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Cecile DelCourt, Audrey Cougnard-Grégoire, Jean-Francois Korobelnik, Isabelle Carrière, Marie-Noëlle Delyfer, Marie-Bénédicte Rougier, Mélanie Le Goff, Jean-François Dartigues, Pascale Barberger-Gateau, Joseph Colin; Light exposure and the risk for cataract extraction and age-related macular degeneration: the Alienor Study. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2737.
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While solar radiation (in particular ultraviolet light) is a recognized risk factor for cataract, its association is more controversial with age-related macular degeneration (AMD). We report the associations of exposure to solar radiation with the risk for cataract extraction and AMD in French elderly subjects.
The Alienor study is a population-based study on age-related eye diseases, performed in 963 residents of Bordeaux (France), aged 73 years or more. Exposure to ambient solar radiation was estimated from residential history in 837 participants (86.9 %) and was divided in 3 groups: low (<468.5 kJ/cm2), medium (468.5-474.7 kJ/cm2) and high (>474.4 kJ/cm2). Medium exposure was used as reference. AMD was classified from colour photographs in five exclusive stages: late neovascular AMD; late atrophic AMD (geographic atrophy); early AMD2 (large soft indistinct drusen and/or reticular drusen and/or large distinct drusen with pigment abnormalities); early AMD1 (large soft distinct drusen alone or pigment abnormalities alone); no AMD. Cataract extraction was verified at slit lamp. Associations were estimated using logistic Generalized Estimating Equations (GEE) models, eyes without AMD (or without cataract extraction) being the reference.
After multivariate adjustment, by comparison with subjects exposed to medium ambient solar radiation, those exposed to high ambient solar radiation were at increased risk for cataract extraction (OR=1.7 (1.2-2.5), p=0.003) and for early AMD2 (2.9 (1.5-5.8), p=0.002). Subjects exposed to low ambient solar were also at increased risk for early AMD2 (2.7 (1.3-5.5), p=0.006). Associations were in the same direction for early AMD1, but did not reach statistical significance (OR=1.3 (0.8-2.2), p=0.22 and OR=1.5 (0.9-2.6), p=0.10, for exposure to high and low ambient solar radiation, respectively). Statistical power was low for detection of associations with late AMD.
This study further confirms the increased risk for cataract extraction in subjects exposed to high solar radiation. Moreover, it suggests that risk for early AMD2 is increased in subjects exposed to high solar radiation, but also to low solar radiation, by comparison with medium exposures.
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