Does postmenopausal hormone replacement therapy affect intraocular pressure?

Purpose: To assess the effects of postmenopausal hormone replacement therapy (HRT) on intraocular pressure (TOP). Patients and Methods: This was a cross-sectional controlled study, including 107 women aged 60 to 80 years receiving HRT and 107 controls who have never received HRT. All subjects underwent TOP assessment and funduscopic photography for cup-to-disc (C/D) ratios, and completed questionnaires regarding personal and family history of glaucoma, hormone replacement therapy, lifetime estrogen and progesterone exposure, and cardiovascular risk factors. Main Outcome Measures included TOP, prevalence of increased TOP, and C/D ratios. Results: The groups did not differ in mean TOP (15.3 versus 15.3 mm Hg), mean vertical (0.18 versus 0.21) and horizontal (0.17 versus 0.14) C/D ratios, and in prevalence of increased TOP (15% versus 14%), C/D ratio (7% versus 7%), or glaucoma (9% versus 11%). A personal history of ischemic heart disease was the only risk factor associated with increased TOP (O.R. 4.63, P = 0.003). Lifetime estrogen and progesterone exposure, including pregnancies, deliveries, menstruation years, and the use of oral contraceptives did not significantly affect the risk for increased TOP. Conclusion: Hormone replacement therapy and lifetime estrogen and progesterone exposure do not seem to affect TOP or the risk for increased TOP. A personal history of ischemic heart disease may be associated with a higher risk for this disorder.