July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Incidence, progression and risk factors of age-related cataract in Malays: the Singapore Malay Eye Study
Author Affiliations & Notes
  • Jie Jin Wang
    Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
    Centre for Clinician-Scientist Dev., Duke-NUS Medical School, Singapore, Singapore, Singapore
  • Ava Grace Tan
    Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
  • Yih Chung Tham
    Singapore Eye Research Institute, Singapore, Singapore
  • Miao Li Chee
    Singapore Eye Research Institute, Singapore
  • Paul Mitchell
    Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
  • Robert G. Cumming
    School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  • Charumathi Sabanayagam
    Singapore Eye Research Institute, Singapore
    Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Signapore, Singapore
  • Ching-Yu Cheng
    Singapore Eye Research Institute, Singapore
    Ophthalmology and Visual Sciences Academic Clinical Program, Singapore National Eye Centre, Duke-NUS Medical School, Singapore, Singapore
  • Tien Yin Wong
    Singapore Eye Research Institute, Singapore
    Ophthalmology and Visual Sciences Academic Clinical Program, Singapore National Eye Centre, Duke-NUS Medical School, Singapore, Singapore
  • Footnotes
    Commercial Relationships   Jie Jin Wang, None; Ava Tan, None; Yih Chung Tham, None; Miao Li Chee, None; Paul Mitchell, None; Robert Cumming, None; Charumathi Sabanayagam, None; Ching-Yu Cheng, None; Tien Wong, None
  • Footnotes
    Support  National Medical Research Council, Republic of Singapore (grant IDs: NMRC/0796/2003; NMRC/1249/2010 and CG/SERI/2010)
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6480. doi:https://doi.org/
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      Jie Jin Wang, Ava Grace Tan, Yih Chung Tham, Miao Li Chee, Paul Mitchell, Robert G. Cumming, Charumathi Sabanayagam, Ching-Yu Cheng, Tien Yin Wong; Incidence, progression and risk factors of age-related cataract in Malays: the Singapore Malay Eye Study. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6480. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess 6-year incidence and progression of age-related cataract and associated factors in a population-based cohort of Malays aged 40+ years.

Methods : Of 3,280 baseline participants of Singapore Malay Eye Study (2004-06), 1901 (72.1% of eligible) were re-examined 6 years later. Eye examinations and lens photography were performed at each visit. Cataract was assessed from lens photos following the Wisconsin Cataract Grading System. Cortical cataract was defined if total lens area involved ≥5%, nuclear cataract if nuclear opacity >standard photo #3, and posterior subcapsular (PSC) cataract if any PSC opacity present. Incidence of cataract was assessed in persons without the corresponding cataract type in either eye at baseline. Progression was assessed in eyes with any of three cataract types at baseline, and defined if at follow-up an increase by: ≥10% of lens area involved by cortical opacity, ≥1.0 grading score of nuclear cataract severity, ≥2% of lens area involved by PSC opacity, or had cataract surgery in the affected eye. Poisson regression and generalized estimating equations models (Poisson link) assessed factors associated with the incidence and progression, adjusting for age, sex, socioeconomic status (SES), ocular and systemic factors.

Results : After age standardizing to 2010 Singapore Malay population, the 6-year incidence of cortical, nuclear and PSC cataract was 14.1%, 13.6% and 8.7%, respectively. Besides age, diabetes (adjusted relative risk, RR, 1.9, 95% confidence intervals, CI, 1.4-2.6), low SES (RR 1.7, 95% CI 1.1-2.4) and C-reactive protein (RR 1.01, 95% CI 1.00-1.03 per mg/L) were associated with incident cortical cataract. Female sex was associated with increased (RR 1.5, 95% CI 1.1-2.1) while chronic kidney disease associated with decreased incident nuclear cataract (RR 0.6, 95% CI 0.4-0.9). Hypertension was associated with incident PSC cataract (RR 2.2, 95% CI 1.3-3.9).

Age-standardized progression rates were 20.4%, 5.9% and 40.6% for baseline cortical, nuclear and PSC cataract, respectively. Age was associated with decreased risk of cortical cataract progression (RR 0.94, 95% CI 0.92-0.96 per year). Diabetes was associated with increased risk of nuclear cataract progression (RR 2.2, 95% CI 1.2-4.0).

Conclusions : Consistent with findings from other populations, diabetes increases the risks of developing and progression of age-related cataract among older Malays.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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