Sex steroids and age-related macular degeneration in older French women: the POLA study

PURPOSE: Postmenopausal women are reported to be at higher risk of eye diseases than men. The purpose of our study is to determine the relationships between endocrine status, specially plasma sex hormones levels, and the severity of age-related macular degeneration (AMD) in a large community-based sample of older French women. METHODS: The POLA (Pathologies Oculaires Liées à l'Age) Study is a population-based study on age-related eye diseases and their risk factors. The study enrolled 2584 residents of Southern France, among whom 1451 women aged 60 years or older were recruited between June 1995 and July 1997. A standardized international classification and grading system for AMD was used. Circulating sex hormones levels were measured from fasting blood samples. RESULTS: No association of hormone replacement therapy (HRT), hysterectomy, or oophorectomy was found with soft drusen, pigmentary abnormalities, or late AMD. After multivariate adjustment, higher plasma levels of dehydroepiandrosterone sulfate (DHEAS) were associated with a higher prevalence of soft drusen (OR = 1.21; 95% CI = 1.01-1.44). CONCLUSION: These results may indicate no beneficial effect of HRT on AMD. The positive association of DHEAS with AMD requires further investigation.