Abstract
AbstractPurpose To assess the prevalence of pseudoexfoliation (PEX) and its associations in a population‐based setting.Methods The population‐based Central India Eye and Medical Study included 4711 individuals. All study participants underwent a detailed ophthalmological examination. After medical pupil dilation, PEX was assessed by an experienced ophthalmologist using slit‐lamp based biomicroscopy.Results PEX was detected in 87 eyes (prevalence: 0.950.10% (95%CI:0.75,1.15) of 69 subjects (prevalence: 1.490.18% (95%CI:1.14,1.83). In multivariate analysis, PEX prevalence was associated with higher age (P<0.001; OR:1.11), lower body mass index (P=0.001) and higher diastolic blood pressure (P=0.002). In the multivariate analysis, PEX was not associated with retinal nerve fiber layer cross section area (P=0.76) and presence of open‐angle glaucoma (P=0.15). Side differences in the presence of PEX were not significantly associated with side differences in intraocular pressure (P=0.40).Conclusion In a rural Central Indian population aged 30+ years, PEX prevalence (mean: 1.490.18%) was significantly associated with older age, lower body mass index and higher diastolic blood pressure. It was not significantly associated with optic nerve head measurements, refractive error, any ocular biometric parameter, nuclear cataract, early age‐related macular degeneration and retinal vein occlusion, diabetes mellitus, smoking, and dyslipidemia.
Highlights
Pseudoexfoliation (PEX) is a disorder which is characterized by the appearance of a fibrillary whitish material on the lens surface, the lens zonules, ciliary body and other parts of the anterior chamber [1,2]
PEX prevalence was associated with higher age (P,0.001; regression coefficient B:0.11; odds ratio (OR): 1.11 (95%confidence intervals (CI): 1.09, 1.13)), lower body mass index (P = 0.001; B: 20.12; Odds ratios (OR): 0.88 (95CI: 0.82, 0.95)) and higher diastolic blood pressure (P = 0.002; B: 0.02; OR: 1.03 (95%CI: 1.01, 1.04))
Since the South Indian population with a mostly Dravidian background is ethnically different from the Central Indian population with a mostly Indo-Aryan background and since most previous studies were performed in urban regions or in rural regions with a relatively developed infrastructure, we conducted this study to assess the prevalence of PEX and to search for associations between PEX and other ocular and systemic parameters in the rural Central Indian population
Summary
Pseudoexfoliation (PEX) is a disorder which is characterized by the appearance of a fibrillary whitish material on the lens surface, the lens zonules, ciliary body and other parts of the anterior chamber [1,2]. Linked to the lysyl oxidase-like-one (LOXL1) gene, PEX has been shown to be associated with changes in the extracellular matrix, involving the skin, extraocular muscles, heart, lung, liver, kidney, and meninges in addition to the eye [1,2,3,4,5]. It is clinically important since it is associated with an instability of the lens zonules during cataract surgery and late postoperative dislocation of the lens capsule including the intraocular lens, to mention only a few reasons [6,7]. Rural central India is one of the least developed regions in India with the lifestyle partially unchanged for the last 100 years
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