 2018). Other studies have suggested that decreased E2 might be associated with POAG pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

Association Between Sex Hormones and Visual Field Progression in Women With Primary Open Angle Glaucoma: A Cross-Sectional and Prospective Cohort Study

Qiu

Tang

et al. 2021

Front. Aging Neurosci.

View full text Add to dashboard Cite

Purpose: We evaluated the level of sex hormones in female patients with primary open angle glaucoma (POAG) to determine whether they are associated with the onset and/or progression of POAG.Methods: The cross-sectional study enrolled 63 women with POAG and 56 healthy women as normal control subjects. Furthermore, 57 women with POAG were included and followed-up for at least 2 years in the cohort study. All subjects were evaluated for serum concentration of sex hormones [prolactin (PRL), luteinizing hormone (LH), testosterone (TESTO), follicle-stimulating hormone (FSH), progesterone (PROG), and estrogen (E2)] and underwent visual field (VF) examination. In the cross-sectional study, Spearman analysis, linear regression analysis, and logistic regression analysis were performed to assess risk factors for POAG in women. In the cohort study, Cox regression analyses and Kaplan–Meier survival analysis were performed to identify factors associated with VF progression in women with POAG.Results: In the cross-sectional study, the level of E2 was significantly lower in the POAG group than in the normal group (p < 0.05). Multiple logistic regression showed that the decreased level of E2 was a risk factor of POAG (OR = 0.27, 95% CI = 0.09–0.78, p < 0.05), especially in premenopausal subjects. In the cohort study, there were 29 non-progression subjects and 28 progression subjects. Patients in the progression group had significantly lower levels of E2 than those in the no progression group (p < 0.01). The decreased level of E2 at baseline was associated with POAG progression (HR = 0.08, 95% CI = 0.02–0.46, p < 0.05), especially in premenopausal subjects. Patients with POAG and with lower baseline E2 levels had significantly lower VF non-progression rates than patients with higher E2 levels (log-rank test p < 0.001), especially premenopausal subjects (log-rank test p < 0.05). Additionally, logistic regression analyses, Cox regression analyses, and Kaplan–Meier survival analysis showed that PROG, LH, FSH, and TESTO were risk factors of POAG and/or significantly associated with POAG progression.Conclusion: A decreased E2 level is a POAG risk factor and is associated with VF progression in women with POAG, especially in premenopausal subjects. Additionally, other sex hormones (PROG, LH, FSH, and TESTO) might also play a role in POAG pathogenesis.

show abstract

“…We identified 7 studies examining PMH use and risks of OAG. One study was an ancillary study within a placebo-controlled RCT, 17 2 studies 14 , 18 were cohort studies ( Table 9 ), and 4 studies 19 , 22 , 24 , 34 were cross-sectional population studies involving a total of 18 152 participants with 853 cases of OAG ( Table 10 ).…”

Section: Resultsmentioning

confidence: 99%

The Association of Female Reproductive Factors with Glaucoma and Related Traits

Madjedi

Stuart

Chua

et al. 2022

Ophthalmology Glaucoma

Self Cite

View full text Add to dashboard Cite

Racial Differences in the Effects of Hormone Therapy on Incident Open-Angle Glaucoma in a Randomized Trial

Abstract: Analysis suggests that HT containing estrogen, but not a combination of estrogen and progesterone, reduces the risk of incident OAG among African-American women. Further investigation is needed.

Cited by 16 publications

References 44 publications

The 2022 hormone therapy position statement of The North American Menopause Society

The 2022 hormone therapy position statement of The North American Menopause Society

Association Between Sex Hormones and Visual Field Progression in Women With Primary Open Angle Glaucoma: A Cross-Sectional and Prospective Cohort Study

The Association of Female Reproductive Factors with Glaucoma and Related Traits

Contact Info

Product

Resources

About