Association of cataract and sun exposure in geographically diverse populations of India: The CASE study. First Report of the ICMR-EYE SEE Study Group


Autoři: Praveen Vashist aff001;  Radhika Tandon aff001;  G. V. S. Murthy aff002;  C. K. Barua aff003;  Dipali Deka aff003;  Sachchidanand Singh aff004;  Vivek Gupta aff001;  Noopur Gupta aff001;  Meenakshi Wadhwani aff001;  Rashmi Singh aff001;  K. Vishwanath aff005
Působiště autorů: Community Ophthalmology, Dr RP Centre for Ophthalmic Sciences, New Delhi, India aff001;  Public Health Foundation of India, Hyderabad, Telangana, India aff002;  Regional Institute of Ophthalmology, Guwahati, Assam, India aff003;  National Physical Laboratory, New Delhi, India aff004;  Pushpagiri Vitreo Retina Institute, Secunderabad, Telangana, India aff005
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227868

Souhrn

Purpose

To determine the prevalence of cataract and its association with sun exposure and other environmental risk factors in three different geographically diverse populations of India.

Design

Population based cross sectional study during 2010–2016

Participants

People aged ≥ 40 years residing in randomly sampled villages were enumerated (12021) and 9735 (81%) underwent ophthalmic evaluation from plains, hilly and coastal regions (3595, 3231, 2909 respectively)

Methods

A detailed questionnaire-based interview about outdoor activity in present, past and remote past, usage of sun protective measures, exposure to smoke, and detailed ophthalmic examination including assessment of uncorrected and best corrected visual acuity, measurement of intraocular pressure, slit lamp examination, lens opacities categorization using LOCS III and posterior segment evaluation was done. Lifetime effective sun exposure was calculated using Melbourne formula and expressed as quintiles. These were supplemented with physical environmental measurements.

Main outcome measures

Lifetime sun exposure hours, smoking, indoor kitchen smoke exposure and their association with cataract and subtypes. Prevalence of cataract calculated based on lens opacities or evidence of cataract surgery.

Results

Cataract was identified in 3231 (33.3%) participants. Prevalence of cataract in males (32.3%) and females (34.1%) was similar. Nuclear cataract was the commonest sub-type identified in 94.7% of affected eyes. Sun exposure had a significant association with cataract with odds ratio (OR) increasing from 1.6 (95% Confidence Intervals [CI]: 1.4, 1.9) in 3rd quintile, to 2.6 (CI: 2.2, 3.1) in 4th quintile and 9.4 (CI: 7.9, 11.2) in 5th quintile (p<0.0001). Cataract also showed a significant association with smoking (OR: 1.4, CI: 1.2, 1.6) and indoor kitchen smoke exposure (OR: 1.2, CI: 1.0–1.4). Nuclear cataract showed a positive association with increasing sun exposure in 3rd (β coefficient 0.5, CI:0.2–0.7), 4th (β: 0.9, CI: 0.7–1.1) and 5th (β: 2.1, CI:1.8–2.4) quintiles of sun exposure, smoking (β: 0.4, CI: 0.2–0.6) and indoor kitchen smoke exposure (β: 0.3, CI: 01–0.5) while cortical cataract showed a positive association with sun exposure only in 5th quintile (β: 2.6, CI:1.0–4.2). Posterior subcapsular cataract was not associated with any of the risk factors.

Conclusion

Cataract is associated with increasing level of sun exposure, smoking and exposure to indoor kitchen smoke.

Klíčová slova:

Cataract surgery – Cataracts – Eyes – India – Medical risk factors – Ultraviolet B – Ultraviolet A – Cataract extraction


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