Postmenopausal hormone therapy and age-related maculopathy in older women

Purpose: To examine the association between postmenopausal hormone therapy and Age-Related Maculopathy (ARM) in older women and to determine if these associations vary by smoking status. Methods: A cross-sectional analysis of 1065 women of European origin aged ≥ 74 years attending the year-10 examination of the Study of Osteoporotic Fractures was performed. Fundus photographs were graded for ARM using a modification of the Wisconsin Age-Related Maculopathy Grading System used in NHANES III. Multiple imputation methods were used to examine the associations of type and duration of postmenopausal hormone therapy use with early and late ARM as well as interactions with smoking history. Results: Compared to never users, Neither estrogen alone (E), Estrogen plus progestin (E+P), nor duration of use was significantly associated with early ARM [odds ratio (OR) E = 1.01, 95% confidence interval (CI) 0.77-1.34; OR E+P = 0.85, 95% CI 0.55-1.35; OR ≤ 3 years use = 1.04, 95% CI 0.74-1.47; OR > 3-12 years use = 0.93, 95% CI 0.64-1.35; OR > 12 years use = 0.95, 95% CI 0.65-1.37] or late ARM (OR any E/E+P = 0.59, 95% CI 0.29-1.19; OR ≤ 3 years use = 0.73, 95% CI 0.30-1.77; OR > 3 years of use = 0.51, 95% CI 0.22-1.17), though power for late ARM was limited. Tests for smoking interactions were not significant. Conclusions: This study found no evidence to support an association between use of E, E+P, or duration of use and ARM risk.