Risk Factors For Cataract Research Articles

Cohen Syndrome-Associated Cataract Is Explained by VPS13B Functions in Lens Homeostasis and Is Modified by Additional Genetic Factors.

PurposeCohen syndrome (CS) is a rare genetic disorder caused by variants of the VPS13B gene. CS patients are affected with a severe form of retinal dystrophy, and in several cases cataracts also develop. The purpose of this study was to investigate the mechanisms and risk factors for cataract in CS, as well as to report on cataract surgeries in CS patients.MethodsTo understand how VPS13B is associated with visual impairments in CS, we generated the Vps13b∆Ex3/∆Ex3 mouse model. Mice from 1 to 3 months of age were followed by ophthalmoscopy and slit-lamp examinations. Phenotypes were investigated by histology, immunohistochemistry, and western blot. Literature analysis was performed to determine specific characteristic features of cataract in CS and to identify potential genotype–phenotype correlations.ResultsCataracts rapidly developed in 2-month-old knockout mice and were present in almost all lenses at 3 months. Eye fundi appeared normal until cataract development. Lens immunostaining revealed that cataract formation was associated with the appearance of large vacuoles in the cortical area, epithelial–mesenchymal transition, and fibrosis. In later stages, cataracts became hypermature, leading to profound retinal remodeling due to inflammatory events. Literature analysis showed that CS-related cataracts display specific features compared to other forms of retinitis pigmentosa-related cataracts, and their onset is modified by additional genetic factors. Corroboratively, we were able to isolate a subline of the Vps13b∆Ex3/∆Ex3 model with delayed cataract onset.ConclusionsVPS13B participates in lens homeostasis, and the CS-related cataract development dynamic is linked to additional genetic factors.

Prevalence and risk factors for age-related cataract in Sweden

Background Cataract is a major cause of visual impairment worldwide. There is a paucity of prevalence studies from Sweden. Therefore, we report the prevalence of cataract and its risk factors in a population-based study of older adults in Sweden. Methods The Tierp Glaucoma Survey was conducted in the municipality of Tierp, Sweden, including 760 subjects aged 65–74 years. The presence of cataract was determined based on retroillumination, with lens opacities evident on slit-lamp examination. To assess risk factors for cataract, odds ratios (ORs) were calculated, adjusted for age and gender. Results A total of 234 individuals were found to have cataract, 12 of whom had undergone cataract surgery. The prevalence adjusted for nonparticipation was 31.5% (95% confidence interval [CI] 29.4–33.6), 35.2% (95% CI 28.7–41.8) in females and 26.2% (95% CI 19.8–32.6) in males. Cataract was associated with age ≥70 years (OR 1.93; 95% CI 1.41–2.64), female gender (OR 1.54; 95% CI 1.12–2.11), and myopia (OR 2.3; 95% CI 1.16–3.56), while pseudoexfoliation, smoking, diabetes, hypertension, and ischaemic heart disease were not. Conclusion Nearly one-third of the sample were estimated to have lens opacities, or had undergone cataract surgery, making cataract a frequent disorder of older age. The study provided further evidence that increasing age, female gender, and myopia are associated with cataract.

Impact of tobacco use on oxidative stress in cataract

Even today, the leading cause of visual impairment is age related cataract. Among the risk factors for cataract, tobacco is one of the modifiable risk factors. Association between smoking and increased oxidative stress among cataract patients has been shown by some studies. But studies related to smokeless tobacco use are not done. The aim of the study was to estimate oxidative stress by markers like enzymatic antioxidant Superoxide Dismutase (SOD) and lipid peroxiation product Malondialdehyde (MDA) in tobacco user age related cataract (ARC) subjects and compare them with tobacco nonuser age related cataract (ARC) subjects. This cross sectional study was performed in 120 subjects divided into 2 groups – 60 tobacco nonuser age related cataract subjects and 60 tobacco user age related cataract subjects. 60 tobacco user cataract subjects divided into 5 groups - tobacco smokers, tobacco chewers, tobacco mishri users, dual tobacco chewers with mishri users and dual smokers with smokeless tobacco users. Oxidative stress was assessed by estimation of erythrocytic SOD and serum MDA. The study showed that in tobacco user group age of cataract patients was significantly less than tobacco nonuser cataract patients (P<0.05). Serum MDA levels were significantly high and erythrocytic SOD levels were significantly low in tobacco user cataract patients than tobacco nonuser cataract patients (P<0.001). Nuclear cataract was significantly more in tobacco user group (P<0.05). On comparison of subtypes of cataract in tobacco user subgroup, no significant difference was found. These results suggested that age related Cataract occurs at an earlier age in tobacco users due to increased oxidative stress. Also nuclear cataract was significantly associated with tobacco use.

Incidence, progression and risk factors of age-related cataract in Malays: The Singapore Malay Eye Study.

Long-term data on age-related cataract, a leading cause of blindness and visual impairment, is scarce in Asian populations. We report the 6-year incidence and progression of age-related cataract and associated risk factors in Malay adults living in Singapore. Population-based cohort study. A total of 3280 Malays aged 40+ years participated in baseline examinations of the Singapore Malay Eye Study (2004-2006). Six years later, 1901 (72.1% of eligible) baseline participants were re-examined. Cataract was assessed using lens photos, taken during eye examinations, following the Wisconsin Cataract Grading System. Incidence and progression of cortical, nuclear and posterior subcapsular (PSC) cataract. Poisson regression models and generalized estimating equations models (with Poisson link) were used to assess factors associated with cataract incidence and progression, respectively, adjusting for age, sex and other risk factors. Age-adjusted 6-year incidence of cortical, nuclear and PSC cataract was 14.1%, 13.6% and 8.7%, respectively, and was strongly age-related (P for trend <.001 for all types). Diabetes (relative risk [RR], 1.97; 95% confidence intervals [CI], 1.46-2.67) was associated with incident cortical cataract, hypertension was associated with PSC cataract incidence (RR, 2.09; 95% CI, 1.22-3.61), after multivariable adjustment. Progression occurred in 20.4%, 5.9% and 40.6% of baseline cortical, nuclear and PSC cataract cases, respectively. Similar to other elderly populations, incidence and progression of cataract were common in this Malay population. Diabetes and hypertension were important modifiable risk factors for cataract, highlighting the importance of systemic health on eye disease.

Prevalence and risk factors on age-related cataract and surgery in adults over 50 years old in Binhu District, Wuxi, China.

To investigate the prevalence and risk factors of age-related cataract (ARC), ARC surgery procedures, and postoperative vision results among adults over 50 years old in the Binhu District of Wuxi City, China. Thirty basic sampling units were analyzed via a cluster random sampling method. Detailed medical histories were collected and eye examinations were performed. Cataract prevalence and surgical procedures were quantified. Among the 6150 participants, 1421 cataract cases were diagnosed and prevalence was 23.1%. The prevalence of cortical, nuclear, and posterior subcapsular cataracts increased with age (P<0.001). Cataract prevalence was significantly higher among elderly, female, or illiterate individuals and people with hypertension, diabetes, and a history of smoking and drinking (all P<0.05). As participant age increased and education level decreased, the frequency of cataract blindness surgeries gradually decreased, but without statistical significance within groups (P>0.05). The odds ratio of cataract patients who had or did not have cataract surgery was 3.15 (87/28) and the frequency of cataract blindness surgery was 75.7% (87/115). Poor visual outcomes was in 107 eyes (40.7%) after cataract surgery. Poor vision was mostly caused by uncorrected reflective errors (30.9%) and ocular comorbidities (41.1%). The prevalence of cataract surgery complications was 5.7% (15/263). Surgical complications and posterior capsular opacification were avoidable factors facilitating poor vision. ARC, especially in females and illiterate individuals, presents a public health problem in this district. Poor visual outcomes after cataract surgery are frequent. High-quality cataract surgeries and treatment of ocular comorbidities are vital.

Association of adjuvant aromatase inhibitor with cataract risk in postmenopausal women with breast cancer.

BackgroundAromatase inhibitor (AI) is a cornerstone drug for endocrine therapy of postmenopausal hormone receptor-positive breast cancer. The relationship between AI medication and subsequent cataract risk is yet inconclusive.MethodsA total of 1,697 postmenopausal, early-staged, and hormone receptor-positive breast cancer patients from the prospectively-maintained database of the Breast Surgery Department at Fudan University Shanghai Cancer Center were included, with 542 patients received no endocrine therapy and 1,155 treated with AI only. We explored the influence the use of AI or not and the duration of AI on the subsequent incidence of cataract.ResultsA total of 146 (8.6%) cataracts were observed in the whole study population. The incidence of cataract is highly related to age, with incidence of cataract in patients <50 years old, 50–60 years, ≥60 years was 2.9%, 6.9%, and 13.3%, respectively (P<0.001). There was no significant relationship between adjuvant AI use and cataract (7.4% in no endocrine group vs. 9.2% in the AI group) with an adjusted hazard ratio of 1.20 (95% confidence interval: 0.8–1.7, P=0.30). The incidence of cataract in patients with long-term AI (more than 5 years) could be high up to 14.7%, but without statistical significance compared to those the shorter duration (P=0.52).ConclusionsThere is no significant association between use of AI and cataract in postmenopausal breast cancer patients. Of note, age is an important risk factor for cataract and it is necessary to surveil the eye health in postmenopausal elderly women.

Audit of 1000 consecutive cases of sutureless cataract surgery in children above two years of age

Purpose:To study the safety of sutureless cataract surgery and risk factors for wound leak of clear corneal incision in children affected with congenital or developmental cataract.Methods:It is a retrospective, noncomparative interventional case study involving children in the age group of 2 to 16 years, who underwent cataract surgery with intraocular lens implantation with the minimum follow up of 1 month.Results:Out of 1000 eyes studied, lens matter aspiration with intraocular lens implantation with or without primary posterior capsulorhexis and anterior vitrectomy was done in 609 and 391 eyes, respectively. Incisions of 943 eyes did not require sutures while sutures were applied for wound leak in 57 eyes on the table and in 5 eyes on postoperative day 1. Risk of wound leak for suture application was found to be greater in patients; having age less than 5 years (P < 0.0001), surgeries performed by junior surgeons (P < 0.0003), wound problems (P < 0.0001), intraocular lens (IOL) related factors (P < 0.0001), use of iris hooks (P < 0.0001), and anterior capsulorhexis extension (P < 0.0001). On the first postoperative day, anterior chamber reaction (P < 0.0001) and fibrinous membrane (P = 0.0007) were significantly more in the sutured group. Incidence of postoperative complications was 0.98 per sutured eyes (59 complications in 60 eyes). One patient developed endophthalmitis after suture removal.Conclusion:Sutureless clear corneal incision in pediatric patients undergoing cataract surgery can achieve stable wound. However, after hydro closure, every wound should be checked for water tightness and the leaky wound should be sutured.

Occupational radiation exposure and excess additive risk of cataract incidence in a cohort of US radiologic technologists

ObjectivesPrevious analyses of cataract in radiation-exposed populations have assessed relative risk; radiogenic excess additive risk (EAR), arguably of more public health importance, has not been estimated. Previous analysis of a...

Philadelphia Telemedicine Glaucoma Detection and Follow-Up Study: Cataract Classifications Following Eye Screening.

Background:Cataracts are a major cause of visual impairment and blindness in the United States and worldwide.Introduction:Risk factors for cataracts include age over 40 years, smoking, diabetes, low socioeconomic status, female sex, steroid use, ocular trauma, genetic factors, and exposure to ultraviolet-B light. Community-based telemedicine vision screenings can be an efficient method for detecting cataracts in underserved populations. The Philadelphia Telemedicine Glaucoma Detection and Follow-Up Study reports the prevalence and risk factors for cataracts in individuals screened and examined for glaucoma and other eye diseases.Materials and Methods:A total of 906 high-risk individuals were screened for glaucoma using telemedicine in seven primary care practices and four Federally Qualified Health Centers in Philadelphia. Participants with suspicious nerves or other abnormalities on fundus photographs, unreadable images, and ocular hypertension returned for an eye examination with an ophthalmologist at the same community location.Results:Of the participants screened through telemedicine, 347 (38.3%) completed a follow-up eye examination by an ophthalmologist. Of these, 267 (76.9%) were diagnosed with cataracts, of which 38 (14.2%) had visually significant cataracts. Participants who were diagnosed with visually significant cataract were more likely to be older (p < 0.001), have diabetes (p = 0.003), and worse visual acuity (p < 0.001).Discussion:Our study successfully detected and confirmed cataracts in a targeted, underserved urban population at high risk for eye disease.Conclusions:Telemedicine programs offer an opportunity to identify and refer individuals who would benefit from continuous follow-up eye care and treatment to improve visual function and quality of life.

No Increased Risk of Cataract in Immune Thrombocytopenia Adult Patients Treated with Eltrombopag. a French Nationwide Nested Case-Control Study

Background: In preclinical studies, eltrombopag has been associated to an increased incidence of cataract in mice and rats. No increased risk has been observed in randomized controlled trials in immune thrombocytopenia (ITP) patients. During the eltrombopag extension study EXTEND, 28/302 patients developed or worsened cataract, i.e. 9.3% of the patients over a median duration of exposure of 2.4 years. Of note, 79% of these 28 patients had at least another risk factor of cataract. Real-life studies assessing the risk of cataract in ITP adult patients exposed to eltrombopag are lacking. Aim: To assess the risk of cataract with eltrombopag in a nationwide cohort of primary ITP adults. Methods: The population was the cohort of all incident primary ITP adult patients (≥18 years) in France from June 2010 (date of eltrombopag marketing in France) to June 2017. This cohort was identified within the national health insurance database using a validated algorithm combining drug exposures and international classification of diseases, version 10 (ICD-10) diagnosis codes (FAITH cohort; NCT03429660). A nested case-control study was conducted within the cohort. Cases were patients who had a surgery for cataract after ITP onset, identified using appropriate codes. Up to five controls for each case were matched on age and sex. Index date was the date of cataract surgery for cases, and the date of cataract surgery of the corresponding case for controls. Two analyses were conducted: one considering the exposure to eltrombopag as ever vs. never exposed; another considering the cumulative exposure to eltrombopag, categorized by never exposed, a 1-365 Defined Daily Dose (DDD) exposure, and a ≥365 DDD exposure. Covariables were the presence of diabetes mellitus, cumulative exposure to corticosteroids considered in prednisone equivalence dosage (by quartiles), and the presence of ophthalmological risk factors of cataract (including previous ophthalmological surgery, glaucoma and other anterior chamber risk factors). Conditional logistic regression models were used to compute adjusted odds ratios (aOR) and their 95% confidence intervals (CI). Results: The cohort included 8,502 incident primary ITP adults. During the follow-up (31,590 patient-years in total; mean follow-up: 44.4 months), 1,097 patients were exposed to eltrombopag, including 310 with a cumulative exposure ≥365 DDDs. Overall, 573 patients had a surgery of cataract; incidence: 1.90/100 person-years (95% CI: 1.75-2.06). Fifty-seven cases occurred in patients ever exposed to eltrombopag; incidence: 1.50/100 person-years (95%CI: 1.15-1.94) in this subgroup. The nested case-control study included the 573 cases and 2699 controls. Median age was 75 years and 50% were women; the median duration of disease was 24.8 months in cases and 24.2 months in controls; 57 (9.9%) cases and 314 (11.6%) controls were exposed to eltrombopag before the index date; 14 (2.4%) and 68 (2.5%) patients had cumulative exposure to eltrombopag ≥365 DDDs, respectively. Cases were more frequently exposed to corticosteroids (83.4% vs. 75.7%), with a higher cumulative exposure to corticosteroids (median: 2800 vs. 2188 mg prednisone equivalent). Diabetes mellitus was present in 25.7% of cases vs. 25.1% of controls while ophthalmological risk factors were present in 5.4% and 2.8%, respectively. In the ever/never exposed analysis, the aOR for eltrombopag was 0.79 (95% CI: 0.58-1.07). In the cumulative exposure analysis, the aOR was 0.76 (95% CI: 0.54-1.08) in the 1-365 DDD group as compared with the never exposed group, and 0.88 (95% CI: 0.49-1.59) in the ≥365 DDD group as compared with the never exposed group. Conclusions: This nationwide pharmacoepidemiological study did not identify an increased risk of cataract in primary ITP adult patients exposed to eltrombopag. Disclosures Moulis: Novartis pharma: Research Funding, Speakers Bureau; Amgen pharma: Research Funding, Speakers Bureau; CSL Behring: Research Funding.

Ophthalmic manifestations of ionising radiation among interventionalists

Background: Ionising radiation (IR) is an occupational hazard for interventionalists. Dry eye syndrome may develop. There may be damage to the corneal epithelium, causing irritation and ulceration. Radiation-induced cataracts commonly develop in the posterior sub-capsular (PSC) region of the lens and are more common in the left eye.Aim: The aim of this study was to describe the ophthalmological findings in South African interventionalists occupationally exposed to IR.Setting: This study was conducted in South Africa.Methods: A prospective cross-sectional study was conducted. Interventional radiologists (25), adult cardiologists (42) and paediatric cardiologists (31) were recruited at conferences and included in the study. Convenience sampling was used. Participants completed a survey that collected data on their demographics, their cataract risk factors and co-morbid diseases, their occupational history, their radiation safety practices and their training in occupational history. Participants’ eyes were examined using a slit lamp after dilation of the eyes. Ethics clearance was obtained and each participant gave informed consent. A descriptive analysis was done.Results: The median age of the 98 interventionalists screened was 43.5 years. They worked with radiation for a median of 7.5 years. Cataracts occurred in the left eye of 17 (17.3%) participants and in the right eye of nine (9.2%). There were five (5.1%) PSC cataracts in the left eye and one (1%) in the right eye. The vitreous was abnormal in 19.4% of participants. The tear break-up time was abnormal in 48% of participants.Conclusion: Ionising radiation is an occupational hazard posing a risk to interventionalists’ eyes. They are at increased risk of cataracts and dry eye syndrome, which can affect their occupational performance and quality of life. Education can positively influence the radiation safety practices of interventionalists that could reduce the detrimental effects of IR on their eyes.

Cataracts Risk Factors and Comparison of Blood Glucose Levels in Diabetic and Non-Diabetic Patients towards the Occurrence of Cataracts.

BACKGROUND:Cataracts are a multifactorial systemic disease that causes opacity of the optical lens. One aetiology of cataracts is chronic hyperglycemia, usually caused by uncontrolled diabetes mellitus.AIM:The objective of this study is to identify risk factors of cataracts and to analyse if there is a significant difference in blood glucose values between diabetic patients with cataracts and non-diabetic patients with cataracts.METHODS:This was an analytical case-control study with a sample size of 140 patients that were obtained via consecutive sampling of medical records.RESULTS:This study found that age, high body mass index and hypertension were the dominant risk factors of cataracts. The mean value of blood glucose levels in diabetic patients with cataracts is 195.58 ± 63.9 and 109.7 ± 26.4 in non-diabetic patients with cataracts. There was a significant difference between the blood glucose values of diabetic patients with cataracts and non-diabetic patients with cataracts (p < 0.001). The dominant risk factors of cataracts were old age, high body mass index and hypertension. The majority of hyperglycemic patients belong in the group of diabetic patients with cataracts.CONCLUSION:Chronic hyperglycemia can increase a patient’s risk of cataracts.

Ionising radiation and lens opacities in interventional physicians: results of a German pilot study

We assessed the feasibility of an epidemiological study on the risk of radiation-related lens opacities among interventional physicians in Germany. In a regional multi-centre pilot study associated with a European project, we tested the recruitment strategy, a European questionnaire on work history for the latter dosimetry calculation and the endpoint assessment. 263 interventional physicians and 129 non-exposed colleagues were invited. Questionnaires assessed eligibility criteria, risk factors for cataract, and work history relating to occupational exposure to ionising radiation, including details on type and amount of procedures performed, radiation sources, and use of protective equipment. Eye examinations included regular inspection by an ophthalmologist, digital slit lamp images graded according to the lens opacities classification system, and Scheimpflug camera measurements. 46 interventional (17.5%) and 30 non-exposed physicians (23.3%) agreed to participate, of which 42 and 19, respectively, met the inclusion criteria. Table shields and ceiling suspended shields were used as protective equipment by 85% and 78% of the interventional cardiologists, respectively. However, 68% of them never used lead glasses. More, although minor, opacifications were diagnosed among the 17 interventional cardiologists participating in the eye examinations than among the 18 non-exposed (59% versus 28%), mainly nuclear cataracts in interventional cardiologists and cortical cataracts in the non-exposed. Opacification scores calculated from Scheimpflug measurements were higher among the interventional cardiologists, especially in the left eye (56% versus 28%). Challenges of the approach studied include the dissuading time investment related to pupil dilatation for the eye examinations, the reliance on a retrospective work history questionnaire to gather exposure-relevant information for dose reconstructions and its length, resulting in a low participation rate. Dosimetry data are bound to get better when the prospective lens dose monitoring as foreseen by 2013 European Directives is implemented and doses are recorded.

Prevalence of cataract among the population aged 50 years and over at different altitudes in Gansu Province

Objective: To assess the prevalence and influence factors of cataract at different altitudes in Gansu Province. Methods: A total of 7 560 permanent residents aged 50 years and over in seven regions of Gansu Province (altitude, 900 meters to 3 500 meters) were selected as subjects, including 2 402 males and 5 158 females, with an average age of 62.04 years. The cluster random sampling method was used to conduct the survey at village or township health service centers. The investigation procedure included questionnaire survey, pre-investigation, visual acuity examination, intraocular pressure measurement, slit lamp microscopy and fundus examination. The diagnostic criterion for cataract was typical opacity of the lens or no other eye diseases that led to visual impairment but with visual acuity less than 0.7. The prevalence of cataract was calculated according to factors such as altitude, age and sex. The Chi-square test and two-element unconditional logistic regression were used for statistical analyses. Results: A total of 7 560 people were surveyed. The prevalence rate of cataract was 39.7%, and the age-standardized prevalence was 37.7%. The prevalence of cataract increased with age (χ(2)=2 107.19, P<0.01). It was 14.1% in the group of 50-59 years, 42.9% in the group of 60-69 years and 79.2% in the group of over 70 years. The prevalence of cataract also increased with altitude (χ(2)=33.66, P<0.01). It was 36.9% in the group of altitude less than 1 000 meters, 39.0% in the group of altitude between 1 000 meters and 1 999 meters, 45.9% in the group of altitude between 2 000 meters and 2 999 meters, and 51.5% in the group of altitude more than 3 000 meters. With age stratification, the prevalence of cataract at high altitude was higher than that at low altitude (χ(2)=26.74, 16.06, P<0.01). Multivariate regression analysis showed that the risk of cataract was higher in subjects at altitude of 2 000-2 999 meters than those below 1 000 meters (OR=1.42, 95%CI 1.11-1.82), and even higher in those at altitude of 3 000 meters (OR=1.76, 95%CI 1.01-3.06). Conclusions: High altitude and old age are important risk factors for cataract, and high altitude is an independent risk factor for cataract. It is necessary for local health institutions to take measures to reduce the prevalence of blindness and low vision, especially the blindness caused by cataract. (Chin J Ophthalmol, 2019, 55:589-594).

Hypertension is the Prominent Risk Factor in Cataract Patients.

Background and objectives: The purpose of this study is to determine the impact of the most prominent cardiovascular and metabolic risk factors in patients undergoing cataract surgery. Materials and Methods: The study included 812 consecutive patients undergoing unilateral, uneventful cataract surgery by means of phacoemulsification, at the 2nd Department of Ophthalmology, Medical School, Aristotle University of Thessaloniki, Greece, during a calendar year. Patients were assessed for the type of cataract and the presence of three diseases, under pharmacological treatment, that have been reported as risk factors for the development of cataract (arterial hypertension, diabetes mellitus, and dyslipidemia). Results: There was a statistically significant difference between the types of cataract and individual risk factors (p < 0.001). Hypertension was the most frequentrisk factor, ranging from 43.8% in patients with subcapsular cataracts, 24.3% in patients with nuclear cataracts, 28.6% in patients with cortical cataracts, and 27.6% in patients with mixed type cataracts. There was a statistically significant difference as to the total number of risk factors per cataract type (p < 0.001); almost all patients with subcapsular cataracts had at least one risk factor (98.4%) while this percentage was 90.5% for patients with mixed cataracts, 85.7% for patients with cortical cataracts, and78.6% for patients with nuclear cataracts. Conclusions: Diabetes mellitus did not have a large incidence in our sample as a single risk factor, while hypertension did. This finding raises the importance of early detection of hypertension, a cardiovascular condition that typically progresses undetected for a number of years.

Risk factors for cataracts in a cohort of Egyptian systemic lupus erythematosus patients

Aim of the workThis study was undertaken to evaluate cataract risk factors in Egyptian systemic lupus erythematosus (SLE) patients. Patients and methodsA cohort of 150 consecutive adult SLE patients was included. None of the patients was diabetic or had cataract before steroids treatment for SLE. Detailed medical and ophthalmological histories were taken. Thorough clinical examination was performed with assessment of SLE disease activity index (SLEDAI) and systemic lupus international collaborating clinics damage index (SLICC DI), along with routine blood tests. Slit lamp examination was done to assess the anterior segment of the eye especially the lens to detect the type and degree of cataract. Results150 SLE patients were studied with a mean age of 37.16 ± 11 years; 129 females and 21 males and a mean disease duration of 11 ± 5.7 years. Their mean SLEDAI was 4.1 ± 3.78 and SLICC/DI 2.1 ± 1.3. The frequency of cataract was 18% (n = 27); 22.2% of them were cortical and 77.8% were posterior subcapsular with mild-moderate degree. Glaucoma was present in only 2%. A significant increase in age, disease duration, age at onset, SLICC/DI, cumulative steroid dose and hydroxychloroquine (HCQ) dose was found in those with cataract compared to non-cataract patients (p < 0.05). The age, age at onset, disease duration, SLICC/DI and cumulative steroid dose were significant independent factors increasing the probability of cataract occurrence among SLE patients (p < 0.01). ConclusionAlthough corticosteroids are prescribed to control SLE symptoms, these results highlight potential risks associated with their use, especially cataracts, which require careful and routine ophthalmologic examination and follow up.

Do systemic steroids increase the risk of ocular complication in uveitis patients? Focus on a Italian referral center.

To describe the ocular inflammatory and iatrogenic complications in a cohort of uveitic patients treated in an Italian referral centre. Retrospective non-comparative case series. Medical history and clinical findings of all consecutive patients referred to the uveitis center of Pisa University from January 2015 to January 2017 were reviewed. Only patients with at least three follow-up visits in our center were included in our series. Three hundred and eighty-nine patients were visited in our center during study period; only 142 patients (90 men and 52 female) satisfied the inclusion criteria. Mean age at presentation was 41 ± 14years. The most common ocular feature was anterior uveitis (46%) and was mainly unilateral. A specific etiological diagnosis was established in 61% of patients. At presentation, 71.43% of patients were on medical therapy for rheumatic disease; 42.86% of patients used systemic steroids Cataract and ocular hypertension were the most common ocular complications during the study period but were not statistically related to systemic steroid treatment. Systemic steroids treatment in uveitis patients does not seem to increase the risk of iatrogenic complications such as cataract and glaucoma. In our series, increasing age appears to be the main risk factor for cataract and glaucoma development. Key points • Cataract, ocular hypertension, and glaucoma are the most common iatrogenic complications. • Systemic steroids can be safely used in uveitis patients.

Cataract and its associated risk factors among elderly population in a rural area of Belagavi: A cross sectional study

Background: The loss of sight of a person should not remain just a statistics but a personal tragedy, not only for the individual concerned, but for all of us who claim to be concerned. According to National Programme for Control of Blindness (NPCB) Pilot Survey 2001-2002, the prevalence of cataract in + 50 - year population was 62.6%. To assess the impact of the NPCB on reduction of avoidable blindness, this study would help in enlightening the present scenario in this region. Material and Method: The present community based cross sectional study was conducted among individuals aged 60 years and above residing in the area covered under Vantamuri Primary Health Centre, Belagavi from 1st January to 31st December 2016. Data was collected from the study subject regarding socio-demographic variables and personal history, external eye examination was conducted Results: The prevalence of cataract among elderly population in rural area was 40.16%. Out of 249 participants who had cataract, 18 (7.23%) had it only in right eye, 19 (7.63%) had in left eye and 212 (85.14%) had cataract in both eyes. The risk factors for cataract included belonging to Muslim and Jain religion, lower literacy status and increased exposure to indoor air pollution. Conclusion: The present cross sectional study, reveals that the prevalence of cataract among elderly in rural area in the past 15 years has reduced by about 20%. But still some socio-cultural factors prevail among the rural population like ignorance towards the effects of morbidity was the major setback for seeking treatment. Such behaviour was more common in elderly female, who were the most affected by it.

Antidepressants, Mood Stabilizers, Antipsychotics, and the Risk of Cataract.

Cataract is a common disease of the eye, and depression is common in patients with cataract. This raises the possibility that depression and the drugs used to treat depression may be risk factors for cataract. In a recent systematic review and meta-analysis of 7 case-control studies with a pooled sample of 447,672 cases and 1,510,391 controls, antidepressant drugs were associated with a very small but statistically significant increase in the risk of cataract; the odds ratios for different classes of antidepressants were in the 1.12-1.19 range. None of the 7 studies in the meta-analysis adjusted their analyses for confounding by indication. Furthermore, the meta-analysis results were characterized by unexplained high heterogeneity, and there was evidence suggestive of publication bias. These data, therefore, do not make a sufficient case for antidepressants being causal for cataract. Rather, the antidepressant data, along with data that associate mood stabilizer exposure with the risk of cataract, suggest that major mental illness and the correlates thereof may be a risk factor for cataract rather than the drugs that are used to treat these disorders. Surprisingly, in similar research designs, antipsychotic drugs were found either to have no effect or to protect against incident cataract. This indicates that the relationship between antidepressant exposure and cataract merits closer investigation, using research designs and analyses that better address confounding by indication. Examples for such research designs and analyses are provided. Until stronger evidence becomes available, a cause for concern remains unestablished.

The prevalence and risk factors for cataract in rural and urban India.

Purpose:To report the prevalence and risk factors of cataract and its subtypes in older age group.Methods:A total of 6617 subjects were recruited from both rural and urban areas. A detailed history including data on demographic, socioeconomic and ocular history was obtained. Lens opacity was graded according to the Lens Opacity Classification System III (LOCS III).Results:Cataract was present in 1094 of the rural and 649 subjects in the urban population. Monotype subtype cataracts were found in 32% and 25% in rural and urban population and 12.68% and 18.6% were mixed cataracts in the rural and urban groups. In baseline characteristics history of diabetes, alcohol intake and presence of age-related macular degeneration were the risk factors in urban group. On multivariate analysis, the only significant risk factors for any cataract in subjects ≥60 years were increasing age in both rural [odds ratio (OR), 1.07] and urban (OR, 1.08) population, and HbA1c (OR, 1.14) in rural population. Overweight (OR, 0.6) was found to be a protective factor, and lower social economic status (OR, 1.52) a risk factor for cataract in urban population. A significant urban–rural difference was found in the prevalence of cataract and its subtypes (P ≤ 0.05).Conclusion:We found the risk factors for any cataract in older age group to be increasing age and HbA1c in rural group. Age and lower social economic status were found to be the risk factors in urban arm. A statistically significant difference was found on comparison of the prevalence of cataract and its subtypes between the rural and urban population.