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Jugnoo S. Rahi, Carol Dezateux, the British Congenital Cataract Interest Group; Congenital and Infantile Cataract in the United Kingdom: Underlying or Associated Factors. Invest. Ophthalmol. Vis. Sci. 2000;41(8):2108-2114.
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purpose. Prevention of visual impairment and blindness in childhood due to
congenital and infantile cataract is an important international goal.
Preventive strategies require information about etiology that
is currently unavailable for many regions of the world. From a national
epidemiologic study, the underlying or associated factors in newly
diagnosed cases of congenital or infantile cataract in the United
Kingdom are reported, and the implications for future etiological
research are discussed.
methods. All children with congenital or infantile cataract newly diagnosed
during 1 year in the United Kingdom were ascertained independently
through two national active surveillance schemes comprising
ophthalmologists and pediatricians, respectively. Detailed information
about cases, including disease causes, was collected from reporting
clinicians using standard questionnaires.
results. Of 243 children with newly diagnosed congenital or infantile cataract,
160 (66%) had bilateral disease. Isolated cataract was more common in
bilateral than unilateral cases (61% versus 47%, P =
0.05) as was cataract associated with a systemic disorder (25% versus
6%, P < 0.001). Conversely, cataract with associated
ocular anomalies was more common in unilateral than bilateral cases
(47% versus 14%, P < 0.001). No underlying or
associated risk factors for cataract could be identified in 92% of
unilateral and 38% of bilateral cases, although putative prenatal and
perinatal risk factors were reported in a proportion of these
idiopathic cases. Hereditary disease was associated with 56% of
bilateral but only 6% of unilateral cases. Prenatal infections and
other systemic factors were reported in only 6% of bilateral and 2%
of unilateral cases.
conclusions. Given the high proportion of idiopathic congenital and infantile
cataract, the scope for primary prevention in the United Kingdom is
currently limited. There is a need for further etiological research, to
examine the roles of environmental and genetic risk factors for
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