Common Type Of Cataract Research Articles

Outcome of Paediatric Cataract Surgery at Tilganga Institute of Ophthalmology, Nepal

Introduction: Paediatric cataract and aphakia are still a major cause of childhood blindness in developing world due to lack of advanced technology. In developing countries like Nepal, many children still present late due to lack of awareness and financial constraints.Objectives: The objective of this study was to determine the outcome of paediatric cataract surgery in a tertiary eye care centre in Nepal.Methodology: A hospital based prospective, observational study taking 42 patients (77 eyes) aged ≦15 years diagnosed with paediatric cataract were enrolled during a period of 1 year ( Jan 2011 - Jan 2012) at Tilganga Institute of Ophthalmology, Kathmandu, Nepal. The patients underwent either: a) Lens aspiration + Primary posterior capsulotomy (PPC) + Anterior Vitrectomy; b) Lens aspiration + PPC+ Anterior Vitrectomy + Intra-ocular lens (IOL); c) Lens Aspiration + IOL. Post-operatively optical ± amblyopia correction. Statistical analysis was carried out by using STATA 9.0. The association of changes in the vision of eyes before and after surgery was analyzed by using generalization of McNemar's test (Stuart-Maxwell test). A pvalue of < 0.05 was considered for the statistical significance. Institutional Ethics Board approval was obtained from the institutional review committee (IRC) of National Academy Medical Sciences ( NAMS ).Results: Mean age of patients was 4.46 yrs ± 4.32(SD), range from (15 days -12 yrs); Male : Female: 22 (52%)/20 (48%); 35 (83%) patients had bilateral cataract and 7(17%) had unilateral cataract. Morphologically, the most common type of cataract was total cataract (27/32%). Post-operatively, a statistically significant improvement in vision was there in all the eyes ( p value : < 0.0001) . Visual axis opacification was the most common post- operative complication seen in 20(26% ) of total eyes by the end of 6 months.Conclusion: Good visual outcome in paediatric cataract surgery can be obtained in developing countries like Nepal with minimal intra and post-op complications. BJHS 2018;3(1)5 : 331-337

Characteristics of Anterior Lens Opacities in Children.

Background:Anterior lens opacities (ALO) are found in 3-14% of pediatric patients with cataracts. No clear guidelines exist in the management and treatment of these cataracts.Objective:To evaluate pediatric patients with anterior lens opacities and assess rate of amblyopia and need for surgery over time.Methods:A retrospective chart review was performed on patients with unilateral and bilateral anterior lens opacities (ALOs) seen between January 2008 and December 2014. Size, location, and type of ALO were noted. Refractive error, necessity for treatment of amblyopia, and interventions were recorded.Results:A total of 31 patients were included in the study. 17 patients had unilateral ALOs and 14 had bilateral ALOs. The majority of the cataracts (90.3%) were centrally located. The most common type of cataract was the polar type of cataract and the vast majority (48.4%) was < 1mm in size. 38.7% of patients had concurrent ocular conditions and 9.7% had systemic associations. 28.6% of patients with bilateral cataracts and 35.3% of the patients with unilateral cataracts were treated for amblyopia. Three patients required cataract surgery.Conclusion:About half of anterior lens opacities are less than 1mm in size and the majority are of the polar type. Risk of amblyopia in these patients is higher than in the general population. Anisometropia is the most common cause of amblyopia. Ocular associations are seen at a relatively high frequency and systemic associations can occur but are uncommon. The need for surgical intervention is infrequent; however, growth of ALOs and associated cortical changes may be risk factors for surgery.

Etiopathogenesis of presenile cataracts in Central Kerala: A cross-sectional observational study

Aim: The aim of this study was to determine the factors responsible for the development of presenile cataracts in patients between 18 and 50 years in Central Kerala. Materials and Methods: This cross-sectional observational study was done on patients diagnosed with presenile cataracts (age group 18–50 years) at Little Flower Hospital, Angamaly, Kerala, from March 2016 to June 2016. A detailed history including the risk factors such as residence and occupation, diabetes mellitus (DM), atopy, and thyroid disorders was taken. Cataract was graded according to the Lens Opacities Classification System III. Statistical analysis of descriptive data was done with bar charts and pie diagrams. Results: Out of 200 participants included in the study, there were 88 males and 112 females. The mean age of the study population was 41.88 years. Pre senile cataract was associated with Diabetes mellitus in 31%, with atopy in 8.5%and with thyroid disorders in 5%of cases. Posterior subcapsular cataract (42%) was the most common type of cataract found. Total cataract was present in 23.5%. The odds of developing cortical cataract was higher in those with thyroid disorder (odds ratio (OR) = 6.97), nuclear cataract was higher in those with uveitis (OR = 6.18) and high myopia (OR = 7.97), and total cataract was higher in those with a history of trauma (OR = 8.95). Conclusion: Apart from DM and atopy, the place of residence and occupation (and thus possibly exposure to ultraviolet radiations) is also associated with the development of presenile cataract. Posterior subcapsular cataract is the most common type of presenile cataract in Central Kerala.

Association of angiotensin-converting enzyme, CYP46A1 genes polymorphism with senile cataract

Background:Senile cataract is the most common type of cataract characterized by gradual progressive thickening of the lens of the eye. Previously, many studies investigated the association between genetic polymorphism and senile cataract. Angiotensin-converting enzyme (ACE) I/D polymorphism is the potential risk factor for many eye-related diseases such as retinopathy and glaucoma. CYP46A1 enzyme converts cholesterol to 24S-hydroxycholesterol; human lens' membranes contain the highest cholesterol content. Defects in enzymes of cholesterol metabolism can be associated with cataracts. Hence, the present study was carried out to investigate the association of ACE and CYP46A1 genes polymorphism with senile cataract cases and controls.Materials and Methods:ACE (rs 4646994) and CYP46A1 (rs 754203) genes polymorphism in cases and controls were evaluated by polymerase chain reaction and restriction fragment length polymorphism.Results:This study included 103 senile cataract cases (55 were males and 48 were females) and 102 controls (53 were males and 49 were females). Mean age of cases in this study was 52.02 ± 12.11 years while in control group 53.74 ± 11.87 years. Frequencies of ACE ID, DD, and II genotypes in senile cataract cases were 64.07%, 4.85%, and 31.06% and controls were 61.76%, 26.47%, and 11.76%, respectively. The CYP46A1 gene CT, CC, and TT genotype frequencies were 48.54%, 8.73%, and 42.71% in senile cataract cases and 28.43%, 3.92%, and 67.64% in healthy controls, respectively. ACE DD and II genotypes (P < 0.001,P = 0.0008) and CYP46A1 CT and TT genotypes (P = 0.003,P = 0.0003) were significantly associated with senile cataract cases compared to the controls.Conclusion:Findings of this study suggest that ACE and CYP46A1 genes polymorphism may be a predictive marker for early identification of population at risk of senile cataract. This potential role of ACE and CYP46A1 genes polymorphism as a marker of susceptibility to senile cataract needs further validation in studies involving larger number of patients from different regions.

A cross-sectional study to compare the complications of cataract surgery with phacoemulsification in eyes with high and normal axial length

Introduction: High myopia is a risk factor for cataract formation. A relationship between myopia and higher complications in cataract surgeries has long been suggested. Materials and methods: After obtaining ethics committee clearance, this cross-sectional, case-control observational study was conducted in 100 participants of age above 18 years. They underwent cataract surgery. Participants were divided into two groups:- Group A & B - Participants with axial length between 21 and 26 mm and more than 26 mm respectively. Results and discussion: This shift of myopic individuals undergoing cataract surgery at an earlier age was found to be statistically significant. There was a statistically significant association between increasing age and PCR. Most common type of cataract in group A is cortical (30.8%) followed by nuclear (28.8%). Most common type of cataract in a group B is PSC (50%) followed by nuclear (22.9%). There was no statistical association between type of cataract and any complication. Conclusions: Intraoperative complications of cataract surgery do not increase significantly with increase in axial length. Myopic individuals are prone to develop cataracts earlier. NS and PSC type of cataracts are more common compared to cortical type of cataracts in emmetropic individuals.

Prevalence of Age-Related Cataract and Cataract Surgery in a Chinese Adult Population: The Taizhou Eye Study.

To study the prevalence of age-related cataract (ARC), cataract surgery, and visual outcomes in a Chinese adult population in Taizhou, China. A population-based, cross-sectional study was conducted using a random cluster sampling method. We evaluated 10,234 eligible subjects 45 years or older (response rate 78.1%) in the Taizhou Eye Study. We conducted a detailed eye examination in all participants, including presenting visual acuity (PVA), best-corrected visual acuity (BCVA), slit-lamp assessment of lens opacities using the Lens Opacities Classification System III (LOCS III), and fundus examination. The standardized prevalences of cortical, nuclear, and posterior subcapsular cataract (PSC) were 28.6%, 24.3%, and 4.4%, respectively, and combined nuclear and cortical cataract was the most common cataract type (40.0%). According to the US visual impairment (VI) criteria and World Health Organization VI criteria, 40.6% and 21.8% of PSC participants had binocular VI, respectively; these values were higher than the VI rates in cortical and nuclear cataract (all P < 0.001). Of 148 patients (3.5%) who had cataract surgeries, 41.2% had PVA <20/63, and 19.6% had PVA <20/200. The main causes of poor visual outcome after cataract surgery were ocular comorbidities (41.3%), uncorrected refractive error (30.0%), surgical complications (15.0%), and posterior capsular opacification (PCO; 13.7%). The high prevalence of cataract and high rate of VI from ARC in the adult Chinese population remains a severe public health problem. Cataract surgery remains insufficient in mainland China and poor visual outcomes were frequent. Surgical complications and PCO were important avoidable causes that attributed to poor visual outcomes after cataract surgeries.

Prevalence of Pseudoexfoliation Syndrome in Turkish Patients with Senile Cataract

Purpose: To investigate the prevalence of pseudoexfoliation syndrome (PEX) among Turkish patients with senile cataract. Materials and Methods: Records of 352 eyes of 352 patients who underwent cataract surgery were analyzed in this retrospective study. The presence of PEX, type of cataract, intraocular pressure (IOP), glaucoma, age-related macular degeneration, and systemic diseases (coronary artery disease, hypertension, diabetes mellitus) were recorded. Results: The overall prevalence of PEX syndrome was detected to be 11%. The mean age of PEX patients was significantly higher than without PEX (74.4 ± 7.2 years and 69.3 ± 11.4 years, respectively, p = 0.004). The most common cataract type in the PEX patients was mixed-type cataract determined in 51.2% of patients. IOP was significantly higher in eyes with PEX than in eyes without it (16.1 ± 4.5 mmHg and 14.7 ± 3.8 mmHg, respectively; p = 0.03). Moreover, the prevalence of age-related macular degeneration was found to be significantly higher, and prevalence of glaucoma slightly higher in PEX patients than without PEX. Conclusion: Pseudoexfoliation syndrome is a common condition in Turkish people. PEX is associated with mixed type of cataract, age-related macular degeneration, and elevated IOP. Therefore, PEX patients should be checked for concomitant diseases.

The activity of superoxide dismutase in the aqueous humour of the patients with senile cataract

Cataract is a dysfunction of the lens of the eye caused by clouding. By far the most common type of cataract is the senile cataract. The immediate cause of the occurrence of cataract is unknown, but oxidative stress is considered important in its etiopathogenesis. The aim: to examine the intensity of oxidative stress, depending on the type and maturity of senile cataract, through the activity of the superoxide dismutase enzyme (SOD) in the aqueous humor of the patients diagnosed with senile cataract. The average activity of the superoxide dismutase enzyme in the aqueous humor of the patients with early nuclear cataract was 41.16 U/mL, which is a significantly higher value (p<0.01) when compared with that of the patients with other types of early cataract, as well as with that of the patients with total cataract (33.88 U/mL). With aging the activity of the superoxide dismutase enzyme decreases, hence the average activity of the enzyme was significantly lower (p<0.05) in the group of patients over 75 years of age (36.28 U/mL vs. 28.91 U/mL).

A study of incidence of posterior capsular opacification after cataract surgery with square edge PMMA intra ocular lens

Introduction: PCO usually leads to a decrease in visual acuity (VA), glare disability and a loss of contrast sensitivity. It has been reported earlier that sharp edge intraocular lens optics are better than rounded edge IOL optics. This study was performed to identify the incidence of Posterior capsular opacification after a cataract surgery with square edge IOLs. Materials and Methods: 75 patients with Senile cataract –irrespective of grade &type, between the ages of 40 – 80 years who underwent cataract surgery were included in this study. The cataract surgery was conducted and square edge IOLs was places within the capsular bag. Signs for PCO was observed during one year of follow-up. Results: The most common type of cataract in our study was mature senile cortical cataract, seen in 23 (28%) of the patients. Post-operative course was uneventful in 64 patients (85.33%). 3 patient(4%) had mild iritis and 8(10.67%) patients were noted with minimal corneal edema at first post-operative day and resolved in the next week with topical medications. capsule opacification was seen in 5 of the 75 patients (6.67%). 2 of the 5 patietns had fibrous membrane type and 3 developed Elsching’s pearl type of PCO. Conclusion: The design of IOLs specially the one with square edge plays a major role in preventing posterior capsule opacification especially in the elderly with a very good visual outcome. Keywords: Posterior capsular opacifications, Intraocular lens, Cataract surgery

Serum electrolyte changes in senile cataract patients at tertiary care teaching hospital in Marathwada region, Maharashtra, India

Background: Cataract is one of the leading causes of blindness in developing countries. The most common type of cataract is senile cataract. The exact pathogenesis of cataract is not known, but it is believed that age, sex, radiation and serum electrolyte changes are important responsible risk factor. Rise in serum sodium level is responsible for formation of cataract. Potassium and chloride are not responsible factor for formation of cataract as that of serum sodium level. The purpose of this study is to estimate serum sodium and potassium in senile cataract patients, as compared to those without cataract. Methods: This study consists of 100 senile cataract patients and age matched 100 normal healthy individuals without cataract, serum electrolyte is measured by using an electrolyte analyzer. Results: In our study there is significant rise in serum sodium and chloride levels in cases compare to control group which is statistically significant. Serum potassium levels are in significant. Conclusion: We have concluded that serum sodium and chloride are important markers of senile cataract formation. Restrictions of salt in the diet delay the process of cataract formation.

English

PURPOSE: To evaluate the prevalence of pseudo exfoliation syndrome among Kashmiri patients with age related cataract scheduled for surgery. In this study we also evaluated the prevalence of glaucoma and intraoperative complications associated with pseudo exfoliative syndrome. METHOD: The present prospective study was conducted in the Postgraduate Department of Ophthalmology, Sher-i-Kashmir Institute of Medical Sciences (SKIMS) Bemina from January 2005 to May 2007. The series included 1434 patients who were admitted for cataract surgery. Only patients with senile cataract were included in this study. All patients underwent a complete ophthalmological examination that included slit lamp evaluation with dilated pupil for pseudo exfoliative material, intra ocular pressure (IOP) measurements. All intraoperative complications were recorded. RESULTS: In our study the prevalence of pseudo exfoliation syndrome was found to be 22.52%. Pseudo exfoliation syndrome was bilateral in 78.83% of subjects and unilateral in 30.96%. Mean age of subjects with pseudo exfoliation was 71.9+8.3 years. Male to female ratio in pseudo exfoliation cases was 5.3:1. The most common type of cataract in pseudo exfoliative cases was nuclear cataract (52.4%) followed by mixed (20.7%), mature cataract (17.4%), cortical cataract (6.1%) and posterior sub capsular cataract (3.4%). Prevalence of glaucoma in the pseudo exfoliative group was 19.5% whereas in non-pseudo exfoliative group it was 3.9%, the difference being statistically significant (chi square = 89.35; p value < 0.001).Subluxation of the lens was seen in 5.26% of cases in pseudo exfoliative group where as in the non-pseudo exfoliative group it was only 0.27%, the difference being statistically significant (chi square = 41.808; p value < 0.001). Intraoperative complications were found more in the pseudoexfoliative group 11.4% as compared to non-pseudoexfoliative group (1.26%). The difference was again statistically significant (chi square = 75.831; p value < 0.001). CONCLUSION: The prevalence of pseudo exfoliation syndrome in Kashmiri population undergoing cataract surgery is on the higher side. Pseudoexfoliation syndrome was found to be significantly associated with glaucoma and increased intraoperative complications.

English

Cataract is the opacification of the crystalline lens and or its capsule. Senile cataract is the cataract occurring commonly in the elderly who are above 50 years of age. It is one of the major causes of blindness in both the developing and the developed countries. Cataracts which develop prior to age of 50 are defined as pre senile cataract. There may be several reasons for an individual to develop such pre senile cataract. Some of the major identified risk factors are ocular trauma, uncontrolled diabetes, nutritional deficiencies, environmental factors like chronic exposure to sunlight as in tropics, cigarette smoking, refractive errors like high myopia, chronic intake of certain drugs for some systemic illness and certain ocular inflammatory diseases. AIM AND OBJECTIVES: To determine the various types of pre senile cataract and to determine the common causes of pre senile cataract. DESIGN: Prospective Observational study. METHODS & MATERIALS: The patients attending the out-patient clinics of the ophthalmology department who are found to have pre senile cataract and who give consent to participate in the observational study are requested to fill the questionnaire and undergo a complete ocular examination. The type of cataract and any cause of the cataract formation identified from the questionnaire, examination or investigations done are documented and analyzed using frequency distribution. RESULTS: 100 eyes of 54 patients were included in the study. Most common type of cataract was found to be posterior sub capsular cataract. The common causes identified were sunlight exposure, chronic steroid use, diabetes, uveitis and smoking. CONCLUSION: Protection from sunlight, avoidance of chronic steroid usage, screening and adequate control of diabetes, meticulous management of uveitis and avoiding cigarette smoking helps to prevent early development of cataracts.

Lenticular Changes in Congenital Iridolenticular Choroidal Coloboma

To evaluate the lenticular changes associated with congenital iridolenticular choroidal coloboma. Retrospective, observational case series. setting: Tertiary eye care center in south India. study population: Total of 145 eyes of 98 patients. observation procedure: Medical records of all patients with the diagnosis of congenital iridolenticular choroidal coloboma between January 2011 and December 2012 were reviewed retrospectively for demographic profile, extent of coloboma, and associated lenticular changes. Median age of patients at the time of initial visit was 23 years (interquartile range, 13-38 years). The male-to-female ratio was ∼ 1:1. Forty-eight percent had bilateral involvement. Lens showed cataract changes in 68 eyes (48.9%). The most common type of cataract was nuclear sclerosis, which was noted in 51% of cases. A distinct type of cataract, called "coloboma cataract" (characterized by linear opacity in the region of the coloboma), was observed in 29% of cases. Other associated findings were phacodonesis in 3 eyes, dislocation in 3 eyes, and subluxation in 5 eyes. Disc and/or macular involvement in 57 eyes (39.3%) did not influence the type or density of cataract (P > .05). Congenital iridolenticular choroidal coloboma is associated with early cataractous changes. The most common type of cataract is nuclear sclerosis. The type and density of cataract do not seem to be related to the extent of the choroidal coloboma. We suggest a distinct description with the nomenclature "coloboma cataract" to be considered in the clinical grading of cataracts in patients with this condition.

Prevalence of pseudoexfoliation syndrome in patients scheduled for cataract surgery in eye camps in Kashmir

Aims: To study the prevalence of pseudoexfoliation syndrome (PEX) in patients scheduled for cataract surgery in eye camps in Kashmir. Materials and Methods: This was a prospective study conducted by the Mobile Ophthalmic Unit holding eye camps in rural areas of Kashmir from December 2010 to July 2011. Total of 1117 patients from 11 areas with age-related cataract scheduled for surgery underwent complete clinical examination. The PEX was diagnosed by the presence of gray flakes on the anterior lens capsule or at the pupillary margin or both. A Chi square test was used for statistical analysis. Results: The prevalence of PEX was 26.32%. The prevalence from the different areas varied from 4 to 36.36%. Males comprised 64.62% of the patients with PEX ranging in age from 49 years to 89 years. Increasing age was associated with increase in prevalence of PEX (P value < 0.001). Prevalence of PEX was higher in patients involved with outdoor activities (P value < 0.001). Most common type of cataract seen in patients with PEX was nuclear sclerosis. Patients with PEX had visual acuity (VA) significantly lower than patients without PEX (P value = 0.0013). Conclusion: The prevalence of PEX in Kashmir is relatively high. This is important from the perspective of mobile eye camps considering the increased frequency of cataract and the surgical complications associated with PEX, and thus the surgery mandates a thorough preoperative clinical examination to ensure good surgical outcome.

The prevalence of pseudoexfoliation syndrome and possible systemic associations in patients scheduled for cataract surgery at the Military Medical Academy in Belgrade

Pseudoexfoliation syndrome (PEX) is an age-related systemic degenerative disorder characterized by the production and progressive accumulation of extracellular fibrillar eosinophilic material in the anterior segment of the eye. The aim of the study was to evaluate several clinical aspects of PEX, such as frequency of PEX and pseudoexfoliation glaucoma (PEXG), intraocular pressure (IOP), the type of lens opacity, and the possible relationship of PEX and systemic diseases. All 674 cataract patients had a comprehensive eye examination, including slitlamp biomicroscopy before and after mydriasis, IOP measurement, and fundus examination. The patients were classified into two groups: the PEX and the non-PEX group. The overall prevalence of PEX syndrome was found to be 17.5% (118 patients). The mean age of PEX patients (79.7 +/- 6.1 years) was significantly higher when compared with those without PEX (73.5 +/- 9.1 years) (p = 0.000). The prevalence of PEX syndrome was found to increase with age, from 7.3% in the 7th decade of life to 27% in patients older than 80 years (p < 0.001). The most common cataract type in the PEX patients was mature cataract observed in 40.7% of patients. The rest of the patients had mixed (30.5%), nuclear (25.4%), cortical (1.7%) and hypermature cataract (1.7%). Among the PEX patients 44 (37.2%) had glaucoma. Intraocular pressure was significantly higher in eyes with pseudoexfoliations than in eyes without it (17.8 +/- 3.2 mmHg and 15.8 +/- 2.8 mmHg, respectively; p = 0.001). Moreover, the prevalence of coronary heart disease was found to be higher in PEX patients. PEX syndrome is a common problem among Serbian patients scheduled for cataract surgery. It represents one of the major glaucoma risk factors and probably associated with ischemic heart disease, intraoperative and postoperative problems in cataract surgery.

Clinical characteristics, course, and visual prognosis of partial cataracts that seem to be visually insignificant in children

To report the clinical characteristics and visual prognosis of pediatric partial cataracts that seem to be visually insignificant. In this retrospective case series, the morphologic type and etiology, laterality, best-corrected visual acuity (BCVA), progression, and visual prognosis of partial cataracts in children with more than 1 year of follow-up were evaluated. Of 110 children (184 eyes), 74 (67%) had bilateral and 36 (33%) had unilateral cataracts. The most common type of cataract was posterior subcapsular (36%), followed by nuclear (18%) cataracts. The most common etiology was idiopathic (51%), followed by steroid-induced (28%). Cataracts progressed to surgery in 21 eyes (11%). Among these patients, BCVA was 20/38 at final examination (average follow-up 5.1 years). Among those in whom cataracts did not progress, BCVA was 20/28 at final examination (average follow-up 6.1 years). Initial BCVA was better in the nonprogression group than in the progression group (P = 0.04), but final BCVA did not differ between the groups (P = 0.96). Most patients with partial cataracts that seemed to be visually insignificant and were treated without surgery did not progress and showed favorable visual outcomes. In children who had progressive vision loss, surgery was necessary: these patients also had favorable visual outcomes.

Protein post-translational modification and age-related cataract

Cataract is the main cause of vision impairment, and age-related cataract is the most common type of cataract. Protein post-translational modification is the enzymatic processing of a polypeptide chain after translation from messenger RNA and after peptide bond formation has occurred. Deamidation, glycation and oxidation are age-related processes. They can change the structure or solubility of crystallin and result in the opacity of lens while acetylation and methylation may be related to the protection of lens protein. Although much effort has been directed towards slowing progression or preventing the occurrence of cataract, the management of cataract remains surgical. This review deals with the relations between different kinds of protein post-translational modification and age-related cataract as well as some protective methods aiming at the process of post-translational modification.

Lens Opacities in Valencia, Spain

To evaluate the most common lens opacities in Valencia (Spain), analyzed by gender, grade, and type of cataracts. The results are compared with other studies performed at other geographical latitudes and on different races. A total of 1951 eyes of patients diagnosed with cataracts, aged between 30 and 96 years, were evaluated in accordance with age, gender, type and degree of the cataract, bilaterality, and symmetry of this disease. Lens Opacities Classification System III was used to classify the cataract and the degree was graded as mild or moderate to advanced. The most common type of cataract is corticonuclear in the elderly and subcapsular in younger subjects. The most common are nuclear (28.4%) followed by cortical (6.2%), if combined cataracts are ruled out. There is a greater incidence of cortical cataracts in women (70%) and subcapsular cataracts in men (70%). The results suggest the existence of a gender factor in cataract formation and coincide with those obtained in similar studies performed in areas at a similar latitude (40º N) and with different race population. The geographical location (intensity and length of exposure to solar radiation) seems to be a determining factor in the formation of a specific type of cataract, more than race, although there are other factors that contribute in the formation of a specific type of cataract.

Healthy Diets and the Subsequent Prevalence of Nuclear Cataract in Women

To assess the association between healthy diet scores and prevalence of nuclear cataract in women. The association between healthy diet scores, which reflect adherence to the US dietary guidelines, and prevalence of nuclear cataract determined 4 to 7 years later was assessed in a sample of Women's Health Initiative Observational Study participants (aged 50-79 years) residing in Iowa, Wisconsin, and Oregon. Scores on the 1995 Healthy Eating Index, which reflect adherence to 1990 guidelines, were assigned from responses to food frequency questionnaires at the Women's Health Initiative baseline (1994-1998). Presence of nuclear cataract was determined from slitlamp photographs and self-reports of cataract extractions were assessed from May 1, 2001, to January 31, 2004, in 1808 women participating in the Carotenoids in Age-Related Eye Disease Study. Having a high 1995 Healthy Eating Index score was the strongest modifiable predictor of low prevalence of nuclear cataract among numerous risk factors investigated in this sample. The multivariate-adjusted odds ratio for high vs low quintile for diet score was 0.63 (95% confidence interval, 0.43-0.91). Higher prevalence of nuclear cataract was also associated with other modifiable factors (smoking and marked obesity) and nonmodifiable factors (having brown eyes, myopia, and high pulse pressure). Vitamin supplement use was not related to cataract. These data add to the body of evidence suggesting that eating foods rich in a variety of vitamins and minerals may contribute to postponing the occurrence of the most common type of cataract in the United States.

Hereditary and Clinical Features of Retinitis Pigmentosa in Koreans

There has been no report about hereditary and clinical features of retinitis pigmentosa (RP) in Koreans. To evaluate these, data were collected from 365 RP patients including age, gender, visual acuity (VA), spherical equivalent (SE) of refractive errors, funduscopic findings, color vision test, visual field score (VFS) obtained from Goldmann perimetry, and the inheritance patterns from pedigrees. Simplex RP was the most common inheritance pattern (61.9%); followed by autosomal recessive RP (17.3%), autosomal dominant RP (12.1%) and X-linked recessive RP (8.8%). Myopia was the most common refractive errors (77.5%) including 16.1% of high myopia. The most common cataract type was posterior subcapsular cataract (25.8%). Observed retinal findings included changes of retinal pigment epithelium (88.8%), bony spicule-like pigmentation (79.7%), attenuation of retinal vessel (76.2%), waxy disc pallor (12.6%), golden ring around optic disc (2.2%), epiretinal membrane (0.8%) and cystoid macular edema (0.5%). Corrected VA and refractive errors did not show any significant difference between the inheritance patterns. VFS was significantly worse in autosomal recessive RP than in autosomal dominant RP. Color vision defect was noted in 66.1% on Hardy-Rand-Rittlers color vision test. In conclusion, Korean RP patients have the indigenous hereditary and clinical features as well as the ordinary ones.