Abstract
Abstract: :
Purpose:To describe the association of risk factors with the progression of type–specific lens opacities in AREDS. Methods: Progression of nuclear opacity (a 1.5–unit increase on a severity scale from 0.9 – 6.1), cortical opacity (10% absolute increase in area of opacity within a standard central 5–mm circle) and PSC opacity (5% absolute increase in the area of opacity within a standard central 5–mm circle) was assessed in AREDS from lens photographs taken at baseline and at annual visits. Average follow–up time was 6.3 years. Baseline risk factors considered included demographic, medical history, use of medications, and ocular factors. Staged model–building with repeated–measures logistic regression was used to identify and assess significant baseline risk factors separately for progression of nuclear opacity among 4,331 participants with follow–up Topcon slit–lamp photographs, and for progression of cortical and PSC opacity among 4,329 participants with follow–up Neitz retroillumination photographs. Results:In multivariable models controlling for age and gender, history of multivitamin use was associated with decreased risk of the progression of nuclear opacity (OR 0.83, 95% CI 0.73, 0.95). For cortical opacity, higher Eeducational status (college grad. vs. high school grad. or less, OR 0.72, 95% CI 0.57, 0.91), and white race (white vs other, OR 0.39, 95% CI 0.27, 0.58) were associated with decreased risk of progression, whereas beta–blocker use (OR 1.48, 95% CI 1.01, 2.16), and hyperopic refractive error (hyperopic vs. myopic, OR 1.43, 95% CI 1.02 – 2.02) were associated with increased risk ofthe progression of cortical opacity. History of angina (OR 1.42, 95% CI 1.04, 1.94) and diabetes (OR 1.63, 1.18, 2.25) were associated with the increased risk of progression of PSC opacity. Conclusion:Data from this large longitudinal study showed several environmental nd systemic exposures demographic, medical history, medication use, and ocular factors that were associated with the risk of progression of type–specific lens opacities.
Keywords: cataract • clinical (human) or epidemiologic studies: risk factor assessment