Younan Christine, Mitchell Paul, Cumming Robert G, Rochtchina Elena, Wang Jie Jin
Department of Ophthalmology, University of Sydney, Australia.
Invest Ophthalmol Vis Sci. 2002 Dec;43(12):3625-32.
To assess whether an association exists between myopia and incident cataract and cataract surgery in an older population-based cohort study.
The Blue Mountains Eye Study examined 3654 participants aged 49 years or more during 1992 to 1994 and then 2334 (75.1%) of the survivors after 5 years. A history of using eyeglasses for clear distance vision was obtained. Objective refraction was performed with an autorefractor, followed by subjective refraction with a logarithm of minimum angle of resolution (logMAR) chart. Emmetropia was defined as a spherical equivalent refraction between +1 D and -1 D, hyperopia as more than +1 D, and myopia as less than -1 D. Slit lamp and retroillumination lens photographs were graded for presence of cortical, nuclear, or posterior subcapsular cataract, according to the Wisconsin Cataract Grading System. Generalized estimating equation models analyzed data by eye.
There was a statistically significant association between high myopia (-6 D or less) and incident nuclear cataract (odds ratio [OR] 3.3, 95% confidence interval [CI] 1.5-7.4). Incident posterior subcapsular cataract was associated with any myopia (OR 2.1, 95% CI 1.0-4.8), moderate to high myopia (-3.5 D or less, OR 4.4, 95% CI 1.7-11.5), and use of distance glasses before age 20 (OR 3.0, 95% CI 1.0-9.3), after adjustment for multiple potential confounders, including severity of nuclear opacity. Incident cataract surgery was significantly associated with any myopia (OR 2.1, 95% CI 1.1-4.2) as well as moderate (-3.5 to more than -6D; OR 2.9, 1.2-7.3) and high myopia (OR 3.4, 95% CI 1.0-11.3).
These epidemiologic data provide some evidence of an association between myopia and incident cataract and cataract surgery, after adjustment for multiple confounders and severity of nuclear opacity. These data support other cross-sectional and longitudinal population-based findings.
在一项基于人群的老年队列研究中，评估近视与白内障发病及白内障手术之间是否存在关联。
蓝山眼研究在1992年至1994年期间对3654名年龄在49岁及以上的参与者进行了检查，5年后对2334名（75.1%）幸存者进行了复查。获取了使用眼镜矫正远视力的病史。先用自动验光仪进行客观验光，然后用最小分辨角对数（logMAR）视力表进行主观验光。正视定义为等效球镜度在+1 D至-1 D之间，远视定义为大于+1 D，近视定义为小于-1 D。根据威斯康星白内障分级系统，对裂隙灯和后照法晶状体照片进行皮质、核或后囊下白内障的分级。采用广义估计方程模型对双眼数据进行分析。
高度近视（-6 D及以下）与核性白内障发病之间存在统计学显著关联（优势比[OR] 3.3，95%置信区间[CI] 1.5 - 7.4）。后囊下白内障发病与任何程度的近视（OR 2.1，95% CI 1.0 - 4.8）、中度至高度近视（-3.5 D及以下，OR 4.4，95% CI 1.7 - 11.5）以及20岁前使用远用眼镜（OR 3.0，95% CI 1.0 - 9.3）有关，在对包括核混浊严重程度在内的多个潜在混杂因素进行调整后。白内障手术发病与任何程度的近视（OR 2.1，95% CI 1.1 - 4.2）以及中度（-3.5至大于-6 D；OR 2.9，1.2 - 7.3）和高度近视（OR 3.4，95% CI 1.0 - 11.3）显著相关。
这些流行病学数据在对多个混杂因素和核混浊严重程度进行调整后，为近视与白内障发病及白内障手术之间的关联提供了一些证据。这些数据支持了其他基于人群的横断面和纵向研究结果。
