Department of Ophthalmology, Kanazawa Medical University, Uchinada, Japan.
PLoS One. 2019 Apr 25;14(4):e0215338. doi: 10.1371/journal.pone.0215338. eCollection 2019.
We investigated associations between ocular ultraviolet (UV) radiation exposure dose and cataract opacities among Han people living in China and Taiwan, to assess the effects of UV exposure intensity.
This cross-sectional study included Han people aged ≥40 years (1,801 individuals, 450 in Sanya, 636 in Taiyuan, and 715 in Taichung) as subjects who completed a questionnaire including items about diabetes, smoking, steroid use, work history, and time spent outdoors, and underwent an ophthalmic examination. Right eye axial length was measured using A-mode ultrasonography or IOLMaster. Slit-lamp imaging under maximum mydriasis was used to classify cataracts into three major types [cortical (COR), nuclear (NUC), and posterior subcapsular cataracts (PSC)] and two subtypes [retrodots (RD) and waterclefts (WC)] by one ophthalmologist. COR was divided into opacity presence (CEN+) or absence (CEN-) in the central 3-mm diameter area of the pupil. COR was also subdivided into three groups according to opacity shape: axle-shaped opacity concomitant with WC, wedge-shaped opacity around the pupil to the eye center, and ring-shaped opacity in the lens equator along the pupillary margin. The cumulative ocular UV exposure (COUV) was calculated. A logistic regression analysis was used for multivariate analysis.
Cataract odds ratios in high COUV eyes were 5.35 for NUC, 1.87 for PSC, and 1.35 for RD. In eyes with WC, risk of COR ring-shaped opacity significantly increased but that of wedge-shaped opacity (CEN+) significantly decreased. In eyes without WC, risk of COR axle-shaped opacity (CEN-) and ring-shaped opacity significantly increased but that of wedge-shaped opacity (CEN+) significantly decreased.
Increased COUV level among Han people may be a risk factor for the development of nuclear cataracts, PSC, retrodots and ring-shaped cortical cataract. Risk of ocular UV exposure for cortical cataract may differ by opacity shape.
我们调查了生活在中国和台湾的汉族人群的眼部紫外线（UV）辐射暴露剂量与白内障混浊之间的关系，以评估 UV 暴露强度的影响。
本横断面研究纳入了汉族≥40 岁人群（1801 人，三亚 450 人，太原 636 人，台中 715 人）作为研究对象，他们完成了一份包括糖尿病、吸烟、类固醇使用、工作史和户外活动时间等项目的问卷，并接受了眼科检查。右眼轴长采用 A 型超声或 IOLMaster 测量。最大散瞳下的裂隙灯成像用于将白内障分为三种主要类型[皮质（COR）、核性（NUC）和后囊下白内障（PSC）]和两种亚型[后点状混浊（RD）和水裂（WC）]，由一名眼科医生进行。COR 在瞳孔中央 3mm 直径区域分为混浊存在（CEN+）或不存在（CEN-）。根据混浊形状，COR 进一步分为三组：伴有 WC 的轴心状混浊、瞳孔至眼球中心的楔形混浊和沿瞳孔缘晶状体赤道的环状混浊。计算累积眼部 UV 暴露（COUV）。采用多变量分析的逻辑回归分析。
高 COUV 眼的白内障比值比为 NUC 5.35、PSC 1.87、RD 1.35。在伴有 WC 的眼中，COR 环状混浊的风险显著增加，但楔形混浊（CEN+）的风险显著降低。在不伴有 WC 的眼中，COR 轴心状混浊（CEN-）和环状混浊的风险显著增加，但楔形混浊（CEN+）的风险显著降低。
汉族人群 COUV 水平升高可能是核性白内障、PSC、RD 和环状皮质白内障发展的危险因素。眼部 UV 暴露对皮质白内障的风险可能因混浊形状而异。
