Female Reproductive Factors in Relation to Risk of Exfoliation Glaucoma or Glaucoma Suspect

Area of Science:

• Ophthalmology
• Epidemiology
• Women's Health

Background:

• Exfoliation syndrome and glaucoma (XFG) incidence is higher in women.
• Female-specific factors are implicated in XFG development.
• Understanding reproductive influences on XFG risk is crucial.

Purpose of the Study:

• To evaluate the association between female reproductive factors and incident XFG.
• To investigate the role of estrogen exposure and menopause on XFG risk.
• To explore potential interactions between genetic susceptibility and reproductive factors in XFG.

Main Methods:

• Prospective cohort study of 121,098 women from the Nurses' Health Study (NHS) and NHSII.
• Analysis included postmenopausal women aged ≥40 without prior XFG or cataract surgery.
• Per-eye Cox proportional hazards models assessed associations, with FDR correction for multiple comparisons.

Main Results:

• Greater lifetime estrogen exposure was suggestively linked to higher XFG/XFGS risk.
• Each year increase in age at menarche was associated with a 9% lower XFG/XFGS risk.
• Surgical menopause was inversely associated with XFG/XFGS risk among women with high genetic susceptibility.

Conclusions:

• Later age at menarche is associated with reduced XFG/XFGS risk.
• Surgical menopause demonstrates an inverse association with XFG/XFGS risk in genetically susceptible individuals.
• These findings require further validation in independent cohorts.