Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea.
Retina. 2021 Oct 1;41(10):2088-2097. doi: 10.1097/IAE.0000000000003164.
To evaluate the association between female reproductive factors and the incidence of exudative age-related macular degeneration (AMD).
A total of 1,297,388 postmenopausal women over 50 years of age who participated in both national health screening and cancer screening in 2009 were identified using the Korea National Health Insurance System database. Data on female reproductive factors were collected using a self-administered questionnaire. Patients were followed up until 2018, and the incident cases of exudative AMD were identified. The hazard ratios and 95% confidence intervals for exudative AMD were estimated using the multivariable-adjusted Cox proportional hazard model.
During a mean follow-up of 7.27 years, 4,086 patients were newly diagnosed with exudative AMD. The hazard ratio (95% confidence intervals) for exudative AMD was 1.14 (1.01-1.31) for a reproductive period ≥40 years compared with a reproductive period <30 years, 1.72 (1.48-2.00) for patients with ≥5 years of hormone replacement therapy, and 1.29 (1.09-1.52) for those with 2 to 5 years of hormone replacement therapy compared with those who never underwent hormone replacement therapy.
Female reproductive factors were associated with the risk of exudative AMD. Greater lifetime exposure to endogenous and exogenous estrogen was associated with a higher incidence of exudative AMD.
评估女性生殖因素与渗出性年龄相关性黄斑变性（AMD）发病的相关性。
利用韩国国家健康保险系统数据库，共纳入了 2009 年参加全国健康筛查和癌症筛查的 1297388 名 50 岁以上的绝经后女性。使用自我报告问卷收集女性生殖因素数据。对患者进行随访至 2018 年，以确定渗出性 AMD 的发病病例。使用多变量调整的 Cox 比例风险模型估计渗出性 AMD 的风险比（95%置信区间）。
在平均 7.27 年的随访期间，有 4086 名患者新诊断为渗出性 AMD。与生殖期<30 年相比，生殖期≥40 年的患者渗出性 AMD 的风险比（95%置信区间）为 1.14（1.01-1.31），激素替代治疗≥5 年的患者为 1.72（1.48-2.00），激素替代治疗 2-5 年的患者为 1.29（1.09-1.52），而从未接受过激素替代治疗的患者为 1.00。
女性生殖因素与渗出性 AMD 的发病风险相关。内源性和外源性雌激素的终生暴露量越大，发生渗出性 AMD 的风险越高。
