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Exogenous estrogen exposures and changes in diabetic retinopathy. The Wisconsin Epidemiologic Study of Diabetic
1Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison 53705-2397, USA. kleinb@epi.ophth.wisc.edu
Objective:
To investigate whether the use of exogenous estrogen is associated with changes in the severity of diabetic retinopathy and the incidence of macular edema.
Research Design And Methods:
The study design involved observation of two well-defined cohorts of women with diabetes. One group was diagnosed with diabetes at < 30 years of age and used insulin (younger-onset group), and the other group was diagnosed at > or = 30 years of age with no criteria regarding therapy (older-onset group). Subjects received standard examinations, medical interviews, and retinal photography in 1980-1982. Specific questions about exogenous hormone exposure were added to the study questionnaire at the first follow-up examination 4 years after the baseline examination. Change in the severity of retinopathy 6 and 10 years after the 4-year follow-up examination were examined regarding the use of oral contraceptives at the first follow-up examination in the younger-onset group and at 6 years after the first follow-up examination regarding hormone replacement therapy in the older-onset group.
Results:
Changes in the severity of retinopathy and incidence of macular edema were unrelated to either type of estrogen exposure in univariable and multivariable analyses.
Conclusions:
These data are compatible with the hypothesis that the medications used by our population do not affect the severity of diabetic retinopathy or macular edema.