Incidence and progression of lens opacities: Effect of hormone replacement therapy and reproductive factors

Background: Hormone replacement therapy (HRT) is associated in cross-sectional studies with a decreased prevalence of lens opacities. We explored the associations of HRT and reproductive factors with the incidence and progression of lens opacities over a 2-year period. Methods: Data were derived from 1458 women ages 65 years and older from the Salisbury Eye Evaluation population-based prospective cohort study in Salisbury, MD, 1993-1997. Results: HRT was not associated with incident nuclear, cortical, or posterior subcapsular opacities, or with progression of nuclear or cortical opacification. Women who had an early menopause had a higher risk of nuclear progression, whereas those who had a later menopause had a lower risk (linear trend P = 0.013). Other variables related to reproduction, such as oral contraceptive use, age at menarche, number of births, and history of hysterectomy, were not associated with any of the outcomes. Conclusions: These data suggest no evidence of protection against the incidence or progression of lens opacities with HRT.