Is open-angle glaucoma associated with early menopause? The Rotterdam Study

The authors examined the association between age at menopause and open-angle glaucoma among women aged greater than or equal to 55 years in the population-based Rotterdam Study (1990-1993). Information on age and type of menopause was obtained by interview. Subjects (n = 3,078) were stratified into three categories according to age at menopause: < 45 years, 45-49 years, and greater than or equal to 50 years, with the last group serving as the reference group. Diagnosis of open-angle glaucoma was based on the presence of a glaucomatous visual field defect and glaucomatous optic neuropathy. Open-angle glaucoma was diagnosed in 78 women with a natural menopause and 15 women with an artificial menopause. In the category of natural menopause, women who went through menopause before reaching the age of 45 years had a higher risk of open-angle glaucoma than the reference group (odds ratio = 2.6; 95% confidence interval. 1.5, 4.8), after adjustment for age and use of hormone replacement therapy. Among women who went through menopause between the ages of 45 and 49 years, the odds ratio was 1.1 (95% confidence interval: 0.7, 2.0). These findings suggest that early menopause is associated with a higher risk of open-angle glaucoma.