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Exogenous estrogen exposures and changes in diabetic retinopathy. The Wisconsin Epidemiologic Study of Diabetic Retinopathy.

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.