Community Ophthalmology, Dr RP Centre for Ophthalmic Sciences, New Delhi, India.
Public Health Foundation of India, Hyderabad, Telangana, India.
PLoS One. 2020 Jan 23;15(1):e0227868. doi: 10.1371/journal.pone.0227868. eCollection 2020.
To determine the prevalence of cataract and its association with sun exposure and other environmental risk factors in three different geographically diverse populations of India.
Population based cross sectional study during 2010-2016.
People aged ≥ 40 years residing in randomly sampled villages were enumerated (12021) and 9735 (81%) underwent ophthalmic evaluation from plains, hilly and coastal regions (3595, 3231, 2909 respectively).
A detailed questionnaire-based interview about outdoor activity in present, past and remote past, usage of sun protective measures, exposure to smoke, and detailed ophthalmic examination including assessment of uncorrected and best corrected visual acuity, measurement of intraocular pressure, slit lamp examination, lens opacities categorization using LOCS III and posterior segment evaluation was done. Lifetime effective sun exposure was calculated using Melbourne formula and expressed as quintiles. These were supplemented with physical environmental measurements.
Lifetime sun exposure hours, smoking, indoor kitchen smoke exposure and their association with cataract and subtypes. Prevalence of cataract calculated based on lens opacities or evidence of cataract surgery.
Cataract was identified in 3231 (33.3%) participants. Prevalence of cataract in males (32.3%) and females (34.1%) was similar. Nuclear cataract was the commonest sub-type identified in 94.7% of affected eyes. Sun exposure had a significant association with cataract with odds ratio (OR) increasing from 1.6 (95% Confidence Intervals [CI]: 1.4, 1.9) in 3rd quintile, to 2.6 (CI: 2.2, 3.1) in 4th quintile and 9.4 (CI: 7.9, 11.2) in 5th quintile (p<0.0001). Cataract also showed a significant association with smoking (OR: 1.4, CI: 1.2, 1.6) and indoor kitchen smoke exposure (OR: 1.2, CI: 1.0-1.4). Nuclear cataract showed a positive association with increasing sun exposure in 3rd (β coefficient 0.5, CI:0.2-0.7), 4th (β: 0.9, CI: 0.7-1.1) and 5th (β: 2.1, CI:1.8-2.4) quintiles of sun exposure, smoking (β: 0.4, CI: 0.2-0.6) and indoor kitchen smoke exposure (β: 0.3, CI: 01-0.5) while cortical cataract showed a positive association with sun exposure only in 5th quintile (β: 2.6, CI:1.0-4.2). Posterior subcapsular cataract was not associated with any of the risk factors.
Cataract is associated with increasing level of sun exposure, smoking and exposure to indoor kitchen smoke.
在印度三个地理位置不同的人群中，确定白内障的患病率及其与阳光暴露和其他环境危险因素的关系。
2010-2016 年进行的基于人群的横断面研究。
从随机抽取的村庄中对年龄≥40 岁的人群进行计数（12021 人），其中 9735 人（81%）接受了来自平原、丘陵和沿海地区（分别为 3595、3231、2909 人）的眼科评估。
对目前、过去和遥远过去的户外活动、使用太阳防护措施、暴露于烟雾、详细的眼科检查（包括未矫正和最佳矫正视力评估、眼压测量、裂隙灯检查、使用 LOCS III 分类晶状体混浊和后段评估）进行了详细的基于问卷的访谈。使用墨尔本公式计算终生有效阳光暴露时间，并表示为五分位数。这些数据由物理环境测量数据补充。
终生阳光暴露小时数、吸烟、室内厨房烟雾暴露及其与白内障和亚型的关系。基于晶状体混浊或白内障手术证据计算白内障的患病率。
在 3231 名参与者（33.3%）中发现了白内障。男性（32.3%）和女性（34.1%）的白内障患病率相似。核性白内障是受影响眼中最常见的亚型，占 94.7%。阳光暴露与白内障有显著关联，优势比（OR）从第 3 五分位数的 1.6（95%置信区间[CI]：1.4, 1.9）增加到第 4 五分位数的 2.6（CI：2.2, 3.1）和第 5 五分位数的 9.4（CI：7.9, 11.2）（p<0.0001）。白内障与吸烟（OR：1.4，CI：1.2, 1.6）和室内厨房烟雾暴露（OR：1.2，CI：1.0-1.4）也有显著关联。核性白内障与阳光暴露的增加呈正相关，在第 3（β系数 0.5，CI：0.2-0.7）、4（β：0.9，CI：0.7-1.1）和 5（β：2.1，CI：1.8-2.4）五分位数中，吸烟（β：0.4，CI：0.2-0.6）和室内厨房烟雾暴露（β：0.3，CI：01-0.5），皮质性白内障仅与第 5 五分位数的阳光暴露呈正相关（β：2.6，CI：1.0-4.2）。后囊下白内障与任何危险因素均无关。
白内障与阳光暴露水平的增加、吸烟和室内厨房烟雾暴露有关。
