Dec. 13, 2002 — Women who take hormone replacement therapy (HRT) may be more than 50% less likely to develop the common, sight-robbing condition known as macular degeneration as they grow older then women who have never used HRT. A new study shows hormone therapy may significantly reduce the risk of developing advanced macular degeneration even among postmenopausal women with early signs of the disease.

The findings appear in the December issue of the American Journal of Opthalmology.

Age-related macular degeneration is the leading cause of blindness and vision loss among people over 65 in the U.S.The progressive condition affects the macula, which is the central part of the thin layer of cells known as the retina that line the inside of the eye, and allows you to focus on and clearly see what’s in front of you. The rest of the retina is responsible for peripheral vision.

Studies have shown that women have a greater risk of developing this problem than men. Several factors reduce the risk, including increasing numbers of pregnancies and medications containing hormones. There is no cure for the condition, but currently available treatments can help slow down or delay damage and vision loss.

In the study, Johanna M. Seddon, MD, ScM, of the Massachusetts Eye and Ear Infirmary, and colleagues analyzed the progression of the disease in 394 women between the ages of 50 and 70 who were in early to late stages of the disease.

They found that women who had used HRT in the past were much less likely to develop advanced macular degeneration than nonusers. Overall, women who had used postmenopausal estrogen therapy had 54% lower odds of advanced disease then women who had never used HRT.

Women who started menstruating at a later age were also somewhat more likely to develop advanced disease, which researchers say may indicate that reduced exposure to estrogen during a woman’s lifetime could play a role in the disease’s progression.

Although this study suggests HRT may offset the risk of developing advanced age-related macular degeneration in women with the disease, researchers say many factors must be considered when decided whether or not to use hormone replacement therapy after menopause.

Recent reports from the Women’s Health Initiative and others have suggested that HRT may have limited benefits in reducing the risk of heart disease, while slightly increasing the risk of breast cancer in some women.

“The decisions regarding the use of postmenopausal hormones are becoming increasingly complex, but it is important to continue to evaluate their effects, including testing their relation to the important eye diseases of aging,” write the authors.