Authors: Christy Costanian,Marie-Josée Aubin, Ralf Buhrmann, Ellen Freeman
Author Disclosure Block:C. Costanian: None. M. Aubin: Any direct financial payments including receipt of honoraria; University of Ottawa Eye Institute, Gilead. Funded grants or clinical trials; PeriPharm. All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity; Gilead. R. Buhrmann: Any direct financial payments including receipt of honoraria; Allergan. E. Freeman: None.

Abstract Body:

Purpose: To determine the association of female reproductive factors, such as age, type of menopause, & hormone replacement therapy (HRT) use and duration, with visual impairment (VI) & eye diseases, including glaucoma, macular degeneration & cataract.
Study Design: This was a cross-sectional analysis of baseline data from the Canadian Longitudinal Study on Aging’s Comprehensive Cohort, a population-based study of 30,097 persons aged 45-85 years, 15,320 of whom were women. Participants were representatively sampled from within a 25-50 km radius of one of 11 data collection sites from 7 Canadian provinces between 2012 and 2015.
Methods: The relationship of sociodemographic, reproductive, health behavior, and clinical factors with VI & eye diseases was examined among 10,827 postmenopausal women who met the eligibility criteria. Presenting visual acuity was measured using the Early Treatment of Diabetic Retinopathy Study letter chart & its standard protocol. VI was defined as binocular acuity worse than 6/12. Participants were asked in a face-to-face interview if they had ever been told by a doctor that they had either glaucoma, cataract, or macular degeneration. Logistic regression analyses adjusting for socio-demographic, reproductive, health behavior, clinical factors & province were used. All analyses were adjusted for the complex survey design. Approval for this study was obtained from the Research Ethics Board of the Ottawa Hospital Research Institute.
Results: Later age (≥ 55 years) at natural menopause was associated with a decreased odds of VI (adjusted odds ratio (OR)=0.75, 95% confidence interval (CI)=0.56-0.99). Women who were either past (OR=1.22, 95% CI=1.08-1.39), or current HRT users (OR=1.28, 95% CI=1.04-1.58) were significantly more likely to report cataract. Moreover, women who used HRT for less than 10 years (OR=1.29, 95% CI=1.13-1.48) had significantly greater odds of having cataract. No statistically significant associations between reproductive variables & either glaucoma or macular degeneration were detected.
Conclusions: This is the first study to our knowledge to report a relationship between age at natural menopause & VI. Also, HRT use & duration were associated with higher odds of cataract. Given the inconclusive evidence on the relationship of menopause & HRT use with cataract & VI, prospective studies are warranted to confirm these findings.