Hormonal replacement therapy in postmenopausal women ≥50 years is associated with the incidence of glaucoma: Evidence from 6576 females in Finland

IF 3 3区医学 Q1 OPHTHALMOLOGY

Acta Ophthalmologica Pub Date : 2026-10-09 Epub Date: 2026-04-12 DOI:10.1111/aos.70138

Sirpa Loukovaara, Jari Haukka

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Abstract

Purpose

Hormonal replacement therapy (HRT) in postmenopausal women appears to affect glaucoma risk, but findings are inconsistent. We aimed to explore whether the use of postmenopausal HRT plays a role in glaucoma development in Finland.

Methods

The main outcome variable was glaucoma incidence measured by initiation of special reimbursement due to glaucoma. The population-based historic cohort consisted of female participants aged ≥50 years whose incident glaucoma was recorded between January 1st, 2015, and December 31st, 2017. The main exposure of interest was postmenopausal HRT with Anatomic Therapeutic Chemical codes G03C (oestrogens), G03D (progestogens), G03F (progestogens and oestrogens in combination). The HRT treatment was initiated during 2001–2010.

Frequencies and odds ratios (ORs) with 95% confidence intervals (CIs) were analyzed with logistic regression models, unadjusted and adjusted for diabetes mellitus, hospital district, socioeconomic status and statin exposure.

Results

Our nested-case-control study involved 1096 cases and 5480 age-matched controls. After adjustment for confounding factors, use of any HRT was associated with an increased risk for the development of glaucoma. The risk was found in estrogen users (adjusted OR, 1.33 [95% CI, 1.17–1.52]), in progestogen users (adjusted OR, 1.25 [95% CI, 1.02–1.53]) and in combinatory estrogen–progesterone users (adjusted OR, 1.19 [95% CI, 1.01–1.39]). In the POAG subgroup, the risk remained in estrogens-only users (adjusted OR, 1.31 [95% CI, 1.10–1.56]).

Conclusions

Our data suggests that use of any postmenopausal HRT may increase the glaucoma risk, but in POAG subgroup estrogen-only therapy remained significant. Further research is needed to confirm the associations.

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≥50岁绝经后妇女激素替代治疗与青光眼发病率相关：来自芬兰6576名女性的证据

目的：绝经后妇女激素替代疗法（HRT）似乎影响青光眼的风险，但研究结果不一致。我们的目的是探讨芬兰绝经后HRT的使用是否在青光眼的发展中起作用。方法：主要结局变量为青光眼发生率，通过青光眼特殊报销的启动来测量。以人群为基础的历史队列包括年龄≥50岁的女性参与者，她们在2015年1月1日至2017年12月31日期间记录了青光眼事件。主要暴露于绝经后HRT，其解剖治疗化学代码为G03C（雌激素），G03D（孕激素），G03F（孕激素和雌激素联合使用）。激素替代疗法于2001-2010年开始。使用logistic回归模型分析频率和优势比（ORs）， 95%置信区间（ci），未调整和调整糖尿病、医院区、社会经济状况和他汀类药物暴露。结果：我们的巢式病例对照研究包括1096例病例和5480例年龄匹配的对照。在调整混杂因素后，使用任何激素替代疗法都与青光眼发生风险增加相关。雌激素使用者（校正OR， 1.33 [95% CI, 1.17-1.52]）、孕激素使用者（校正OR， 1.25 [95% CI, 1.02-1.53]）和雌激素-孕激素联合使用者（校正OR， 1.19 [95% CI, 1.01-1.39]）均存在风险。在POAG亚组中，仅使用雌激素的患者的风险仍然存在（校正OR为1.31 [95% CI, 1.10-1.56]）。结论：我们的数据表明，绝经后使用任何激素替代疗法都可能增加青光眼的风险，但在POAG亚组中，仅雌激素治疗仍然显著。需要进一步的研究来证实这些关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Ophthalmologica 医学-眼科学

CiteScore

7.60

自引率

5.90%

发文量

433

审稿时长

6 months

期刊介绍： Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.