Lens retrodots and vacuoles and their associations with the prevalence and incidence of age-related cataract

Abstract

To assess the prevalence of retrodots and vacuoles and their associations with the prevalence and long-term incidence of age-related cataract in an older Australian cohort. Of 3654 baseline participants of the Blue Mountains Eye Study aged 49+ years (1992-1994), 2335 and 1952 were re-examined after 5 and 10 years, respectively. Lens photographs were graded for cataract, retrodots, and vacuoles. Eye-specific data were used to assess the associations between retrodots or vacuoles at baseline and the prevalence and 10-year incidence of nuclear, cortical, and posterior subcapsular (PSC) cataract and cataract surgery. At baseline, retrodots were present in 142 persons (4%) and vacuoles in 1333 persons (40%). Prevalence of both lens features increased with increasing age (P for trend <0.0001). After adjusting for age and gender, vacuoles were associated with prevalent PSC cataract at baseline (odds ratio (OR), 1.60, 95% confidence interval (CI), 1.25-2.05). After adjusting for age, gender, smoking, hypertension, diabetes, education, and use of inhaled/oral steroids, baseline retrodots were associated with an increased incidence of cataract surgery (OR 2.90, 95% CI 1.71-4.91), while 3+ vacuoles at baseline were associated with an increased risk of PSC cataract (OR 3.56, 95% CI 2.13-5.95) and cataract surgery (OR 1.84, 95% CI 1.22-2.77). Lens retrodots and vacuoles were found to be positively associated with 10-year incidence of cataract surgery, and vacuoles associated with PSC cataract, a finding suggestive of shared risk factors or pathogenesis between these two lens features and the development of PSC cataract.