Table 3.

Summary of previous studies investigating the effects of hormone therapy on intraocular pressure

Study	Average Age	Population Demographics and Sample Size	Hormone(s) Administered	Main Findings
Interventional studies
Treister, 1970	37–55 yrs (average age not available)	45 non-glaucomatous women	Mestranol 0.1 mg (n = 15) vs. mestranol and progestin ethynodiol diacetate 1 mg (n = 15) vs. placebo (n = 15)	Significantly lower IOP (2 mmHg) at 6 mos in mestranol group. Combining ethynodiol had no additional effect on IOP.
Sator, 1997	56 yrs	25 non-glaucomatous women	2 mg oral estradiol valerate + 10 mg medroxyprogesterone acetate	Significantly lower IOP (1.3–2.2 mmHg) after hormone therapy for 12 wks
Affinito, 2003	53 yrs	50 non-glaucomatous women; 25 women with hormone therapy vs. 25 without hormone therapy (randomized, non-placebo controlled)	Transdermal 17β estradiol (50 μg/day) + medroxyprogesterone acetate (10 mg/day)	Significantly lower IOP (2 mmHg) after hormone therapy at 12 wks and 24 wks No significant change in CCT
Altintas, 2004	47 yrs	15 non-glaucomatous women	0.625 mg of oral conjugated equine estrogens + 2.5 mg of medroxyprogesterone acetate (n = 17) or 2 mg of estradiol hemihydrate (n = 3); 5 women discontinued hormone therapy due to undesirable side effects	Significantly lower IOP (3–4 mmHg) after hormone therapy at 24 wks
Uncu, 2006	48 yrs (Group 1) 52 yrs (Group 2) 51 yrs (Group 3)	30 women Glaucoma status not specified	Group 1 (n = 19): 0.625 mg of oral conjugated equine estrogens + 2.5 mg medroxyprogesterone Group 2 (n = 6): oral tibolone Group 3 (n = 5): 3.9 mg/12 cm2 of transdermal estrogen	Groups 1 and 2: No significant difference in IOP pre- and post-hormone therapy at 6 and 12 mos Group 3: Significantly lower IOP (2 mmHg) after hormone therapy at 12 mos
The present study	72 yrs in estrogen-alone trial vs. 72 in estrogen-plus-progestin trial	Final analysis included 4,105 of 4,347 women in the Women's Health Initiative Sight Exam (7% self-reported glaucoma) (randomized, active-controlled)	Estrogen-alone trial: 0.625 mg conjugated equine estrogens Estrogen-plus-progestin trial: 0.625 mg of conjugated equine estrogens + 2.5 mg of medroxyprogesterone acetate	Significantly lower IOP (0.5–0.6 mmHg) in estrogen-alone group compared to placebo after 5 yrs of hormone therapy No difference in IOP in the estrogen-plus-progestin group compared to placebo after 5 yrs
Observational studies
Toker, 2003	53 yrs with hormone therapy vs. 52 yrs without hormone therapy	62 women; 30 with hormone therapy vs. 32 without hormone therapy Glaucoma status not specified	0.625 mg of oral conjugated equine estrogens + 2.5 mg of medroxyprogesterone acetate	No difference in IOP after mean of 4 yrs on hormone therapy Higher serum testosterone associated with higher IOP No significant association between IOP and serum estradiol (E2) and follicle-stimulating hormone (FSH)
Abramov, 2005	66 yrs with hormone therapy vs. 67 yrs without hormone therapy	214 non-glaucomatous women 107 with hormone therapy vs. 107 without hormone therapy 15% of women had IOP higher than 21 mmHg	Oral hormone therapy; 89% with combination of estrogen and progesterone and 11% with estrogen alone	No difference in IOP after mean duration of 7 yrs No associations between IOP and estrogen and progesterone exposure as measured by number of pregnancies, number of deliveries, duration of menstruation, or duration of hormone therapy and oral contraceptive use
Deschenes, 2010	57 yrs	64 women; 35 with hormone therapy vs. 29 without hormone therapy Glaucoma status not specified	Oral hormone therapy (mixed types, not specified)	No significant difference in IOP after mean duration of 8 yrs
Tint, 2010	53 yrs	263 non-glaucomatous women 96 with hormone therapy (33 estrogen alone and 58 a combination of estrogen and progesterone) vs.172 without hormone therapy	Oral hormone therapy (mixed types and duration, not specified)	Significantly lower IOP in hormone therapy group (1.4 mmHg) compared to non-hormone therapy group, adjusted for age, use of beta blockers, and time of IOP measurements No significant difference in IOP between estrogen-alone group vs. a combination of estrogen and progesterone group

CCT, central corneal thickness; IOP, intraocular pressure; mos, months; wks, weeks; Yrs, years.