Diabetes Care, Vol 22, Issue 12 1984-1987, Copyright © 1999 by American Diabetes Association
Exogenous estrogen exposures and changes in diabetic retinopathy. The Wisconsin Epidemiologic Study of Diabetic Retinopathy
BE Klein, R Klein and SE Moss
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison 53705-2397, USA. kleinb@epi.ophth.wisc.edu
OBJECTIVE: To investigate whether the use of exogenous estrogen is
associated with changes in the severity of diabetic retinopathy and the
incidence of macular edema. RESEARCH DESIGN AND METHODS: The study design
involved observation of two well-defined cohorts of women with diabetes.
One group was diagnosed with diabetes at < 30 years of age and used
insulin (younger-onset group), and the other group was diagnosed at > or
= 30 years of age with no criteria regarding therapy (older-onset group).
Subjects received standard examinations, medical interviews, and retinal
photography in 1980-1982. Specific questions about exogenous hormone
exposure were added to the study questionnaire at the first follow-up
examination 4 years after the baseline examination. Change in the severity
of retinopathy 6 and 10 years after the 4-year follow-up examination were
examined regarding the use of oral contraceptives at the first follow-up
examination in the younger-onset group and at 6 years after the first
follow-up examination regarding hormone replacement therapy in the
older-onset group. RESULTS: Changes in the severity of retinopathy and
incidence of macular edema were unrelated to either type of estrogen
exposure in univariable and multivariable analyses. CONCLUSIONS: These data
are compatible with the hypothesis that the medications used by our
population do not affect the severity of diabetic retinopathy or macular
edema.