NEW YORK - Use of conjugated equine estrogens (CEE), either alone or combined with progestin, seems to have no effect on the overall risk of age-related macular degeneration (AMD), according to an analysis of data from the Women's Health Initiative (WHI) Sight Exam Study.
However, in subgroup analysis, there was evidence that use of CEE plus progestin may cut the risk of soft drusen or neovascular AMD, the authors note in the Archives of Ophthalmology for July. Recent evidence has tied cardiovascular disease to AMD. Thus, by affecting the risk of cardiovascular disease, hormone therapy could have an impact on the occurrence of AMD.
Dr. Mary N. Haan, from the University of Michigan at Ann Arbor, and colleagues used fundus photography to assess the occurrence of AMD in 4262 women who had been treated with CEE, CEE+P, or placebo for 5 years as part of the WHI study. All of the subjects were at least 65 years of age. Roughly, one fifth of subjects had AMD, the report indicates. As noted, CEE alone or with progestin did not seem to affect the overall risk of AMD.
Treatment with CEE plus progestin was associated with a 17% reduced risk of soft drusen, often considered a precursor to AMD, and with a 71% reduced risk of neovascular AMD.
"Our finding of a protective effect for neovascular AMD is consistent with a case-control study that found a protective effect for CEE use but did not evaluate unopposed vs. combination therapy," the authors point out.