Abstract
BackgroundCataract is the leading cause of blindness worldwide. Many observational studies assessed the relationship between postmenopausal hormone replacement therapy (HRT) and risk of cataract development, but the reported results were controversial. The aim of present meta-analysis was to evaluate the association of postmenopausal hormone replacement therapy with risk of cataract development.MethodsThe eligible observational studies, including cross-sectional, case–control and cohort studies, were identified by searching PubMed and Embase during March of 2013. Either a fixed- or a random-effects model was used to calculate the pooled odds ratio (OR) with its 95% confidence interval (95%CI). Subgroup analysis on cataract types was performed.ResultsA total of four cohort and five case-control or cross-sectional studies were finally included into this meta-analysis. Overall, a significant decreased risk of developing any type of cataract was found in ever HRT group as compared with non-HRT group among cohort studies (OR 0.83; 95%CI: 0.71,0.97) and case-control or cross-sectional studies (OR 0.74; 95%CI: 0.59,0.93). Subgroup analysis on cataract types determined that the significantly decreased risk of nuclear cataract in current HRT group (OR 0.72; 95%CI: 0.61,0.85) and also a critically reduced risk of nuclear cataract in ever HRT group (OR 0.80; 95% CI: 0.64,1.01) were found among case-control or cross-sectional studies, as compared with non-HRT group. No association of HRT with risk of cortical and posterior subcapsular cataract was observed.ConclusionsThe results of present meta-analysis indicate that postmenopausal hormone use may play a protective role in cataract development.
Highlights
Cataract is the major cause of visual impairment and blindness in older adults in the world [1]
Cross-sectional, case–control or cohort studies incorporated in the present meta-analysis should meet the following inclusion criteria: (1) original papers which reported independent data; (2) the studies which considered the postmenopausal females as an independent study population for analysis; (3) the studies which estimated the effects of hormone replacement therapy (HRT) on the risk of cataract with odds ratio (OR) or relative ratio (RR) and its 95% confidence interval (CI)
Past HRT had a history of HRT with no current HRT prescription
Summary
Cataract is the major cause of visual impairment and blindness in older adults in the world [1]. Data from Australia and the Barbados eye studies indicated that female gender is one of the risk factors for cortical and nuclear cataract [2,3]. A number of previous epidemiologic studies have shown an increased prevalence of cataract in women compared with men [4,5,6,7]. Evidence from laboratory studies has suggested that estrogen may protect against the development of cataract [12,13]. The results from epidemiological studies indicated that the association of HRT with risk of cataract was inconclusive. Several studies reported no protective effect of HRT on cataract development [19–21]. In present investigation the methods of metaanalysis of the published observational studies were utilized to analyze the relationship between HRT and the prevalence of cataract, in order to provide high-quality evidence for potential therapeutic options
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