Estrogen’s Impact on Glaucoma

A study published in Investigative Ophthalmology & Visual Science has sought to explore the relationship between postmenopausal hormone therapy (HT) and the onset of glaucoma in women. The US-based researchers conducted a retrospective analysis of female veterans diagnosed with open-angle glaucoma, focusing on how HT use impacts the age at which glaucoma is diagnosed.

The study analyzed Veterans Affairs (VA) medical records from 2000 to 2019, including 1,926 women who used HT and 1,026 who did not. The researchers employed propensity score matching to control for various factors, such as age at menopause, BMI, blood pressure, and any comorbidities. They discovered that women using HT experienced a delayed onset of glaucoma, with longer HT durations correlating with later diagnoses.

Specifically, the study found that women who used estrogen-containing HT for 0–2 years, 2–5 years, and more than 5 years, experienced respective delays in glaucoma diagnosis by 2.20, 3.74, and 4.51 years. The study also highlighted that the effect of HT diminishes with later menopause ages, indicating that these effects may be modulated by age. The findings suggest a protective role of estrogen in glaucoma pathogenesis (a concept supported by several previous clinical studies), which supports the authors’ hypothesis that HT can delay the onset of glaucoma in postmenopausal women.

The researchers do caution that further studies are needed to fully understand the mechanisms at play and to evaluate the potential risks and benefits of HT in different populations. And given the potential risks associated with systemic use of HT, the authors say, continued research is needed to accurately identify potential targets based on these hormonal pathways and effectively minimize those risks.