Haan Mary N, Klein Ronald, Klein Barbara E, Deng Yingzi, Blythe Lynn K, Seddon Johanna M, Musch David C, Kuller Lewis H, Hyman Leslie G, Wallace Robert B
Department of Epidemiology, University of Michigan, 611 Church Street, Ann Arbor, MI 48104, USA.
Arch Ophthalmol. 2006 Jul;124(7):988-92. doi: 10.1001/archopht.124.7.988.
To determine the effectiveness of treatment with conjugated equine estrogens (CEE) or with CEE combined with progestin (CEE + P) on age-related macular degeneration (AMD).
In an ancillary study to the Women's Health Initiative clinical trial of hormone therapy, 4262 women 65 years and older underwent fundus photography for the determination of AMD. Participants were recruited from April 2000 to June 2002 at 21 clinical sites an average of 5 years after randomization. Participants were randomized to treatment with CEE, CEE + P, or placebo. Participants had been treated for an average of 5 years at the ophthalmic evaluation for AMD.
The overall prevalence of any AMD was 21.0%. No association was found between CEE + P (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.75-1.11) or CEE alone (OR, 0.98; 95% CI, 0.78-1.25) and early-stage AMD. The CEE + P was associated with a reduced risk of soft drusen (OR, 0.83; 95% CI, 0.68-1.00) after adjustment for covariates and with a reduced risk of neovascular AMD (OR, 0.29; 95% CI, 0.09-0.92).
Treatment with CEE alone or CEE + P does not affect early- or late-stage AMD. Treatment with CEE + P may reduce the risk of soft drusen or neovascular AMD.
确定结合马雌激素（CEE）或CEE联合孕激素（CEE + P）治疗对年龄相关性黄斑变性（AMD）的有效性。
在一项激素治疗的女性健康倡议临床试验的辅助研究中，4262名65岁及以上的女性接受了眼底照相以确定是否患有AMD。参与者于2000年4月至2002年6月在21个临床地点招募，平均在随机分组后5年。参与者被随机分配接受CEE、CEE + P或安慰剂治疗。在进行AMD眼科评估时，参与者平均已接受治疗5年。
任何类型AMD的总体患病率为21.0%。未发现CEE + P（优势比[OR]，0.91；95%置信区间[CI]，0.75 - 1.11）或单独使用CEE（OR，0.98；95% CI，0.78 - 1.25）与早期AMD之间存在关联。在调整协变量后，CEE + P与软性玻璃膜疣风险降低相关（OR，0.83；95% CI，0.68 - 1.00），与新生血管性AMD风险降低相关（OR，0.29；95% CI，0.09 - 0.92）。
单独使用CEE或CEE + P治疗不影响早期或晚期AMD。CEE + P治疗可能会降低软性玻璃膜疣或新生血管性AMD的风险。
