Those experiencing early menopause developed glaucoma about 5.5 years earlier than average, and those with late menopause developed glaucoma about 5.3 years later than average. Photo: James Fanelli, OD. Click image to enlarge.

Editor’s Note: As part of our “Year in Review” retrospective, we’ve selected the top 30 news stories of the year and are re-sharing them as we close out 2023. Follow along as we count down to number 1!

This story was originally published May 2, 2023.

No. 22 biggest news story of 2023:

Females make up the majority of glaucoma patients; it’s been hypothesized that estrogen exposure may provide a protective effect to the optic nerve, while decreased estrogen levels increase the optic nerve’s vulnerability to glaucomatous damage. Researchers at a VA Center in Atlanta conducted a retrospective study of female US veterans to investigate previously suggested connections between menopause and glaucoma development. They presented their supportive findings last Tuesday at ARVO 2023 in New Orleans.

The study included female patients with negative ophthalmological and menopausal screenings prior to glaucoma and menopause diagnoses. The analyses considered the following covariates: race and ethnicity, BMI, blood pressure, systemic antihypertensive usage and comorbidity index.

To estimate the impact of age of menopause on glaucoma onset, the researchers created two separately matched populations. The first group consisted of those with early menopause (n=221, ages 35 to 45) matched against a control menopause group (n=663, 45 to 55). The second group was composed of those with late menopause (n=488, 55 to 65) matched against a control menopause group (n=488, 45 to 55).

The researchers reported that patients in the early menopause group developed glaucoma an average of 5.5 years earlier than their matched controls. Those in the late menopause group developed glaucoma an average 5.3 years later than their matched controls. “These models predicted that for each year later a women went into menopause, there was a 0.67-year and 0.68-year delay in developing glaucoma for the early-to-control and late-to-control populations, respectively,” they wrote in their abstract.

“Our study is the first to demonstrate a direct association between the age of menopause and the onset of glaucoma,” they wrote, adding that patients who reach menopause early are likely to develop glaucoma at an earlier age, impacting long-term vision outcomes. “Future work will look at the impact of menopause on glaucoma incidence and the role of hormone replacement therapy on the onset of glaucoma,” they concluded.

Original abstract content © Association for Research in Vision and Ophthalmology 2023.