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
"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.