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KJ Cruickshanks, BE K Klein, DM Nondahl, CR Schubert; Carotid Artery Plaque and Cortical Cataract in Beaver Dam, WI . Invest. Ophthalmol. Vis. Sci. 2002;43(13):938.
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Purpose:To evaluate the relationship between subclinical atherosclerosis and cortical cataract in a population-based cohort of older adults. Methods:Participants in the 1998-2000 examinations for both the Beaver Dam Eye Study and the Epidemiology of Hearing Loss Study were eligible for analyses. Standardized photographic and grading methods were used to assess cortical cataracts. B-mode carotid ultrasound scans were performed using an adaptation of the Atherosclerosis Risk in Communities Study protocol. The presence of plaque in the carotid artery was assessed by the certified sonographer at three sites on each side, the common carotid artery (CCA), internal carotid artery (ICA) and the bifurcation (BIF). There were 1770 participants with gradable cortical cataract data and sonographer-assessed carotid artery plaque data. The mean age of participants in these analyses was 67 years and 44% were men. Results:Overall, 18.6% of left eyes and 18.3% of right eyes had cortical cataracts. Carotid artery plaque was present in the ICA on the left side in 32% and on the right side in 31% of participants. In analyses adjusting for age, sex, diabetes, and smoking, people with plaque in the left ICA were more likely to have cortical cataracts in the left eye than those without ICA plaque (OR=1.34, 95% CI=1.01,1.78). Similar but non-significant associations were seen for plaque in the CCA and BIF. Participants with plaque in two or more sites were more likely to have cortical cataracts than those without any plaque (Left side, OR=1.38, 95%CI=1.04,1.84). Similar results were found for the right side (ICA plaque OR=1.24, 95%CI=0.93,1.64) and for the participant as a whole (ICA plaque OR=1.33, 95%CI=1.04,1.70). A subset analysis restricted to those left eyes at risk for incident cortical cataracts (no cortical cataract at the examination five years earlier) also demonstrated an association between ICA plaque and cortical cataract (OR=1.47, 95%CI=1.00,2.15; adjusted for age, sex, diabetes and smoking). Conclusion:Subclinical atherosclerosis is associated with cortical cataract in older adults. This may reflect the greater risk of ischemic events marked by the presence of carotid artery plaque or the more subtle effects of generalized arteriosclerosis. Prospective studies using more quantitative measures of the severity of atherosclerosis, such as the intima-medial thickness of carotid artery walls, are needed to further explore this association.
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