Reply

Abstract

We thank Drs Ekaterina Yonova-Doing and Christopher J. Hammond for their interest in our paper1Datiles 3rd, M.B. Ansari R.R. Yoshida J. et al.Longitudinal study of age-related cataract using dynamic light scattering: loss of α-crystallin leads to nuclear cataract development.Ophthalmology. 2016; 123: 248-254Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar and would like to respond to their questions. With regard to lens brunescence, we used the Age-Related Eye Disease Study Cataract Clinical Grading System, which in contrast with the Lens Opacities Classification System, does not grade brunescence separately from opalescence. Brunescence is typically a later feature in nuclear cataract. The advantage of the dynamic light scattering system is that it can detect lens protein changes in the precataractous stages, when the lens is still transparent. Thus, at the time when dynamic light scattering is most useful, brunescence will generally not be an issue. We agree that smoking is associated with increased risk of nuclear sclerosis and we would expect smoking to be associated with a decrease in α-crystallin index. However, we did not assess risk factors and did not know the smoking status of the individual patients. We did not perform genetic analysis in this study, but it could be an important feature in future studies. Re: Datiles et al.: Longitudinal study of age-related cataract using dynamic light scattering: loss of α-crystallin leads to nuclear cataract development (Ophthalmology 2016;123:248-54)OphthalmologyVol. 123Issue 8PreviewWe read with great interest the recent article by Datiles et al1 exploring whether a longitudinal dynamic light scatter measurement of changes in unbound α-crystallin concentration within the lens predicts cataract progression. This study is built on a previous cross-sectional study for early detection of α-crystallin changes in lens using the same method.2 We wondered whether brunescence and nuclear opalescence were graded separately, because they both are reflected within the term “nuclear cataract” and whether dynamic light scatter measurements reflect one more than the other, or are influenced by brunescence? Similarly, the published paper does not comment on smoking status, which is a major environmental influence on nuclear cataract, and we wondered whether the authors had any insights into whether smoking status differed in each tertile of the α-crystallin index, and might increase unbound α-crystallin, thereby causing cataract? Full-Text PDF