Abstract
Purpose: :
To identify biological risk factors associated with the 4-year incidence of nuclear, cortical, and posterior subcapsular (PSC) opacities in adult Latinos.
Methods: :
In LALES, Latinos 40 years and older from Los Angeles County were examined at baseline and again 4 years later. A home interview and clinical examination, including slit-lamp assessment of lens opacities using the Lens Opacities Classification System II (LOCS II), were performed. Incidences of any nuclear, any cortical, or any PSC lens opacity (with LOCS II grading ≥2) were defined in persons without that opacity at baseline. Univariate and forward stepwise logistic regression analyses were used to identify independent risk factors associated with 4-year incidence of any nuclear, cortical, and PSC lens opacities.
Results: :
Of 4658 Latinos with gradable lenses at baseline and 4-year follow-up, 392 had incident nuclear opacity, 249 had incident cortical opacity, and 93 had incident PSC opacity. Older age (per year; Odds Ratio [OR] 1.2; P-value <0.0001) and hemoglobin A1c greater than 7% (OR 2.0; P-value <0.0001) were risk factors for developing any nuclear opacity. Similarly, older age (per year; OR 1.1; P-value <0.0001) and hemoglobin A1c greater than 7% (OR 3.95; P-value <0.0001) were risk factors for developing any cortical opacity. Older age (per year; OR 1.1; P-value <0.0001), hemoglobin A1c greater than 7% (Odds Ratio 2.1; P-value 0.004), and longer axial length (per millimeter; OR 1.3; P-value 0.02) were risk factors for developing any PSC lens opacity.
Conclusions: :
Glycemic control is a modifiable risk factor for developing nuclear, cortical, and PSC opacities in Latinos, and improved diabetic control may help reduce the incidence of lens opacification in this population. Older age and longer axial length are non-modifiable biological risk factors that may aid clinical risk stratification. Knowledge of these risk factors may also inform research to understand cataract pathogenesis.
Keywords: cataract • aging • diabetes