Risk Factors For Cataract Research Articles

Menopausal hormone therapy and the risk of cataract in postmenopausal women in South Korea

AbstractPurpose: Postmenopausal women have a higher prevalence of cataract than similar‐aged men. This study aimed to evaluate the effects of menopausal hormone therapy on lens opacity in postmenopausal women.Methods: This retrospective cohort study analysed population‐based health insurance data in South Korea collected from 2002 to 2019. To determine the risk factors associated with cataract, postmenopausal women (N = 2 506 271) were grouped according to postmenopausal hormone therapy use. The treatment group was further divided into the following subgroups: tibolone, combined oestrogen plus progestin by manufacturer, oral oestrogen, combined oestrogen plus progestin by physician, and topical oestrogen groups. The main outcome measure was the prevalence of cataract.Results: The control group comprised 463 151 postmenopausal women who had never used menopausal hormone therapy after menopause, while the treatment group included 228 033 postmenopausal women who had used menopausal hormone therapy continuously for at least 6 months. The treatment group had a higher incidence of cataract than the control group based on Cox proportional hazards ratio analysis. Low socioeconomic status and high parity were identified as risk factors for cataract, and reduced risk of cataract was associated with living in rural areas and drinking.Conclusions: Women undergoing postmenopausal hormone therapy, including tibolone, had a higher incidence of cataract than those who were not. Old age, low socioeconomic status, and high parity were risk factors for cataract. Our findings may help physicians identify postmenopausal women at a greater risk of developing cataract.

Predictors of Long-term Ophthalmic Complications after Closed Globe Injuries Using the IRIS® Registry (Intelligent Research in Sight)

To identify clinical factors associated with the need for future surgical intervention following closed globe ocular trauma. Retrospective cohort study. Patients in the American Academy of Ophthalmology Intelligent Research in Sight (IRIS®) Registry with a diagnosis of closed globe ocular trauma occurring between 2013 and 2019, identified using International Classification of Disease, 10th Revision and Systematized Nomenclature of Medicine codes. Diagnosis codes were used to identify multiple concomitant diagnoses present on the date of closed globe ocular trauma. Survival analyses were performed for each outcome of interest, and linear regression was used to identify clinical factors associated with the risk of surgical intervention. Outcomes included retinal break treatment, retinal detachment (RD) repair, retinal break treatment or RD repair, glaucoma surgery, and cataract surgery. Of the 206 807 patients with closed globe ocular trauma, 9648 underwent surgical intervention during the follow-up period (mean, 444 days): 1697 (0.8%) had RD repair, 1658 (0.8%) had retinal break treatment, 600 (0.3%) had glaucoma surgery, and 5693 (2.8%) had cataract surgery. Traumatic cataract was the strongest risk factor for cataract surgery (hazard ratio, 13.0; 95% confidence interval, 10.8-15.6), traumatic hyphema showed highest risk for glaucoma surgery (7.24; 4.60-11.4), and vitreous hemorrhage was the strongest risk factor for retinal break treatment and detachment repair (11.01; 9.18-13.2 and 14.2; 11.5-17.6, respectively) during the first 60 days after trauma date. Vitreous hemorrhage was a risk factor for cataract surgery at > 60 days after trauma date only. Iris-angle injury was the strongest risk factor for glaucoma surgery > 60 days after trauma, while vitreous hemorrhage remained the strongest factor for retinal break treatment and detachment repair at > 60 days. Traumatic hyphema was a risk factor for all surgical outcomes during all follow-up intervals. Diagnosis of concomitant traumatic cataract, vitreous hemorrhage, traumatic hyphema, and other risk factors may increase the likelihood of requiring surgical intervention after closed globe ocular trauma.

Radiation induced cataracts in interventionalists occupationally exposed to ionising radiation.

BackgroundOccupational exposure to ionising radiation may have detrimental health effects. Longer and more complex fluoroscopic procedures have placed interventionalists at increased occupational health risks especially for developing cataracts in the radiosensitive lenses of the eyes.ObjectivesThis study aimed to determine the prevalence of occupational related cataracts and describe the risk factors for cataracts in occupationally exposed interventionalists compared with unexposed doctors.MethodA cross-sectional study using multiple methods. A survey was conducted. The radiation workload was determined based on a self-administered questionnaire and dose area product values determined in previous studies. Both groups had slit lamp examinations. The data were analysed analytically using R software version 9.3.ResultsThe study included 98 interventionalists. The combined prevalence of posterior sub-capsular (PSC) and cortical cataracts was 18.8% in the exposed and 13.9% in the unexposed group. The prevalence of PSC cataracts in the exposed group was 5.9% and 2.8% in the unexposed group, with an odds ratio (OR) of 2.2 (95% confidence interval [CI]: 0.58; 8.61). Posterior sub-capsular cataracts were more common in the left eye. The increase in cataracts was not statistically significant in the exposed group but is of clinical significance.ConclusionThe findings are important as they highlight the need for greater vigilance for protecting the radiation healthcare workforce in a developing country setting.ContributionThe research is the first of its kind in South Africa and Africa and contributes to determining the prevalence in this highly skilled and occupationally vulnerable group.

Prevalence and Risk Factors for Adult Cataract in the Jingan District of Shanghai.

Purpose We report the prevalence of age-related cataract (ARC) in the Jingan district of Shanghai and analyze the risk factors for ARC to be better prepared for the increasing burden of cataracts as a significant cause of visual impairment worldwide. Methods From March to June 2010, a population-based, cross-sectional study was conducted in a community selected by stratified cluster sampling in the Jingan district of Shanghai. Residents aged 40 and older were recruited and investigated by questionnaires and ophthalmic examination. Univariate and multivariate logistic regression models were used to evaluate the association of these risk factors with any cataract. Results A total of 2894 subjects aged 40 years and above were included in our study. Nine hundred forty-eight people (32.8%) were diagnosed with cataract, including 845 with bilateral cataracts (29.2%) and 292 with moderate and severe visual impairment (low vision, 10.1%). There were significant differences in low vision among different age groups and gender (Χ2age = 84.420, Page < 0.001, Χ2gender = 7.696, Pgender = 0.021). For any cataract, we found age (OR = 1.107, 95% CI: 1.094–1.120) and refractive error (OR = 1.352, 95% CI: 1.127–1.622) were independent risk factors. Conclusion The prevalence of cataract is estimated to be nearly one-third of the sample, increasing with age. We provided further evidence that age and refractive error are independent cataract risk factors.

‏Impact of Food Habits on Cataract Development Among Adults in Aseer Region, Saudi Arabia: A Retrospective Study.

Background: Cataracts are the main cause of visual impairment among the aging population, with a high impact on patients’ quality of life. It has been suggested that the antioxidant carotenoids lutein and zeaxanthin may play a role in cataract prevention. Recently, significant evidence has associated abnormal glucose metabolism with an increased likelihood of the development of cataracts.Aim: The current study aims to assess the relationship between nutrition and cataracts among adults in the Aseer Region, Saudi Arabia.Methods: A retrospective study was conducted targeting all accessible patients diagnosed with cataracts at Aseer Central Hospital during the period from August 8, 2019, to March 3, 2021, and at Khamis Mushayt General Hospital during the period from June 11, 2018, to March 3, 2021. Data were collected using a pre-structured data collection sheet that covered patients’ socio-demographic data, including age, gender, education, work type, and marital status. Also, the type of cataract diagnosed for the study patients was recorded with associated risk factors of cataracts, including chronic diseases, trauma, eye surgery, and family history. The last section covered patients’ dietary habits and frequency of dietary intake. Results: A total of 140 patients with cataracts who fulfilled the inclusion criteria were included in the study. Patients' ages ranged from 21 to 65 years, with a mean age of 54.2 ± 12.9 years old. Additionally, 12.1% of the study patients were smokers, 44.3% were diagnosed with hypertension, and 45% were diabetic, which was type 1 diabetes mellitus (T1DM) among 36.5% and type 2 diabetes mellitus (T2DM) among 52.4%. A family history of congenital cataracts was reported among 12.9%, and 12.9% had a history of eye trauma. Moreover, 37.1% of the study patients had vegetables once per week. Eating fruits or having juice was reported as once per week among 40% of the study patients and three times per week among 20%. Finally, 31.4% take nutritional supplements or vitamins.Conclusion: There is currently an inquiry to endorse or exclude a specific diet or dietary intake that may reduce or even prevent the development and progression of cataracts. It appears beneficial for people to have some antioxidants in their daily food.

Commentary: Analyzing prevalence and risk factors of cataract: Its importance and effort.

The leading cause of avoidable blindness and the second-highest cause of visual impairment worldwide is cataract.[1] Therefore, it is important to understand the prevalence and risk factors of cataract in different parts of the world so as to reduce the same. Guo et al. in their study[2] have brought out well the importance of analyzing the prevalence of cataract. A comparison was made between the past and present prevalence of cataract in South East Asia, wherein they observed that the prevalence remained unchanged since 1990 despite an overall global reduction in cataract prevalence.[3] This indeed is an ironically striking feature because despite the overall advancement of eyecare facilities all over the world, the prevalence of cataract in South East Asia has remained unchanged over a period of 30 years, a difference well brought out.[2] As regards analysis of various risk factors, the authors have found no association of gender, diabetes mellitus, smoking, ocular trauma, and body mass index with cataract. On the other hand, increasing age, rural inhabitants, and hypertensive patients were associated with increased incidence of cataract. The authors have also compared well regarding the type of cataract and its association with the various risk factors: Patients with hypertension were associated with nuclear and cortical cataract whereas rural inhabitants had more frequently cortical cataract. This was compared with other East Asian countries as well. This kind of study definitely helps in understanding the burden of cataract in a particular region, which is an important cause of avoidable blindness. This further helps in better planning and management so as to reduce the prevalence of cataract. Like any other study, this study too has its own limitations, where sample size was calculated based on visual impairment rather than prevalence of cataract. Interestingly, the Vientiane study is first of its kind and paradoxically, there is no published data on the prevalence of cataract in the other neighboring countries of Thailand, Cambodia, Vietnam, or the Yunnan Province of China. This calls for more similar studies across the world especially so in the developing countries.

Prevalence and risk factors for cataracts in the Lao People's Democratic Republic: The Vientiane Eye Study.

Purpose:To determine the prevalence and risk factors for cataracts in the Vientiane Province.Methods:We conducted a population-based study of 1264 participants aged ≥40 years of age from urban and rural areas of Vientiane Province. Data collection included demographic information, smoking history, body mass index, blood pressure, history of trauma and dilated lens examination using the World Health Organization WHO Simplified Cataract Grading System. Aphakic and pseudophakic eyes were included as operated cataracts for statistical analysis.Results:The mean age of the 1264 participants was 57.6 years. The prevalence of any cataract including operated eyes was 46.8% (95% CI: 44.1 – 49.6%): 36.9% nuclear, 21.7% cortical and 10.1% posterior subcapsular cataracts.Conclusion:The prevalence of cataract in the Vientiane Eye Study is similar compared to the prevalence reported in other studies from Asian regions; however, the median age in this study was low, reflecting the age group of the population and the rapid urbanisation occurring in the Lao People’s Democratic Republic. A significant association for any cataract was found with elevated blood pressure >148mmHg (OR2.48, 95%CI:1.55 - 3.97, P < 0.01), increasing age (OR1.19, 95%CI:1.17 - 1.22, P < 0.001) and rural inhabitants for cortical cataract (OR1.99, 95%CI:1.37 - 2.90, P < 0.001). An inverse relationship between rural inhabitants with any cataract and nuclear cataract was found (OR 0.63, 95%CI: 0.45 – 0.89, P < 0.01 and OR 0.42, 95%CI: 0.31 - 0.59, P < 0.001) respectively.Nevertheless, cataract remains a high prevalence disease in this population.

Risk Factor Analysis of Early-Onset Cataracts in Taiwan.

Purpose: According to previous studies, the prevalence rate of cataracts has increased in recent years. This study aims to investigate and analyze the risk factors of early-onset cataracts in Taiwan. Methods: A total of 71 subjects aged between 20 and 55 were diagnosed with cataracts in a medical center. Participants were divided into three groups: control, early-onset cataract (EOC), and combined (EOC combined with dry eye) groups. Eye examinations including autorefraction, best-corrected visual acuity (BCVA), subjective refraction, axial length, fundus, slit lamp, and reactive oxygen species (ROS, including total antioxidative capacity, TAC; C-reactive protein, CRP; and glutathione peroxidase, GPx) were performed. In addition, a questionnaire on patient information, history, habits, family history, and Depression Anxiety Stress Scales (DASS) was completed before the examination. Results: 27 non-EOC (control group), 20 EOC, and 24 combined patients participated in the study. Compared with the control group, Body Mass Index (BMI), gender, educational level, hypertension, diabetes, hyperlipidemia, chronic pain, and body-related diseases were significantly different between the three groups. Family history was also significantly different: family heart disease, hypertension, asthma, allergies, stroke, and immune system were also significantly different. In addition, subjects who took hypertensive drugs, antihistamines, and other medications were also significantly different. Statistical analysis indicated that best corrective visual acuity and the spherical equivalent were significantly different between the three groups. Similar results were found in CRP blood analysis. Discussion and Conclusion: According to the results, EOC may result from systemic diseases. The risk corresponded to an increase in ROS blood analysis. Furthermore, eye drops and medicine intake significantly influenced EOC patients. To prevent or defer early-onset cataracts, monitoring physical health, CRP, and GPx analysis may be worth considering in the future.

Statin as a Risk Factor for Cataract in Cases of Antioxidant Gene Polymorphism in Pakistani Population

Introduction: Cataract is main cause of reversible blindness and visual impairment. Risk factors include anti-hyperlipidemic drugs such as statin. However, the mechanism of statins as a risk factor for cataracts is not clear. The antioxidant effect of statin is reported in some studies while other studies showed negative results. This study was conducted to understand the association of cataract in statin users with antioxidant gene abnormalities.&#x0D; Objective: To investigate the risk factor of statin in the formation of cataracts in the Pakistani population.&#x0D; Methods: This was a multi-centric case-control study in Karachi, Pakistan between September 2019 and 2020. A single nucleotide polymorphism (SNP) at rs2070424 locus for superoxide dismutase (SOD1) gene, at rs1050450 for glutathione peroxidase (GPX) and rs7943316 locus for catalase (CAT), were examined with polymerase chain reaction (PCR) using high resolution melting curve (HRM) technique in 250 cataract patients.&#x0D; Results: The risk ratio with statin was seen and found that it was 1.5 times increased in SOD1 gene mutations, the statin benefit was 1.2 times reduced in GPX gene mutation and ratio was 1.1 in the CAT gene mutations.&#x0D; Conclusion: Statin is a risk factor for cataracts in those patients who have mutated antioxidant genes. The risk ratio of cataracts was found to be increased in the mutated genes of patients compared with non-mutated ones. This study proved the effect of statin as a risk factor associated with antioxidant genes in the development of cataracts in the Pakistani population.

Preventing Cataracts with a Plant-Based Diet

The percentage of complications in cataract surgery, even if only 5%, the cost of surgery, whether borne by the patient or insurance, and the stress that any surgical procedure causes, makes prevention of primary importance. A plant-based diet reduces the risk of cataracts. In a British study risk reduction for cataract for low meat eaters was 15%, 21% for fish eaters, 30% for vegetarians and 40% for vegans. In a Taiwanese study, a vegetarian diet reduced the risk of cataract by 30%. This may be partly explained by the greatly reduced risk of type 2 diabetes in vegans. Diabetes is a risk factor for cataracts. Vegans also have a much lower risk of hypercholesterolemia, another risk factor for cataracts. Contributing to the reduced risk of cataracts in vegans is the increased intake of antioxidants including lutein and zeaxanthin, which some studies show reduces the risk of cataracts. On average, plant foods provide 11.57 mmol/100gm antioxidant content, while animal foods provide only on average 0.18mmol/100gm. Prophylaxis with a vegan diet has no adverse effects or contraindications and treats common comorbidities including type 2 diabetes and hypercholesterolemia.

The association between bariatric surgery and cataract: a propensity score-matched cohort study

Obesity is considered a risk factor for cataracts. The association between weight loss and a cataract among patients with obesity has not been assessed to date.To assess the association between weight loss following bariatric surgery and cataracts.Nationwide Swedish healthcare registries between 2006 and 2019.We performed a population-based cohort study. Patients aged 40-79 years who underwent bariatric surgery were matched on their propensity score (PS) to up to 2 patients with obesity ("unexposed patients"). Cox proportional hazard regression analyses calculated hazard ratios (HRs) and 95% confidence intervals (CIs) of developing cataracts following bariatric surgery, compared with unexposed patients. Subgroup analyses by age, sex, bariatric surgery type, and duration of follow-up were conducted.In total, 22,560 bariatric surgery patients were PS-matched to 35,523 unexposed patients. The risk of cataracts was decreased in bariatric surgery patients compared with unexposed patients (HR .71, 95% CI .66-.76). We observed the lowest risk of cataracts among bariatric surgery patients aged 40-49 years (HR .52, 95% CI .44-.75) but a null result for patients aged ≥60 years. Gastric bypass or duodenal switch were associated with decreased risks of cataracts, whereas sleeve gastrectomy yielded a null result. Subgroups of sex and duration of follow-up showed no evidence of effect modification (hazards were proportional throughout follow-up).Our results suggest that substantial weight loss following bariatric surgery is associated with a decreased risk of cataracts, especially if bariatric surgery was performed before age 60.

Marijuana smoking and cataract

Cigarette smoking is a well-known risk factor for cataract and other ailments, including heart disease, lung cancer, and chronic obstructive pulmonary disease. Cannabis smoke, like tobacco smoke, contains a comparable variety of carcinogenic and toxic compounds. In the present study, we analyzed UK Biobank data to determine whether smoking cannabis, like cigarettes, might be related to cataract. Our analysis included all UK Biobank subjects with cataracts and information on cannabis and cigarette smoking habits. The diagnosis of cataract was ascertained using the 10th Revision of the International Classification of Diseases (ICD10), H25. The age at diagnosis of cataract was obtained from UK Biobank data field 4700. Cannabis information was recorded in UK Biobank category 143, data field 20453, ever taken cannabis. Subjects who used cannabis 11-100 times or more were significantly younger (4-5 years) when they developed cataract than subjects who never used cannabis. To determine the relationship of current cigarette smoking to cannabis use and age at cataract, the univariate general linear model of SPSS was used, dependent variable age at cataract, fixed factor cannabis use, random factor pack years of cigarettes smoked. Cannabis use was significantly related to age at cataract diagnosis (P<0.001) and independent of the effect of pack-years of cigarettes smoked (P=0.008). Linear regression revealed an insignificant relationship between pack-years of cigarette smoking and age at cataract diagnosis (P=0.073). To further evaluate the relationship of cannabis to cataract, propensity score matching was performed. We identified 28,432 subjects with cataract. Current cigarette smoking and age were covariates;cannabis use (yes/no) was the indicator variable.Current cigarette smoking was significantly associated with a 1.2 odds ratio for cataract. Cannabis use was not significantly associated with the odds ratio for cataract. Like tobacco smoke, cannabis smoke contains thousands of organic and inorganic chemical compounds. Cannabis tar is chemically similar to tar found in tobacco smoke, and over fifty known carcinogens have been identified in cannabis smoke, including nitrosamines, reactive aldehydes, and polycyclic hydrocarbons. Thus, the association of cannabis with cataract that we report here is not entirely surprising. Further studies are warranted.

Opium Use and the Risk of Cataract: a Hospital-based, Group-matched, Case–control Study in Iran

ABSTRACT Purpose Cataract is the most prevalent cause of reversible blindness worldwide. Although studies have identified risk factors for cataract, its association with opium use has not been studied. This study aimed to evaluate the association between opium use and cataract in Iran in 2020. Methods In a hospital-based, group-matched case–control study in Kerman, a city in southeast Iran, 160 new cases of cataract and 320 controls without cataract underwent ophthalmological examination and were interviewed. Logistic regression models tested the association between cataract and history of opium use, adjusting for demographic characteristics and history of hypertension, coronary heart disease, renal disease, smoking, alcohol use, and unprotected sun exposure. Results After controlling for potential confounders, opium use increased the odds of cataract, exhibiting a dose–response relationship. The adjusted odds ratio (aOR) for mild use was 1.44 (95% confidence intervals [CI] 0.80–2.58), and 2.10 (95% CI 1.04–4.25) for heavy use. Exposure to opium juice use further increased the odds of cataract (aOR 2.24, 95% CI 1.00–5.10). Other significant associations with cataract were lower education level (aOR 5.46, 95% CI 2.45–11.29), being unmarried (aOR 2.88, 95% CI 1.65–5.00), both underweight (BMI <18.5, aOR 5.27, 95% CI 2.02–13.70) and overweight (BMI >25, aOR 1.82, 95% CI 1.15–2.87), and family history of cataract (aOR 2.07, 95% CI 1.32–3.23). Conclusion Our study provides evidence that opium use could increase the odds of cataract. Results also support the association of cataract with other modifiable risk factors, such as very low and high BMI and unprotected sun exposure.

Association of single nucleotide polymorphism variations in CRYAA and CRYAB genes with congenital cataract in Pakistani population

BackgroundThe purpose of present study was to analyze the association of single nucleotide polymorphism (SNPs) variant in CRYAA and CRYAB genes with Congenital Cataract. MethodTotal 196 blood samples of children were collected, out of which 102 samples were congenital cataract (case group) and 94 samples were normal individuals (control group). Genomic DNA was extracted by using optimized inorganic method. Tetra primers for SNPs were designed and TETRA-ARMs assay was performed on both groups. Genotypic, allelic frequency and haplotype analyses were obtained by using SNPstats software. ResultsThe coordination of genotypic and allelic frequencies of CRYAA and CRYAB genes variants and the association between case and control groups showed increased risk of congenital cataract in children who contained rs13053109 G > C variant of CRYAA in all models (all P > 0.05). This depicts the evident difference between the frequencies of case and control groups. The haplotype analysis of SNPs rs3761382, rs7278468 and rs13051039 of CRYAA gene showed weak linkage disequilibrium between the 3 SNPs (r2 < 0.8). The haplotype CTC indicated the high risk of congenital cataract in infants based of its p value (OR = 1.60 95% CI = 0.11–22.64, P > 0.05). ConclusionThe variation in CRYAA gene can be the risk factor for congenital cataract in infants.

Glutathione Peroxidase and Catalase Gene Polymorphism in Pakistani Cataract Patients

Introduction: Cataract is the major cause of blindness and visual impairment. Although there are several reasons for the generation of cataract, however, most of the cases are due to inter-individual genetic variations in antioxidant genes. Many studies have been conducted for the understanding of the role of reactive oxygen species (ROS) in the regulation of cataract. However, the study of single nucleotide polymorphisms (SNP) of the Glutathione peroxidase gene and Catalase gene and its association with cataract is still lacking in the Pakistani population. Objective: To investigate the relationship between GPX and CAT gene variations and the development of Cataract in Pakistani cataract patients. Methods: This was a case-control study carried out at different centres in Karachi, Pakistan between September 2019 and 2020. A single nucleotide polymorphism (SNP) at rs1050450 for GPX and rs7943316locus for Catalase gene mutations was examined with polymerase chain reaction (PCR) using high resolution melting curve (HRM) technique in 250 cataract patients and 250 healthy control groups of similar age. Results: We detected the ratio of SNP in GPX gene in cataract patientsis higher than in control (OR: 1.8, 95% CI) while there is no significant difference in CAT gene between cataract and control participants. Conclusion: Our findings indicate potential genetic variations in antioxidant genes particularly GPX and CAT genes polymorphisms as risk factors for cataract. This is study the first studyto report the antioxidant SNPs associated with the developmentof cataract in the Pakistani population.

Incidence and Predictors of Cataract among People with Type 2 Diabetes Mellitus: Using Secondary Data Analysis from the Ansan Cohort of the Korean Genome and Epidemiology Study.

This study investigated the incidence and risk factors of cataract in people with diabetes mellitus (DM) using data from Ansan cohort of the Korean Genome and Epidemiology Study (KoGES). Data from a total of 329 patients with type 2 DM without cataract who participated in Ansan cohort of the KoGES from baseline survey (2001-2002) to fifth follow-up visit (2011-2012) were examined. The characteristics of the subjects were analyzed with frequency and percentage, and mean and standard deviation. Cataract incidence was measured as incidence proportion (%). For risk factors of cataract, hazard ratio (HR) and 95% confidence interval (CI) were obtained using the Cox proportional hazard model. The cataract incidence over a 10-year follow-up period was 19.1% (15.1 in males and 25.8 in females), and mean age at the incidence of cataract was 63.48 years (61.58 years in males and 65.31 years in females). Age (HR=1.09, 95% CI=1.05-1.13) and HbA1c (HR=1.21, 95% CI=1.07-1.37) or the duration of DM (HR=1.05, 95% CI=1.00-1.09) were found to be independently associated with cataract development. Cataract development in people with DM is common, and its likelihood increases with age, HbA1c, and the duration of DM. Considering negative effect of cataract on their quality of life and economic burden, nurses should identify people with DM at a higher risk of cataract development, and plan individual eye examination programs to detect cataract development as early as possible.

РАЗРАБОТКА РИСК-ОРИЕНТИРОВАННОГО ПОДХОДА В ПРОФИЛАКТИКЕ СТАРЧЕСКОЙ КАТАРАКТЫ НА ОСНОВЕ КОМОРБИДНОЙ ПАТОЛОГИИ

Significance. Cataracts are the second most common cause of low vision and blindness. In this regard, development of a new analytical approach is required to optimize algorithms of preventive measures. The purpose of the study is to develop a method of screening diagnostics of age-related cataract among people aged 40-99, based on comorbid pathology, as well as an algorithm for stratification into target groups depending of the risk for senile cataract development. Material and methods. The study is based on information extracted from electronic medical records (EMRs) of patients aged 40-99 residing in Tambov and assigned to the city polyclinic (n=38328). The technique was developed using a binary logistic regression analysis with a step-by-step algorithm for including variables, where age-related cataract acted as the dependent variable, and age-related cataract risk factors associated with chronic diseases were used as independent variables. The models were compared by building ROC curves with calculations of the area under the curve (AUC). Results. A screening technique has been developed to identify individuals at high risk for developing age-related cataract among people aged 40 -99 based on data on chronic diseases associated with age-related cataract, including hypertension, coronary heart disease, cerebrovascular diseases, varicose veins of the lower extremities, and diabetes mellitus, taking into account age standardization. Data on the level of risk for developing age-related cataract made it possible to develop an algorithm for stratifying population into target groups, depending on the required level of sensitivity and specificity. Conclusion. Based on the data on cardiometabolic diseases associated with age-related cataract, a methodology was developed that allows to establish the risk level for developing age-related cataract among people aged 40-99, and an algorithm for stratification into target groups. Scope of application. The acquired knowledge can be used in the process of developing differentiated measures of primary prevention of age-related cataract, taking into account target groups and the established modifiable risk factors.

Proteomic Analysis of Aqueous Humor Proteins in Association with Cataract Risks: Diabetes and Smoking.

Cataracts are one of the most common eye diseases that can cause blindness. Discovering susceptibility factors in the proteome that contribute to cataract development would be helpful in gaining new insights in the molecular mechanisms of the cataract process. We used label-free nanoflow ultra-high-performance liquid chromatography–tandem mass spectrometry to compare aqueous humor protein expressions in cataract patients with different cataract risk factors such as diabetes mellitus (DM) and smoking and in controls (with cataract) without risk exposure. Eight patients with diabetes and who smoked (with double risk factors), five patients with diabetes and five patients who smoked (both with a single risk factor), and nine aged-matched cataract controls patients (non-risk exposure) were enrolled. In total, 136 aqueous humor proteins were identified, of which only alpha-2-Heremans–Schmid (HS)-glycoprotein was considered to be significantly risk-associated because it was differentially expressed in these three groups and exhibited increased expression with increasing risk factors. Significant changes in the aqueous humor level of alpha-2-HS-glycoprotein between DM and control samples and between smoking and control samples were confirmed using ELISA. The alpha-2-HS-glycoprotein, called fetuin-a, could be a potential aqueous biomarker associated with DM and smoking, which were cataract risk factors.

Senile Cataract in Patients with Diabetes with and Without Diabetic Retinopathy: A Community-Based Comparative Study

AimWe compare the incidence rates of cataract in persons with diabetes with and without diabetic retinopathy in Saudi Arabia, for the first time. In addition, we explored the role of new factor, diabetes age of onset and several other known factors.MethodsIn a community-based cross-sectional study, 334 persons with diabetes type 2 were randomly selected from a diabetic register. Detailed history and comprehensive ophthalmic examination was done at an eye clinic. Body Mass Index, blood pressure and glycosylated hemoglobin were also recorded.ResultsIn 668 eyes, cataract and diabetic retinopathy were present in 35.5% and 32.2%, respectively. Diabetic retinopathy, age, duration of diabetes and systolic BP were found to be independent risk factors for cataract. Whereas, gender, BMI, HbA1c use of insulin and diastolic BP have no significant association with cataract. Persons with cataract had significantly higher age of onset of diabetes. Most of the cataracts were cortical followed by PSC, while minority were nuclear.ConclusionDR is an independent risk factor of developing cataract in persons with diabetes. Others are age, duration of DM and hypertension. Age-of-onset of DM is a new factor we report it to be significantly associated with cataract.

Descriptive and risk factor analysis of infantile cataracts: National Birth Defects Prevention Study, 2000-2011.

Using National Birth Defects Prevention Study (NBDPS) data, we sought to estimate birth prevalence, describe clinical characteristics, and examine risk factors for infantile cataracts. We calculated birth prevalence using the numbers of NBDPS-eligible cataract cases and live births in the study area. We described case infants by the presence of associated ipsilateral eye defects (IEDs) and non-eye-related major birth defects. Using maternal exposure information collected via telephone interview, we conducted logistic regression analyses among the interviewed cases and controls. Birth prevalence of infantile cataracts was 1.07/10,000 live births. Unilateral cataracts were more often associated with IEDs, while infants with bilateral cataracts were more often preterm, full-term with low birth weight, or had non-eye-related major birth defects. Unilateral cataracts were positively associated with maternal nulliparity (adjusted odds ratio [aOR]=1.61, 95% confidence interval [CI]=1.18, 2.20; reference: multiparity), whereas bilateral cataracts were positively associated with maternal education <12 years (aOR=2.08, 95% CI=1.13, 3.82; reference: education >12 years), and foreign-born nativity (aOR=1.92, 95% CI=1.04, 3.52; reference: U.S.-born nativity). The current analysis can inform future epidemiological studies aimed at identifying mechanisms underlying the associations between infantile cataracts and complex maternal exposures, such as lower levels of education and foreign-born nativity.