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A. Hennis, S. Wu, B. Nemesure, M.C. Leske, Barbados Eye Studies Group; Risk Factors for Incident Cortical and PSC Lens Opacities in the Barbados Eye Studies . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4240.
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Purpose: To examine risk factors for the 4-year incidence of cortical and posterior subcapsular (PSC) lens opacities in black participants of the Barbados Eye Studies cohort (85% participation). Methods: The standardized protocol included ophthalmic, anthropometric and blood pressure measurements, an interview, LOCS II slit-lamp lens gradings, fundus photography, and an ophthalmologic examination. Incidence of cortical and PSC opacities was defined by the development of those opacities (LOCS II score>2) among persons unaffected at baseline and associations were evaluated by logistic regression. Results: The 4-year incidence of cortical and PSC opacities was 22.2% (452/2040) and 3.3% (97/2954), respectively. Risk of either opacity increased markedly with age, and more than doubled with a diabetes history (Relative Risk (RR)=2.4 (95% confidence interval: 1.8-3.2) for cortical; 2.8 (1.8-4.4) for PSC). Other risk factors for incident cortical opacities included female gender (RR=1.3(1.0,1.6)), and low socioeconomic status (SES; RR=1.4 (1.0-1.9)), while aspirin use was associated with reduced risk (RR=0.2 (0.1-0.8)), which was based on a low frequency of aspirin users (2.7% among incident cases and 0.7% among the non-incident group). Pulse rate was positively associated with increased risk of incident PSC opacities (RR=1.02). Conclusions: Older age and diabetes increased the risk of both cortical and PSC lens opacities over a 4-year period. Risk of cortical opacities was somewhat higher in women and persons with low SES, but markedly lower in aspirin users at baseline, a result requiring confirmation; higher pulse rate was associated with incident PSC opacities. Diabetes control is likely to have important public health implications in reducing the burden of cataract-related visual impairment in this high-risk population.
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