Menopausal Hormone Therapy and Conversion from Intermediate to Advanced Age-Related Macular Degeneration

Area of Science:

• Ophthalmology
• Gerontology
• Endocrinology

Background:

• Age-related macular degeneration (AMD) is a leading cause of vision loss in older adults.
• Intermediate AMD (iAMD) is a stage characterized by drusen and/or pigmentary changes, with a risk of progression to advanced AMD.
• Menopausal hormone replacement therapy (HRT) is widely used by women, and its potential effects on ocular health are of interest.

Purpose of the Study:

• To investigate the association between self-reported menopausal hormone replacement therapy (HRT) use and the conversion to advanced forms of age-related macular degeneration (AMD).
• To analyze this relationship specifically in female patients diagnosed with intermediate AMD (iAMD).

Main Methods:

• A prospective cohort study was conducted using data from the University of Colorado AMD Registry.
• Female patients with iAMD were followed, and conversion to advanced AMD (non-neovascular or neovascular) was determined via multimodal imaging review.
• Kaplan-Meier curves and Cox proportional hazards models were employed to assess time-to-conversion, with hazard ratios (HRs) reported.

Main Results:

• The study included 285 female patients with iAMD, with a mean follow-up of 36.3 months.
• Conversion to advanced AMD occurred in 28.8% of patients during the follow-up period.
• Multivariable analysis revealed no significantly elevated risk of conversion to advanced non-neovascular AMD (HR, 1.03) or neovascular AMD (HR, 2.10) in patients who had ever used HRT compared to those who had not.

Conclusions:

• Self-reported hormone replacement therapy use in female patients with intermediate AMD is not associated with an increased risk of progression to advanced AMD.
• These findings suggest that HRT may not negatively impact AMD progression in this patient group.