Glaucoma affects a wide swathe of the elderly population, but its prevalence is greater in some non-Caucasian cohorts. It’s known to be approximately three to four times more common in the African-American population than in those of European ancestry.1 Some research speculates that these differences are connected to biological features, like thinner corneas or larger optic nerves.

The distinction holds for response to therapy as well. A study published in the American Journal of Ophthalmology finds a new hormone therapy can reduce the risk of incident open-angle glaucoma among black women.2 The hormone therapies under examination included estrogen monotherapy and a combination of estrogen and progesterone. The study linked Medicare claims data to 25,535 women in the Women’s Health Initiative and divided them into four groups:

  1. Women post-hysterectomy who would receive an oral conjugated equine estrogens (CEE).
  2. Women post-hysterectomy who would receive a placebo.
  3. Women without a hysterectomy who would receive oral CEE and medroxyprogesterone acetate.
  4. Women without a hysterectomy who would receive placebo.

Overall, the hormone therapies did not reduce the risk of open-angle glaucoma in all patients. When the data were modified to include only black women in the hysterectomized group who received the estrogen (but not a combination of estrogen and progesterone) therapy, the benefits were significant.

This therapy may be in the early stages of development and may only impact a single cohort of patients, but any risk factor reduction must be seen as a victory for eye care.

1. Ou Y. How glaucoma affects different ethnic groups. Bright Focus Foundation. July 11, 2018. Accessed August 24, 2018.

2. Vajarant T, Ray R, Pasquale L, et al. Racial differences in the effects [Epub ahead of print].