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. 2024 Aug 1;65(10):32.
doi: 10.1167/iovs.65.10.32.

Association of Age of Menopause and Glaucoma Diagnosis in Female Veterans

Kelleigh Hogan  1   2   3 , Xiangqin Cui  1   4 , Annette Giangiacomo  5 , Andrew J Feola  1   2   3
Affiliations

Association of Age of Menopause and Glaucoma Diagnosis in Female Veterans

Kelleigh Hogan et al. Invest Ophthalmol Vis Sci. .

Abstract

Purpose: Age of menopause has been associated with the risk of developing glaucoma; however, it is unclear if the onset of menopause is directly associated with the development of glaucoma. Our objective was to determine if there is an association between the age at diagnosis of menopause and glaucoma.

Methods: This retrospective, case-only analysis was performed using the Veterans Affairs (VA) Corporate Data Warehouse of female veterans from 2000 to 2019. Women with both menopause and glaucoma diagnoses were matched based on covariates. The two matched cohorts were early menopause-early comparative (EM-EC; n = 1075) and late menopause-late comparative (LM-LC; n = 1050) women. We used a Pearson correlation to examine the linear relationship between age at diagnosis of menopause and glaucoma. Afterward, we used a multivariate linear regression model with age at diagnosis of glaucoma serving as the outcome variable to account for the covariates.

Results: We found that EM women developed glaucoma 6.0 years (interquartile range [IQR], 5.1-6.5) earlier than the EC group (P < 0.001), and LM women developed glaucoma an average of 5.2 years (IQR, 4.8-5.7) later than the LC group (P < 0.001). There was a modest linear relationship between the age of menopause and glaucoma diagnoses in the EM-EC (r = 0.40) and LM-LC (r = 0.46) cohorts. In our multivariate analysis, age at diagnosis of menopause was the largest factor related to age at diagnosis of glaucoma while accounting for our covariates. Our models predicted a 0.67-year delay in age at diagnosis of glaucoma with each additional premenopausal year.

Conclusions: This case-only analysis elucidates a temporal association between menopause and glaucoma, highlighting the need to characterize the role of menopause in the onset of glaucoma for women.

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Conflict of interest statement

Disclosure: K. Hogan, None; X. Cui, None; A. Giangiacomo, None; A.J. Feola, None

Figures

Figure 1.
Figure 1.
Inclusion and exclusion criteria for the overall study. From the 31,487 female patients in the VA Healthcare system with at least a single prescription or procedure record for glaucoma treatment, the final study population of 1825 women was selected. Gray boxes show patients who were excluded by criterion, and the black boxes show the number of patients that met each criterion. See Methods for detailed information about ICD, CPT, and VA drug classification codes.
Figure 2.
Figure 2.
Positive linear relationship between ages of menopause and glaucoma onset in the study population. Means and 95% CIs for the ages of glaucoma onset for each age of menopause integer are indicated by dotted lines and shading, respectively, between the EM-EC (green; r = 0.40, P < 0.001) and LM-LC (purple; r = 0.46; P < 0.001) cohorts with linear regression of age of glaucoma onset versus continuous age of menopause onset.
Figure 3.
Figure 3.
Age of menopause diagnosis was associated with a delay in glaucoma diagnosis. (A, B) Distribution of age of glaucoma diagnosis for women in the EM (green) and the EC (light blue) cohorts (A) and women in the LM (purple) and LC (dark blue) cohorts (B). (C) Distribution of percentile differences between the EC and EM groups (green), EC and LC groups (gray), and LC and LM groups (purple). All distributions were significantly non-zero, with the LC-EC (median of 1.8 years later; IQR, 1.5–1.9) and LM-LC (median of 5.2 years later; IQR, 4.8–5.7) distributions having a positive shift and the EM-EC distribution having a negative shift (median of 6.0 years earlier; IQR, 5.1–6.5). *P < 0.05, **P < 0.01, ***P < 0.001.
Figure 4.
Figure 4.
Relationship between age at diagnosis of menopause and glaucoma as modulated by race. (A, B) Distribution of age of glaucoma diagnosis by race, with the color signifying group and sample size: EC (light blue) and EM (green) (A) and LC (dark blue) and LM (purple) (B). (C, D) Univariate linear regression of age of glaucoma diagnosis versus age of menopause diagnosis for patients of black or African American descent (solid) or white descent (dashed) versus age of menopause diagnosis in early (C) and late (D) menopausal cohorts. Points and error bars represent mean and 95% CIs. *P < 0.05, **P < 0.01, ***P < 0.001.
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References

    1. Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY.. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014; 121(11): 2081–2090. - PubMed
    1. Higginbotham EJ. Does sex matter in glaucoma? Arch Ophthalmol. 2004; 122(3): 374–375. - PubMed
    1. Quigley HA, Broman AT.. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006; 90(3): 262–267. - PMC - PubMed
    1. Madjedi KM, Stuart KV, Chua SYL, et al. .. The association of female reproductive factors with glaucoma and related traits: a systematic review. Ophthalmol Glaucoma. 2022; 5(6): 628–647. - PMC - PubMed
    1. Panchami P, Pai SR, Shenoy JP, Shivakumar J, Kole SB. Postmenopausal intraocular pressure changes in South Indian females. J Clin Diagn Res. 2013; 7(7): 1322–1324. - PMC - PubMed