Nordström Moa, Holm Mathias, Havstam Johansson Lena, Rydberg Sterner Therese, Ahlner Felicia, Falk Erhag Hanna, Skoog Ingmar, Zetterberg Madeleine
Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden.
Clin Ophthalmol. 2022 Oct 10;16:3269-3281. doi: 10.2147/OPTH.S366897. eCollection 2022.
The study aimed at determining the prevalence and sex differences in cataract, pseudophakia, lens opacities and self-reported cataract in 70-year-old people in Gothenburg, Sweden. The purpose was also to identify correlations between lens opacities, visual acuity and subjective visual function, and to validate self-reported cataract and cataract surgery.
Population-based cross-sectional study where participants (n=1182) answered questions about self-reported diagnosis of cataract and cataract surgery. A total of 1139 subjects completed the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25), 560 subjects underwent ophthalmic examination including visual acuity and lens photography. -test, Pearson chi-square and Mann-Whitney -test were used for obtaining p-values. ANOVA (analysis of variances, Kruskal-Wallis, one-way) was used to compare VFQ-25 between 3 groups; no cataract, cataract and pseudophakia. To clarify the differences between specific pairs of groups post-hoc test (Bonferroni) was used after ANOVA.
Self-reported cataract was more common in women than in men (27.2% vs 19.1%, p=0.001, chi-square). Cataract surgery was reported by 16.3% of women and 12.6% of men (p=0.072). Upon eye examination, the prevalence of pseudophakia was 16.9% in women compared to 10.2% in men (p=0.020). The prevalence of cataract, including pseudophakia, was 31.9% in women versus 23.8% in men (p=0.033). Significant correlations (Spearman's rho) were found between lens opacities and visual acuity. Self-reported cataract surgery showed a very high specificity and high sensitivity. The composite score from NEI VFQ-25 was lower in people with pseudophakia than in people with/without cataract (p=0.012, Kruskal-Wallis).
The prevalence of cataract including pseudophakia in 70-year-olds in Gothenburg is higher compared to previous studies in similar geographical areas. Also, it is more common in women than in men. The lack of significant sex differences in lens opacities may be due to cataract surgery at an earlier stage. Validation showed very good agreement between pseudophakia and self-reported cataract surgery.
本研究旨在确定瑞典哥德堡70岁人群中白内障、人工晶状体、晶状体混浊及自我报告白内障的患病率和性别差异。研究目的还包括确定晶状体混浊、视力与主观视觉功能之间的相关性，并验证自我报告的白内障及白内障手术情况。
基于人群的横断面研究，参与者（n = 1182）回答了关于自我报告的白内障诊断和白内障手术的问题。共有1139名受试者完成了美国国立眼科研究所视觉功能问卷-25（NEI VFQ-25），560名受试者接受了眼科检查，包括视力检查和晶状体摄影。采用t检验、Pearson卡方检验和Mann-Whitney U检验来获得p值。使用方差分析（ANOVA，Kruskal-Wallis单因素方差分析）比较3组（无白内障、白内障和人工晶状体）之间的NEI VFQ-25得分；方差分析后使用事后检验（Bonferroni）来明确特定组对之间的差异。
自我报告的白内障在女性中比男性更常见（27.2%对19.1%，p = 0.001，卡方检验）。报告进行白内障手术的女性占16.3%，男性占12.6%（p = 0.072）。眼科检查显示，女性人工晶状体患病率为16.9%，男性为10.2%（p = 0.020）。包括人工晶状体在内的白内障患病率女性为31.9%，男性为23.8%（p = 0.033）。晶状体混浊与视力之间存在显著相关性（Spearman等级相关系数）。自我报告的白内障手术显示出非常高的特异性和高敏感性。人工晶状体患者的NEI VFQ-25综合得分低于有/无白内障患者（p = 0.012，Kruskal-Wallis检验）。
与之前在类似地理区域的研究相比，哥德堡70岁人群中包括人工晶状体在内的白内障患病率更高。此外，女性比男性更常见。晶状体混浊缺乏显著的性别差异可能是由于早期进行了白内障手术。验证显示人工晶状体与自我报告的白内障手术之间具有很好的一致性。
