Klein R, Klein B E, Jensen S C, Cruickshanks K J
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison 53705-2397, USA.
Arch Ophthalmol. 1998 Apr;116(4):506-13. doi: 10.1001/archopht.116.4.506.
To examine the association between ocular factors and the incidence and progression of age-related maculopathy.
A population of 3684 adults (43-86 years of age at baseline) living in Beaver Dam, Wis, studied at baseline and 5 years later.
Standardized protocols for refraction and determination of iris color, administration of a questionnaire, and slitlamp and retroillumination photographs of the lenses to determine cataract type and stereoscopic color fundus photographs to determine presence and severity of age-related maculopathy. Standard univariate and multivariate analyses were performed.
Incidence and progression of age-related maculopathy.
After controlling for age, eyes that had undergone cataract surgery before baseline were more likely to have progression of age-related maculopathy (odds ratio, 2.71; 95% confidence interval [CI], 1.69-4.35) and to develop signs of late age-related maculopathy (odds ratio, 2.80; 95% CI, 1.03-7.63) than were eyes that were phakic at baseline. These relationships remained after controlling for other risk factors in multivariate analyses. There was no relationship of nuclear cataract, cortical cataract, or iris color to the incidence and progression of age-related maculopathy.
These findings indicate a relationship between cataract surgery and increased risk of progression of age-related maculopathy.
研究眼部因素与年龄相关性黄斑病变的发病率及病情进展之间的关联。
居住在威斯康星州比弗代尔的3684名成年人（基线时年龄为43 - 86岁），在基线时及5年后进行研究。
采用标准化方案进行验光及确定虹膜颜色、发放问卷、拍摄裂隙灯及晶状体后照像以确定白内障类型，拍摄立体彩色眼底照像以确定年龄相关性黄斑病变的存在及严重程度。进行标准的单变量和多变量分析。
年龄相关性黄斑病变的发病率及病情进展。
在控制年龄因素后，基线前接受过白内障手术的眼睛比基线时晶状体完整的眼睛更易出现年龄相关性黄斑病变进展（优势比，2.71；95%置信区间[CI]，1.69 - 4.35），且更易出现晚期年龄相关性黄斑病变体征（优势比，2.80；95% CI，1.03 - 7.63）。在多变量分析中控制其他危险因素后，这些关系依然存在。核性白内障、皮质性白内障或虹膜颜色与年龄相关性黄斑病变的发病率及病情进展无关。
这些发现表明白内障手术与年龄相关性黄斑病变进展风险增加之间存在关联。
