Incidence Of Age-related Cataract Research Articles

Risk-benefit analysis of the association of ambient fine particulate matter pollution and physical activity with age-related cataract: A prospective cohort study

The aim of this study was to examine the associations of fine particulate matter (PM2.5) and physical activity (PA) with age-related cataract and its subtypes, and to explore potential interactions between PM2.5 and PA. A total of 291,627 participants enrolled in the UK Biobank cohort during 2006–2010 was included. The annual mean concentration of PM2.5 at each participant's residential address was estimated using Land Use Regression models. PA was measured using the International Physical Activity Questionnaire. Cox proportional hazards model was used to examine the associations of PM2.5 and PA with incident age-related cataract, and to assess their interactions on additive and multiplicative scales. We identified 12,826 incident cases of age-related cataract, including 7686 cases of nuclear cataract and 5140 cases of non-nuclear cataract. Higher PM2.5 exposure was associated with a higher risk of age-related cataract [HR = 1.140; 95% CI: 1.105, 1.177; per 1 μg/m3 increase], and the association was stronger for non-nuclear cataract than for nuclear cataract. There was a negative association between PA and cataract [HR = 0.925; 95% CI: 0.879, 0.974; comparing high to low level]. No clear evidence of the interactions between PM2.5 and PA was found. Our findings indicated that high PM2.5 exposure and low levels of PA were independently associated with increased risks of incident age-related cataract.

Polygenetic-Risk Scores Related to Crystallin Metabolism Are Associated with Age-Related Cataract Formation and Interact with Hyperglycemia, Hypertension, Western-Style Diet, and Na Intake.

Age-related cataract (ARC) development is associated with loss of crystalline lens transparency related to interactions between genetic and environmental factors. We hypothesized that polygenetic risk scores (PRS) of the selected genetic variants among the ARC-related genes might reveal significant genetic impacts on ARC risk, and the PRS might have gene–gene and gene–lifestyle interactions. We examined the hypothesis in 1972 and 39,095 subjects aged ≥50 years with and without ARC, respectively, in a large-scale hospital-based cohort study conducted from 2004 to 2013. Single nucleotide polymorphisms (SNPs) of the genes related to ARC risk were identified, and polygenetic risk scores (PRS) were generated based on the results of a generalized multifactor dimensionality reduction analysis. Lifestyle interactions with PRS were evaluated. The PRS derived from the best model included the following six SNPs related to crystallin metabolism: ULK4_rs1417380362, CRYAB_rs2070894, ACCN1_rs55785344, SSTR2_rs879419608, PTN_rs322348, and ICA1_rs200053781. The risk of ARC in the high-PRS group was 2.47-fold higher than in the low-PRS group after adjusting for confounders. Age, blood pressure, and glycemia interacted with PRS to influence the risk of ARC: the incidence of ARC was much higher in the elderly (≥65 years) and individuals with hypertension or hyperglycemia. The impact of PRS on ARC risk was greatest in middle-aged individuals with hypertension or hyperglycemia. Na, coffee, and a Western-style diet intake also interacted with PRS to influence ARC risk. ARC risk was higher in the high-PRS group than in the low-PRS group, and high Na intake, Western-style diet, and low coffee intake elevated its risk. In conclusion, ARC risk had a positive association with PRS related to crystallin metabolism. The genetic impact was greatest among those with high Na intake or hypertension. These results can be applied to precision nutrition interventions to prevent ARC.

Panel-based targeted exome sequencing reveals novel candidate susceptibility loci for age-related cataracts in Chinese Cohort.

BackgroundAge‐related cataracts (ARC) is the most common blinding eye disease worldwide, and its incidence tend to become younger. However, the relationship between genetic factors and mechanisms is not fully understood. The aim of the study was to further clarify the relationship between ARC and genetic mechanisms in East Asian populations and to elucidate the pathogenesis.MethodsThe study collected 191 sporadic cataracts and 208 healthy people from the eastern provinces of China, with an average age of about 60 years. All participants were subjected to a comprehensive ophthalmic clinical examination and peripheral blood samples were collected and their genomic DNA was extracted. Mutations were screened among 792 candidate genes to enhance understanding of the disease through targeted capture and high‐throughput sequencing.ResultsWe identified novel candidate susceptibility gene, which may serve as a potential susceptibility factor leading to an increase in the incidence of age‐related cataracts. Three novel loci are associated with age‐related cataracts significant significance: rs129882 in DBH (p = 5.27E‐07, odds ratio = 3.9), rs1800280 in DMD (p = 2.85E‐06, odds ratio = 1.4) and rs2871776 in ATP13A2 (p = 4.18E‐05, odds ratio = 0.04). Gene–gene interaction analysis revealed that the most significant interactions between genes include the interaction between DBH and TUB (rs17847537 in TUB, rs129882 in DBH, p‐value = 2.12E‐14), and the interaction between DBH and DMD (rs1800280 in DMD, rs129882 in DBH, p‐value = 2.12E‐14). Pathway analysis shows that the most significant processes are concentrated in response to light stimulation (adjusted p‐Value = 5.56E‐03), response to radiation (adjusted P‐Value = 5.56E‐03), abiotic stimulus (adjusted p‐Value = 5.56E‐03). eQTL analysis shows that DBH rs129882 could regulate the expression of DBH mRNA in various tissues including retina.ConclusionOur study indicates rs129882 and rs1800280 loci are associated with age‐related cataracts, which enlarge the gene map of age‐related cataracts.

Association between dietary glycemic index and glycemic load, insulin index and load with incidence of age-related cataract: Results from a case-control study

AimTo identify the association between the dietary carbohydrate indexes, such as dietary glycemic index (DGI) and load (DGL), dietary insulin index (DII) and load (DIL), with the possibility of cataract. MethodThis case–control study consisted of 101 new cases of cataract and 202 controls. DGI and DGL were computed through DGI values previously published. DII was also calculated based on dietary insulin index data published previously. ResultsThere was a significant positive association between the highest quartiles of DGI (OR = 6.56; 95% CI = 2.67–16.06; P < 0.001), DGL (OR = 6.17; 95% CI = 1.93–19.37; P = 0.002) and DIL (OR = 4.17; 95% CI = 1.41–12.27; P = 0.004) with risk of cataract, compared to those on the lowest quartile, but not for DII (OR = 0.85; 95% CI = 0.39–1.86; P = 0.82). Furthermore, after stratifying groups by BMI, a significant direct association between highest quartile of DGI (OR = 6.76; 95% CI = 2.49–18.38; P < 0.001) and DGL (OR = 3.45; 95% CI = 0.96–12.37; P = 0.05) with risk of cataract was evident in individuals with elevated BMI (BMI≥25). ConclusionWe found a significant, direct, relationship between DGI, DGL and DIL with risk of cataract. However, the association between DII and the risk of cataract was not significant, even after adjusting for related confounders.

The Combination of Healthy Diet and Healthy Body Weight Is Associated with Lower Risk of Nuclear Cataract in the Blue Mountains Eye Study

Greater adherence to dietary guidelines has previously been found to be associated with decreased risk of visual impairment. However, whether or not this association extends to age-related cataract, 1 of the leading causes of visual impairment, is unknown. The aim of this study was to assess the association between adherence to dietary guidelines, using total diet score, and incidence of age-related cataract. Of 3654 baseline participants of the population-based Blue Mountains Eye Study cohort (1992-1994), 2334 (75.8% survivors) and 1952 (76.7% survivors) were examined after 5 and 10 y, respectively. Cataract was assessed from lens photographs using the Wisconsin Cataract Grading System. Baseline total diet score was calculated from FFQ data following a modified version of the Healthy Eating Index for Australians. OR with 95% CI were estimated using discrete logistic regression analyses, adjusting for age, sex, and other confounders. To test interaction, a cross-product term of 2 factors was included in regression models. Of 2173 participants (84.7% of those returned for 1 or both follow-ups) with total diet score estimated, 57% were women, mean baseline age was 63.9±8.4y, and mean baseline BMI was 26.3±4.3 kg/m2. After multivariable adjustment, baseline total diet score was not associated with incidence of any cataract. A multiplicative interaction was observed between total diet score and BMI for incident nuclear cataract (P-interaction=0.04): increasing baseline total diet score was associated with decreased risk of nuclear cataract among participants with BMI <25 (per unit increased total diet score, OR: 0.90; 95% CI: 0.81, 0.99; P=0.02), but not among participants with BMI ≥25 (OR: 1.00; 95% CI: 0.92, 1.10; P=0.95). Adherence to dietary guidelines had no appreciable influence on cataract development overall in this older Australian population. However, adherence to dietary guidelines combined with healthy BMI is associated with decreased risk of nuclear cataract, an aging marker.

Cumulative Lead Exposure and Incidence of Age-related Cataract in Older Men

Purpose: Cumulative lead exposure has been suggested as a risk factor for age-related cataract (ARC) A previous study in a cohort of elderly men reported a significant association between cumulative lead exposure and risk of ARC. Here, we extended this analysis and examined new incident cases of ARC in relation to lead exposure. We also evaluated potential effect modification by dietary intake of antioxidant vitamins, calcium and iron. Methods: This study includes ARC-free 632 males (mean age=66.2±6.4 years) from the Normative Aging Study who had tibia and patella lead levels measured by K X-ray fluorescence (KXRF) from 1991 to 1999. Cataract status was graded through Slit Lamp Exam and ARC cases were defined as those who had cataract surgery or were diagnosed as any subtype of cataract grade 3 or higher. Cox proportional hazards model was used to estimate hazard ratio (HR) and 95% confidence interval (CI) of incident ARC. Calorie-adjusted daily intake of iron, calcium, vitamin D, vitamin C, vitamin E and carotenoids were computed and dichotomized at the median (low vs. high) for testing effect modification. Results: Of 632 participants, we identified 208 incident ARC at the end of follow-up (316 cases/10,000 person years). After adjusting for important confounders, tibia lead was significantly associated with incident ARC (HR per interquartile range increase (IQR:15 μg/g) =1.21, 95% CI: 1.05, 1.40, p=0.03). We found a weaker and non-significant association with patella lead (HR per IQR increase (20 μg/g) =1.05, 95% CI: 0.52, 2.11, p=0.11). The association between tibia lead and ARC was stronger in people with lower carotene intake and higher intake of vitamins C, D and E and iron and calcium but the interaction terms were not statistically significant . Conclusions: Our findings reinforce that cumulative lead exposure is an important risk factor for ARC. We found no consistent patterns in effect modification by nutrients.

Folic Acid, Vitamin B6, and Vitamin B12 in Combination and Age-Related Cataract in a Randomized Trial of Women

ABSTRACTPurpose: To examine the incidence of cataract and cataract extraction in a trial of folic acid and vitamins B6 and B12.Methods: In a randomized, double-masked, placebo-controlled trial, 5442 female health professionals aged 40 years or older with preexisting cardiovascular disease (CVD) or three or more CVD risk factors were randomly assigned to receive a combination of folic acid (2.5 mg/day), vitamin B6 (50 mg/day), and vitamin B12 (1 mg/day), or placebo. A total of 3925 of these women did not have a diagnosis of cataract at baseline and were included in this analysis. The primary endpoint was age-related cataract, defined as an incident age-related lens opacity, responsible for a reduction in best-corrected visual acuity to 20/30 or worse, based on self-report confirmed by medical record review. Extraction of incident age-related cataract was a secondary endpoint of the trial.Results: During an average of 7.3 years of treatment and follow-up, 408 cataracts and 275 cataract extractions were documented. There were 215 cataracts in the combination treatment group and 193 in the placebo group (hazard ratio, HR, 1.10, 95% confidence interval, CI, 0.90–1.33; p = 0.36). For the secondary endpoint of cataract extraction, there were 155 in the combination treatment group and 120 in the placebo group (HR 1.28, 95% CI 1.01–1.63; p = 0.04).Conclusions: In this large-scale randomized trial of women at high risk of CVD, daily supplementation with a combination of folic acid, vitamin B6, and vitamin B12 had no significant effect on cataract, but may have increased the risk of cataract extraction.

Interaction of αA-crystallin F71L mutant with wild type αA- and αB-crystallins by mammalian two hybrid assay

Incidence of age related cataract (ARC) increases by a variety of factors including metabolic and environmental factors. Nonetheless, genetic mutations are responsible for the altered structural stability of the proteins, especially; the F71L mutation in αA-crystallin has been shown to be responsible for the incidence of cataracts. However, structural characteristics and chaperone function of this mutant and its interaction with wild type (WT) crystallins may aid to decipher its role in cataractogenesis. The aim of the present study is to show the interaction of F71L mutant protein with the WT α-crystallins. The F71L mutant used in this study was created by site-directed mutagenesis, overexpressed and purified. Biophysical characteristics determined by size exclusion HPLC, DLS, CD spectrometry, tryptophan fluorescence and surface hydrophobicity did not show significant structural changes in the mutant protein compared to WT counterpart. Interestingly, the F71L mutant displayed a significant loss in homogenous interaction with WT αA-crystallin and F71L mutant as well as heterogeneous interaction with αB-crystallin as evaluated by mammalian two hybrid system. Our findings suggest that F71L loses the ability to form homo and hetero-oligomers seems to result in the loss in chaperone like activity (CLA) and refractive index resulting in the development of cataracts.

Long-Term Physical Activity and Risk of Age-Related Cataract: A Population-Based Prospective Study of Male and Female Cohorts

To examine the association of total and specific types of physical activity, including walking or bicycling, exercising, work or occupational activity, home or housework, and leisure time inactivity with the risk of age-related cataract in women and men. Population-based prospective cohort study. A total of 52 660 participants (23 853 women and 28 807 men) 45 to 83 years of age from the Swedish Mammography Cohort and the Cohort of Swedish Men. Physical activity was assessed using a self-administered questionnaire at baseline. Cataract diagnosis and extraction were identified through linkage to registers. Incident age-related cataract diagnosis and cataract extraction. During a mean 12.1 years of follow-up (between January 1, 1998, and December 31, 2011; 634 631 person-years), 11 580 incident age-related cataract cases were identified. After adjusting for potential confounders, the highest quartile of total physical activity was statistically significantly associated with 13% decreased risk of cataract compared with the lowest (hazard ratio [HR], 0.87; 95% confidence interval [CI], 0.82-0.92). Walking or bicycling (>60 minutes/day vs. hardly ever; HR, 0.88; 95% CI, 0.82-0.95) and work or occupational activity (heavy manual labor vs. mostly sitting; HR, 0.84; 95% CI, 0.78-0.91) also were associated with decreased risk of cataract. Exercise training and home or housework were not associated with cataract risk. Leisure time inactivity was associated with increased risk of cataract (>6 vs. <1 hours/day; HR, 1.27; 95% CI, 1.07-1.50). The HR for high long-term total physical activity compared with low levels both at 30 years of age and at baseline was 0.76 (95% CI, 0.69-0.85). Our findings indicate that high total physical activity, especially in the long term, and such specific types of physical activity as walking or bicycling and work or occupational activity, may be associated with decreased risk of age-related cataract. Conversely, high inactivity levels may be associated with increased risk of cataract.

Overweight, Obesity, and Age-Related Cataract

To examine the longitudinal association of overweight/obesity with age-related cataract. A systematic review of the literature was performed using PubMed and Embase from their inception until June 2013 for prospective data on body mass index categories identical or similar to the World Health Organization-recommended classifications of body weight and age-related cataract including nuclear, cortical, and posterior subcapsular (PSC) cataract. Meta-analyses were conducted using random-effects models with results reported as adjusted relative risks (RRs). A total of 163,013 subjects aged 40 to 84 years from six prospective cohort studies were included in the meta-analysis. Obesity was associated with an increasing risk of nuclear cataract (pooled RR, 1.12; 95% confidence interval [CI], 1.02 to 1.25), cortical cataract (pooled RR, 1.34; 95% CI, 1.07 to 1.66), and PSC cataract (pooled RR, 1.52; 95% CI, 1.31 to 1.77). Overweight was only associated with an increasing risk of PSC cataract (pooled RR, 1.23; 95% CI, 1.09 to 1.40). The longitudinal associations of obesity with incident age-related cataract are confirmed by the findings in this six-study meta-analysis. The association of obesity with PSC cataract is stronger than that with nuclear or cortical cataract. Randomized control trials are warranted to examine the effectiveness and cost-effectiveness of weight reduction in obese populations to decrease the risk of age-related cataract.

Myopia and Age-Related Cataract: A Systematic Review and Meta-analysis

To examine if myopia is a risk factor for age-related cataract. Systematic review and meta-analysis. A systematic review of the literature was performed using PubMed and Embase from their inception to March 2013 for population-based studies with data on myopia and age-related cataract, including nuclear, cortical, and posterior subcapsular (PSC) cataract. Separate meta-analyses for case-control/cross-sectional studies and cohort studies were conducted using random-effects models, with results reported as adjusted odds ratios (ORs) and relative risks (RRs), respectively. A total of 38 007 subjects aged 30-97 years from 12 population-based studies were included in the meta-analysis. Meta-analysis of the 7 cross-sectional studies and 1 case-control study confirmed that myopia was associated with increasingly prevalent nuclear (pooled OR 2.81, 95% CI 1.94-4.06) and PSC cataract (pooled OR 1.93, 95% CI 1.49-2.49) but not with cortical cataract (pooled OR 1.08, 95% CI 0.90-1.30). Meta-analysis from 3 or 4 cohort studies showed nonsignificant associations of myopia with incident nuclear (pooled RR 1.25, 95% CI 0.71-2.21), cortical (pooled RR 1.21, 95% CI 0.67-2.19), and PSC cataract (pooled RR 1.26, 95% CI 0.92-1.74). The associations of myopia with prevalent nuclear and PSC cataract are confirmed in meta-analysis of 8 study findings. The association of myopia with incidence of age-related cataract could not be confirmed in meta-analysis of 4 study findings.

High-Dose Supplements of Vitamins C and E, Low-Dose Multivitamins, and the Risk of Age-related Cataract: A Population-based Prospective Cohort Study of Men

We examined the associations of high-dose supplements of vitamins C and E and low-dose multivitamins with the risk of age-related cataract among 31,120 Swedish men, aged 45-79 years, in a population-based prospective cohort. Dietary supplement use was assessed from a questionnaire at baseline in 1998. During follow-up (January 1998-December 2006), 2,963 incident age-related cataract cases were identified. The multivariable-adjusted hazard ratio for men using vitamin C supplements only was 1.21 (95% confidence interval (CI): 1.04, 1.41) in a comparison with that of non-supplement users. The hazard ratio for long-term vitamin C users (≥10 years before baseline) was 1.36 (95% CI: 1.02, 1.81). The risk of cataract with vitamin C use was stronger among older men (>65 years) (hazard ratio = 1.92, 95% CI: 1.41, 2.60) and corticosteroid users (hazard ratio = 2.11, 95% CI: 1.48, 3.02). The hazard ratio for vitamin E use only was 1.59 (95% CI: 1.12, 2.26). Use of multivitamins only or multiple supplements in addition to vitamin C or E was not associated with cataract risk. These results suggest that the use of high-dose (but not low-dose) single vitamin C or E supplements may increase the risk of age-related cataract. The risk may be even higher among older men, corticosteroid users, and long-term users.

Age-related cataract in dogs: a biomarker for life span and its relation to body size

Clinical data from 72 dog breeds of varying size and life expectancy were grouped according to breed body mass and tested for prevalence at ages 4 to 5, ages 7 to 10, and lifetime incidence of non-hereditary, age-related cataract (ARC). The incidence of ARC was found to be directly related to the relative life expectancies in the breed groups: The smallest dog breeds had a lower ARC prevalence between ages 4 and 5 than mid-size breeds and these, in turn, a lower prevalence than the giant breeds. A similar sequence was evident for ages 7 to 10 and for overall lifetime incidence of ARC. These differences became more significant when comparing small and giant breeds only. We could also confirm the inverse relationship between body size and life expectancy in these same sets of dog breeds. Our results show that body size, life expectancy, and ARC incidence are interrelated in dogs. Given that ARC has been shown to be at least partially caused by oxidative damage to lens epithelial cells and the internal lens, we suggest that it can be considered not only as a general biomarker for life expectancy in the canine and possibly other species, but also for the systemic damages produced by reactive oxygen species. This suggests new approaches to examine the gene expression pathways affecting the above-noted linkages.

Effect of Gender on Radiation-Induced Cataractogenesis

Radiation cataractogenesis is an important consideration for radiotherapy patients and for astronauts. Data in the literature suggest that gender and/or estrogen may play a role in the incidence of age-related cataracts. However, few data exist on the effect of gender on radiation-induced cataractogenesis. We compared the incidence and rate of progression of cataracts induced by ionizing radiation in male and female Sprague-Dawley rats. Male rats were implanted with either an empty silastic capsule or a capsule containing 17-beta-estradiol. Ovary-intact female rats were implanted with empty capsules. All rats received a single dose of 10 Gy (60Co gamma rays) to the right eye only. Lens opacification was measured at 2-4-week intervals with a slit lamp. The incidence of radiation-induced cataracts was significantly increased in male rats compared to female rats (P=0.034). There was no difference in the rate of cataract progression between the three groups. Our data suggest there is a gender-related difference in radiation-induced cataractogenesis, but the increased incidence of radiation cataractogenesis in male rats compared to female rats cannot be attributed to estrogen levels, since there was no difference in cataract incidence between male rats implanted with empty capsules and those implanted with capsules containing 17-beta-estradiol.

Cystatin C, other markers of kidney disease, and incidence of age-related cataract.

To investigate the 15-year incidence of 3 specific types of age-related cataract as related to cystatin C and other measures of kidney function. Examinations of a population-based cohort (n = 4926) occurred at 5-year intervals for 15 years. Assessment of medical history, examination, and photographs of the lens after pupil dilation were performed at each examination. Protocols for photography and grading were used. Laboratory measures were from specimens collected at baseline. In multivariable analyses, a 1-SD increase in the logarithm of cystatin C was associated with 15-year incidence of cortical (odds ratio [OR], 1.24; 95% confidence interval [CI], 1.09-1.41) and posterior subcapsular (OR, 1.24; 95% CI, 1.02-1.50) cataracts. One SD increase in the logarithm of blood urea nitrogen and creatinine were associated with 15-year incidence of posterior subcapsular cataract (OR, 1.22; 95% CI, 1.04-1.42 and OR, 1.26; 95% CI, 1.03-1.54, respectively). Increased levels of cystatin C are associated with increased risk of specific types of age-related cataract. Whether the associations are due to the metabolic changes associated with decreased renal function, common genes, or both awaits further research.

Supplements and Age-Related Eye Conditions: The Beaver Dam Eye Study

To investigate the association of use of vitamin, mineral, and nonvitamin nonmineral supplements with common age-related eye diseases. Population-based prospective study with incidence data. Subjects were participants in the Beaver Dam Eye Study who contributed data in 1988 to 1990 (n = 4926), 1993 to 1995 (n = 3722), 1998 to 2000 (n = 2962), and 2003 to 2005 (n = 2375). Use of all medications and supplements were collected from study participants at each of 4 examinations. Intraocular pressure (IOP) measurement and fundus and lens photography were done at each visit. Visual field data are available only from baseline. Photographs of the lenses, retina, and discs were graded using standard protocols by trained graders. Incidence of age-related cataracts, macular degeneration (AMD), and high IOP for one set of analyses and incidence of supplement use for the second set of analyses. There was little evidence of any significant associations between supplement use and incident ocular outcomes except for a small protective effect for cortical cataracts by vitamins A and D, zinc, and multivitamins and increased odds of late AMD. Late AMD was associated with incident use of vitamins A, C, and E and zinc. Age-related macular degeneration seems to precede use of vitamins A, C, and E and zinc. This may reflect advice by family, friends, and health care providers about the benefits of Age-Related Eye Disease Study-like supplements.

Reduced Age-Related Cataracts Among Elderly Persons Who Reach Age 90 With Preserved Cognition: A Biomarker of Successful Aging?

Tissue damage due to oxidative stress has been implicated in aging, memory loss, and cataract formation. We hypothesized that persons who achieved exceptional longevity with preserved cognition (successful aging [SAG]) would exhibit a lower rate of age-related cataract (ARC) than the general population. The age-specific rates of ARC for a group of 100 (50 male, 50 female) elderly persons who reached at least age 90 years with preserved cognition were compared to the corresponding rates of ARC reported in five population-based studies. The principal finding of this report was that the SAG group manifested a significant reduction in the age-specific rate and lifetime cumulative incidence of ARC compared to the general population. Steroid use, alcohol consumption, gout, and skin lesions resulting from excessive sun exposure emerged as risk factors. Our findings suggest that the progressive development of lens opacities may be reflective of degenerative events occurring more generally throughout the body.

Dietary glycemic load and risk of age-related cataract

Metabolism of many of the most commonly consumed carbohydrates in the United States results in a high plasma glucose response, which can be quantified by the glycemic load. Although hyperglycemia is a risk factor for cataract, there is no information on the potential effect of a high dietary glycemic load on the incidence of age-related cataract. Our objective was to prospectively examine the association between dietary glycemic load and incident age-related cataract. We studied 2 cohorts-71 919 women and 39 926 men-aged > or =45 y who had no previous diagnosis of cataract, diabetes mellitus, or cancer and who were followed for 14 and 12 y, respectively, for the occurrence of cataract extraction. We calculated dietary glycemic load from data reported on multiple validated food-frequency questionnaires and used pooled logistic regression models to estimate the association with incident cataract extraction. We performed analyses separately for each cohort and then calculated pooled estimates across cohorts. During 980 683 person-years of follow-up, we confirmed 4865 incident age-related cataract extractions. After adjustment for age, cigarette smoking, body mass index, total caloric intake, dietary intake of lutein and zeaxanthin, and alcohol consumption, there was no significant relation of dietary glycemic load to risk of cataract extraction (P for trend = 0.10). The pooled relative risk between the highest and lowest quintiles of dietary glycemic load was 0.95 (95% CI: 0.81, 1.11; P for heterogeneity by cohort = 0.1). These prospective epidemiologic data do not support the hypothesis that a high dietary glycemic load, primarily a result of consumption of refined carbohydrates, increases the risk of cataract extraction.

Another Cinder in the Eye of the Marlboro Man

JAMA Smoking Cessation and Risk of Age-Related Cataract in Men <i>William G. Christen, ScD; Robert J. Glynn, ScD; Umed A. Ajani, MBBS; Debra A. Schaumberg, ScD; Julie E. Buring, ScD; Charles H. Hennekens, MD; JoAnn E. Manson, MD</i> JAMA .2000;284:713-716 <i>Corresponding author: William G. Christen, ScD, 900 Commonwealth Ave E, Boston, MA 02215-1204</i>. <h3>Context</h3> Although cigarette smoking has been shown to be a risk factor for age-related cataract, data are inconclusive on the risk of cataract in individuals who quit smoking. <h3>Objective</h3> To examine the association between smoking cessation and incidence of age-related cataract. <h3>Design</h3> Prospective cohort study conducted from 1982 through 1997, with an average follow-up of 13.6 years. <h3>Setting and Participants</h3> A total of 20 907 US male physicians participating in the Physicians' Health Study I who did not have a diagnosis of age-related cataract at baseline and had reported their level of smoking at baseline. <h3>Main Outcome Measures</h3> Incident age-related cataract defined as self-report confirmed by medical record review, diagnosed after study randomization and responsible for vision loss to 20/30 or worse, and surgical extraction of incident age-related cataract, in relation to smoking status and years since quitting smoking. <h3>Results</h3> At baseline, 11% were current smokers, 39% were past smokers, and 50% were never smokers. Average reported cumulative dose of smoking at baseline was approximately 2-fold greater in current than in past smokers (35.8 vs 20.5 pack-years). Two thousand seventy-four incident cases of age-related cataract and 1193 cataract extractions were confirmed during follow-up. Compared with current smokers, multivariate relative risks (RRs) of cataract in past smokers who quit smoking fewer than 10 years, 10 to fewer than 20 years, and 20 or more years before the study were 0.79 (95% confidence interval [CI], 0.64-0.98), 0.73 (95% CI, 0.61-0.88), and 0.74 (95% CI, 0.63-0.87), respectively, after adjustment for other risk factors for cataract and age at smoking inception. The RR for never smokers was 0.64 (95% CI, 0.54-0.76). The reduced risk in past smokers was principally due to a lower total cumulative dose (RR of cataract for increase of 10 pack-years of smoking, 1.07; 95% CI, 1.04-1.10). A benefit of stopping smoking independent of cumulative dose was suggested in some analyses. Results for cataract extraction were similar. <h3>Conclusion</h3> These prospective data indicate that while some smoking-related damage to the lens may be reversible, smoking cessation reduces the risk of cataract primarily by limiting total dose-related damage to the lens.

Reproductive exposures, incident age-related cataracts, and age-related maculopathy in women: the Beaver Dam Eye Study

PURPOSE: To evaluate the relationship of reproductive exposures and incident age-related cataract and maculopathy in women. METHODS: This was a population-based cohort study including all adults 43 to 84 years of age living in Beaver Dam, Wisconsin (a representative midwestern community) who were identified during a census in 1987 to 1988. They were evaluated initially in 1988 to 1990 and at follow-up in 1993 to 1995. Evaluations included medical histories and both fundus and lens photography. All procedures were done according to protocols that were the same at both examinations. All photographs were graded by trained observers using defined grading schemes. The severities of age-related cataracts and maculopathy were determined by grading of photographs. Information on hormone exposures was ascertained from structured interviews. RESULTS: After adjusting for age, the only significant finding for lens end points was a trend indicating a possible protective effect of increasing number of live births and incident posterior subcapsular cataract. There were no significant associations of any reproductive exposure with lesions of early or late age-related maculopathy. CONCLUSIONS: In these population-based data, there is little evidence of association of hormone exposures with incident age-related eye disease in women 5 years later. Longer follow-up of this population, whose mean age is approaching that of heightened incidence, may disclose significant relationships.