Gender, oestrogen, hormone replacement and age‐related macular degeneration: Results from the Blue Mountains Eye Study

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Abstract
Purpose: To determine whether females have a higher age‐specific age‐related maculopathy prevalence than males; whether there is an increased risk of age‐related macular degeneration (AMD) with early menopause; and whether there is a decreased risk of AMD with use of hormone replacement therapy (HRX). Methods: Pooled data from three study populations that have used similar AMD diagnostic criteria were used to answer the first hypothesis: the Beaver Dam Eye Study (BDES), the Rotterdam study of the elderly, and the Blue Mountains Eye Study (BMES). The BMES population was used to answer the second and third hypotheses. This population included residents aged 49 or older with 2072 women participating, of whom 1899 postmenopausal women answered questions about menopause, menarche and HRT AMD was diagnosed from graded retinal photographs using modified international criteria. Results: The overall pooled odds ratio (OR) for association between sex and AMD revealed a significant increase in AMD prevalence among females compared with males, adjusting for 10‐year age categories, OR = 1. 15 (1. 10‐1.21), with no significant heterogeneity between studies. A significant decrease in the odds of early AMD with increasing years from menarche to menopause was observed. Conclusions: The results suggest that females may have a higher risk of AMD. The significant decrease in early AMD with increasing years from menarche to menopause supports the concept that a shorter duration of oestrogen production may increase risk of AMD.