Clinical Study

Eye (2011) 25, 633–641; doi:10.1038/eye.2011.34; published online 18 February 2011

Female reproductive factors and primary open-angle glaucoma in the Nurses’ Health Study

L R Pasquale1,2 and J H Kang2

  1. 1Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
  2. 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA

Correspondence: LR Pasquale, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Brigham and Women's Hospital, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA. Tel: +1 617 573 3674; Fax: +1 617 573 4300. E-mail: Louis_Pasquale@meei.harvard.edu

Received 5 January 2011; Revised 31 January 2011; Accepted 31 January 2011; Published online 18 February 2011.

This work is scheduled for presentation at the annual American Glaucoma Society Meeting in Dana Point, CA, USA on 4 March 2011.

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Abstract

Purpose

  

The purpose of this study was to explore the relation between age at menarche, parity, and oral contraceptive (OC) use, and primary open-angle glaucoma (POAG).

Methods

  

We followed 79440 women in the Nurses’ Health Study prospectively from 1980 to 2006 and identified 813 cases of incident POAG. Eligible participants were ≥40 years old, free of POAG at baseline, had information on reproductive history, and reported receiving eye examinations during follow-up. Relevant exposure data and POAG risk factors were updated using biennial questionnaires. We used proportional hazards models to calculate multivariable rate ratios (MVRRs) of POAG and 95% confidence intervals (CI).

Results

  

In multivariable analysis, there were no significant linear trends between age at menarche (Pfor trend=0.65) or reproductive duration defined as time between age at menarche and menopause (Pfor trend=0.30) and POAG. Although ever using OCs was not associated with POAG risk (MVRR=1.14; 95% CI, 0.98, 1.34), ≥5 years of OC use was associated with a modest 25% increased risk of POAG (MVRR=1.25; 95% CI, 1.02, 1.53; Pfor linear trend=0.04). Furthermore, among past OC users, a shorter time since stopping OC use was also associated with an increased risk of POAG (Pfor linear trend=0.02). Parity was not associated with POAG risk.

Conclusion

  

The ≥5 years of OC use was associated with a modestly increased risk of POAG. These data add further support for a role of circulating estrogen in the pathogenesis of POAG.

Keywords:

female reproductive factors; age at menarche; parity; oral contraceptives; primary open angle glaucoma