DNA修复基因的多态性以及DNA损伤与年龄相关性白内障的关系

目的 探讨DNA氧化损伤修复基因BLM、WRN、ERCC6以及OGG1的单核苷酸多态性(single nucleotide polymorphisms,SNP)是否影响年龄相关性白内障(age-related cataract,ARC)的发生,并检测SNP是否会引起外周血淋巴细胞DNA损伤程度的改变.方法 从“江苏眼病研究”人群收集ARC患者789例及对照组531例.提取DNA分析BLM、OGG1、ERCC6及WRN基因18个SNP位点的基因型.同时应用彗星试验检测部分受试者外周血淋巴细胞的DNA损伤程度.结果 WRN-rs11574311与ARC、皮质型以及混合型ARC相关(P=0.003,OR=1.49;P=0.001,OR=1.68;P＜0.000 1,OR=2.08),BLMrs1063147与核型ARC相关(P=0.03,OR=1.31),WRN-rs2725383与皮质型ARC相关(P =0.01,OR=1.49),WRN-rs4733220以及WRN-rs2725338与混合型ARC相关(P=0.04,OR =0.74;P =0.003,OR =0.60).经过Bonferroni校正后,WRN-rs11574311仍与皮质型以及混合型ARC相关,WRN-rs2725338仍然与混合型ARC相关.SNP位点不同基因型的外周血淋巴细胞DNA损伤程度的差异无统计学意义.结论 WRN基因在ARC的发生发展过程中起重要作用,而且在不同亚型ARC中所起的作用也有所不同,说明不同亚型ARC可能具有特异性的危险因素以及致病机制.     

人8-羟基鸟嘌呤糖苷酶1与年龄相关性白内障关系的临床研究

目的探讨与年龄相关性白内障（ARC）患者晶状体上皮细胞（LECs）中参与DNA损伤后碱基清除修复途径的氧化损伤修复基因—人8-羟基鸟嘌呤糖苷酶1（HOGG1）水平与ARC的关系。方法收集三种ARC（皮质性、核性、后囊下性）LECs样本,以透明晶状体LECs为对照组,用免疫组化、RT-PCR方法测定HOGG1在LECs的表达情况。结果对照组LECs中可见HOGG1的表达,三种ARC患者LECs中可见HOGG1表达较对照组增高（F=107.62,P〈0.01）,但三种ARC之间没有统计学差异。对照组与ARC组HOGG1均位于细胞质和细胞核。说明ARC LECs的细胞核和细胞质中HOGG1的表达量上调。结论 HOGG1表达上调参与ARC的发生发展。     

中老年人高血压和糖尿病与年龄相关性白内障的关系

目的：探讨中老年人高血压、糖尿病与年龄相关白内障（age-relatedcataract,ARC）危险性之间的关系。方法：采用以医院为基础的病例对照研究方法。病例由45～85岁的360例因患ARC施行白内障手术摘除的患者组成,对照由同期入住相同医院的360例非白内障患者组成,采取1∶1匹配。采用标准调查表对研究对象进行面对面调查,内容包括人口学特征、生活方式、疾病既往史等,同时对血压、血糖进行测量。应用多因素Logistic回归分析估计高血压及糖尿病与ARC关联的比值比（OR）及其相应的95%可信区间（CI）。结果：在调整了年龄和性别因素后,高血压与ARC呈显著正相关（OR=1.573,P=0.005）。与收缩压正常者相比较,收缩压≥180mmHg者发病的危险性增加（OR=2.812,95%CI：1.450～5.455,P=0.002）。高血压病程10a～的研究对象发病的危险性显著地高于病程〈10a者（OR=1.867,95%CI：1.053～3.307,P=0.033）。同样,与非糖尿病患者相比,糖尿病患者发生ARC的危险性显著升高（OR=2.151,95%CI：1.470～3.149,P〈0.001）。与非糖尿病患者相比,糖尿病病程〈10a和10～19a者发生ARC的OR分别为2.374（95%CI：1.502～3.752,P〈0.001）和2.683（95%CI：1.267～5.683,P=0.010）。结论：ARC患病率增高与高血压、糖尿病及其病程增加有关。对这些可变危险因素采取干预性措施,尤其是对高危人群,可能意味着对ARC导致的视觉障碍必须采取控制性措施,因为此症是全球致盲的首要原因。     

高脂血症、糖尿病与年龄相关性白内障的关系

目的：探讨中老年人群高脂血症、糖尿病与年龄相关性白内障（age-related cataract,ARC）的关系。方法：采用以医院为基础的病例对照研究方法,病例组由年龄45～85岁的360例ARC患者所组成;对照为与病例同期入住相同医院,未患与ARC有关眼病的360例患者,对照组与病例采取1：1匹配方式。采用自行设计的调查表对研究对象进行调查,内容包括人口学特征、生活方式、疾病既往史等,同时收集研究对象的临床生化检测资料,包括空腹血糖、高密度脂蛋白胆固醇（HDL-C）、总胆固醇（TC）及甘油三酯（TG）等。采用多因素Logistic回归分析,估计研究因素与ARC关联的比值比（OR）及其相应的95%可信区间（CI）。结果：调整了年龄和性别因素后,高脂血症、高脂血症病程、TC及TG与发生ARC的危险性无关（P〉0.05）,仅HDL-C下降与发生ARC的危险性升高有关（OR=1.519,95%CI：1.093～2.110,P=0.013）。在调整了多种潜在性混杂因素后,经多因素Logistic回归分析的结果显示,空腹血糖受损的研究对象发生ARC的危险性升高了73%（OR=1.734,95%CI：1.102～2.725,P〈0.001）,而已确诊的糖尿病患者发生ARC的危险性升高了94%（OR=1.938,95%CI：1.293～2.906,P〈0.001）。糖尿病病程也与ARC呈显著性正相关,糖尿病病程〈10a和10～19a的病例发生ARC的危险性分别是未患糖尿病对照的2倍（OR=2.347,95%CI：1.502～3.752,P=0.010）和3倍（OR=2.683,95%CI：1.267～5.683,P〈0.001）。结论：HDL-C下降及糖尿病可使中老年人群发生ARC的危险性增加。     

鼻咽癌患者放化疗前后外周血浆EB病毒DNA含量变化

目的比较鼻咽癌（nasopharyngeal carcinoma,NPC）患者放化疗前后血浆EB病毒DNA（EpsteinBarrVirusDNA,EBV-DNA）水平的变化,评价EBV—DNA水平与NPC肿瘤负荷及短期疗效的关系。方法采用实时荧光定量聚合酶链反应测定60例鼻咽癌患者放化疗前后及40例健康对照者外周血浆中的EBV—DNA水平。结果NPC治疗前EBV-DNA阳性率为83．3％,中位拷贝数为8869copy／mL;治疗后阳性率为21．7％,中位拷贝数为0copy／mL;健康对照组阳性率为5．0％,中位拷贝数为0copy／mL。NPC残留组阳性率为81．8％,中位拷贝数为7263copy／mL;消退组阳性率为8．2％,中位拷贝数为0copy／mL。NPC患者治疗前及治疗后组血浆游离EBV—DNA水平及阳性率均高于健康对照组（P〈0．05）,治疗前高于治疗后（P〈0．01）。放化疗后,NPC残留组高于消退组（P〈0．01）。结论NPC患者血浆EBV—DNA水平是反映肿瘤负荷的灵敏指标,可作为短期疗效评估的参考。     

Eales病与人类白细胞抗原-A/B、-DRB/DQB的相关性研究

目的 26例临床确诊为Eales病的遵义市汉族患者作为研究组,选取与研究组患者年龄、性别、民族等因素无差异的100名健康人为对照组。抽取外周静脉血,提取DNA,采用聚合酶链式反应特异序列引物法（PCR-SSP）检测HLA-A/B,HLA-DRB/DQB等位基因频率分布,计算两组优势比（OR）。结果 Eales病患者HLA-A*01 （P=0.041,OR=20.5）A*02（P=0.00;OR=54.667;OR95%CI为11.837-252.473）、B*55（P=0.047;OR=4.524;OR95%CI为1.200-17.047）,HLA-DRB*01（P=0.048;OR=5.879;OR95%CI为1.227-28.169）,DQB*05（P=0.021,OR=2.769,OR95%CI为1.145-6.692）其分布频率明显高于对照组,差异有统计学意义(P＜0.05),HLA-A*11（P=0.031,OR=0.383,OR95%CI为0.158-0.930）明显低于对照组,差异有统计学意义(P＜0.05)。结论 Eales病可能存在遗传易感性,HLA-A*01,-A*02,-B*55,-DRB*01,-DQB*05可能是遵义市汉族Eales病患者的遗传易感基因,而HLA-A*11可能是该病的保护基因。     

实时荧光定量PCR技术在年龄相关性白内障患者GSTM1、GSTT1基因拷贝数变异检测中的应用

目的　应用实时荧光定量ＰＣＲ技术检测年龄相关性白内障（ａｇｅ-ｒｅｌａｔｅｄｃａｔａｒａｃｔ,ＡＲＣ）患者谷胱甘肽-Ｓ-转移酶（ｇｌｕｔａ-ｔｈｉｏｎｅＳｔｒａｎｓｆｅｒａｓｅ,ＧＳＴ）Ｍ１、Ｔ１基因拷贝数变异。方法　采用实时荧光定量ＰＣＲ技术检测２７９例（５５８眼）ＡＲＣ组患者和１４５例（２９０眼）对照组的ＧＳＴＭ１、ＧＳＴＴ１基因重复或缺失等拷贝数变异情况,验证此方法在拷贝数检测中的准确性。结果　相同条件下ＧＳＴＭ１、ＧＳＴＴ１基因和ＲＮａｓｅＰ基因３次ＰＣＲ扩增曲线基本重合、扩增效率基本一致、Ｃｔ值基本相同。ＧＳＴＴ１基因完全缺失（０个拷贝）的ＡＲＣ个体（尤其是后囊下性ＡＲＣ）和对照组相比,差异有统计学意义（Ｐ＜０．０５）;至少有１个拷贝缺失的ＧＳＴＴ１基因型的个体发生ＡＲＣ和皮质性ＡＲＣ的风险升高（ＯＲ值分别为２．１６、４．８１,均为Ｐ＜０．０１）,而＞２个拷贝缺失的ＧＳＴＴ１基因型的个体发生这种风险降低（ＯＲ＝０．１９,Ｐ＜０．０５）。ＧＳＴＭ１基因拷贝数变异的ＡＲＣ个体与对照组相比,差异无统计学意义（Ｐ＞０．０５）。结论　ＧＳＴＴ１基因拷贝数的缺失可能是ＡＲＣ特别是皮质性和后囊下性白内障发生的危险因素。实时荧光定量ＰＣＲ检测准确、效率高,适用于ＧＳＴＭ１、ＧＳＴＴ１基因拷贝数变异的检测,适用于包括ＡＲＣ在内的眼病流行病学调查研究。     

血管内皮生长因子基因多态性与早产儿视网膜病变发病和预后的关系

背景不同早产儿个体之间对早产儿视网膜病变（ROP）发病易感性的差异较大,可能与血管内皮生长因子（VEGF）基因多态性有关。目的研究ROP患儿VEGF基因多态性的表型,探讨VEGF基因多态性与ROP的关系。方法采用前瞻性系列病例对照研究设计,纳入2006年1月至2009年12月在湖南省儿童医院新生儿科住院的1～5期ROP患儿99例作为ROP组,另纳入80例同期未发生ROP的早产儿为对照无ROP组;在ROP组中将行激光或冷冻治疗的患儿39例作为治疗组,同期未经治疗ROP自发消退的患儿60例作为非治疗组。ROP组与无ROP组间、治疗组与非治疗组问的人口基线学特征比较差异均无统计学意义（P〉0．05）。抽取各组患儿外周血2ml以提取DNA,利用焦磷酸测序法进行VEGF—A＋405、VEGF—A936基因的多态性研究。结果ROP组患儿与无ROP组患儿VEGF—A＋405基因表型的差异均无统计学意义（P=0．071,OR=0．675,95％c,=0．444～1．026）。ROP组患儿与无ROP组患儿VEGF—A936基因表型的差异亦无统计学意义（P=0．118,OR=0．768,95％CI为2．823～4．614）,但治疗组与非治疗组VEGF—A＋405,VEGF—A936基因多态性表型的差异均有统计学意义（VEGF—A＋405：P〈0．01,OR=0．875,95％C1为5．239～14．024;VEGF—A936：P=0．000,OR=3．609,95％CI为0．711～0．829）。结论VEGF—A＋405和VEGF—A936基因的多态性与ROP易感性无关,但与ROP预后有关。携带VEGF—A＋405、VEGF—A936等位基因可能增加ROP进展的风险。     

甲状腺相关眼病与肿瘤坏死因子α基因启动子区-863C/A多态性相关性的初步研究

目的探讨肿瘤坏死因子仅（TNF-α）基因启动子区-863C／A多态性与甲状腺相关眼病（TAO）的相关性。方法选择2002年7月至2003年12月于我院内分泌门诊就诊的符合本研究人选标准的患者和正常对照者,并抽取外周抗凝血提取基因组DNA,采用多聚酶链反应-限制性片段长度多态性（PCR—RFLP）方法检测76例正常对照者（对照组）、54例TAO患者（TAO组）和60例自身免疫性甲状腺疾病（AITD）无眼病患者（无眼病组）TNF-α基因-863C／A多态性。分析比较此多态位点的基因型和等位基因频率在不同人群中分布的差异。结果（1）TAO组、无眼病组及对照组CA＋AA基因型频率分别为46．3％、30．0％、25．0％,A等位基因频率分别为27．8％、15．0％、12．5％。（2）TAO组A等位基因频率显著高于无眼病组和对照组（P=0．018,P=0．002）。（3）按性别分层后,TAO组男性患者CA＋AA基因型与A等位基因频率均显著高于对照组男性（OR=4．31,P=0．019：OR=4．81,P=0．003）和无眼病组男性患者（OR=4．87,P：0．027;OR=5．38,P=0．008）;而女性患者组间比较差异无统计学意义（均P〉0．05）。（4）TAO组ATA分级5＋6级眼病患者CA＋AA基因型和A等位基因的频率均显著高于无眼病组（OR=20．68,P=0．021;OR=39．67,P〈0．001）。结论TNF-α基因启动子区-863位点A等位基因可能是TAO尤其是男性TAO患者的易感基因。（中华眼科杂志,2005,41：786—790）     

中老年人心血管疾病与年龄相关性白内障的关系

目的:评价人群心血管疾病对年龄相关性白内障(age-related cataract,ARC)发生的影响。方法:采用回顾性病例对照研究方法,2009-09/2011-03对360例病例和匹配的360例对照进行了调查。主要的测量指标为心血管疾病(cardiovascular disease,CVD)与ARC关联的比值比(OR)及其相应的95%可信区间(CI)。采用自行设计的调查表对研究对象进行调查。结果:病例组与对照组之间,年龄、职业,以及居住地的差异无统计学意义。调整了多种潜在性混杂因素后,空腹血糖受损的研究对象和已确诊的糖尿病患者发生ARC的危险性分别升高了62.4%和69.8%(OR=1.624,95%CI:1.068～2.553,P=0.007;OR=1.698,95%CI:1.412～2.719,P=0.009);高血压患者与ARC的关联性较强(OR=1.431,95%CI:1.098～1.997,P=0.007);现行吸烟者和现行饮酒者发生ARC的危险性也显著增高(OR=1.712,95%CI:1.312～2.344,P=0.010;OR=1.912,95%CI:1.310～2.896,P=0.003)。结论:糖尿病、高血压、吸烟及饮酒可使发生ARC的危险性增加,最终导致ARC的发生。     

The impact of GJA3 SNPs on susceptibility to age-related cataract

AIM: To determine the association of gap junction protein alpha 3 (GJA3) gene tag single-nucleotide polymorphisms (SNPs) with susceptibility to age-related cataract (ARC). METHODS: In total, 486 ARC patients were matched with 500 healthy controls. All the participants underwent complete ophthalmic examinations. Haplotype-tagging SNPs of GJA3 gene were selected from the HapMap Beijing Han Chinese population. Genomic DNA was extracted from the peripheral blood leukocytes of all the subjects. Under three different genetic models: dominant, recessive, and additive, the association between SNPs and ARC was examined. After adjusting for age and sex, the genetic effects of the GJA3 SNPs were evaluated with logistic regression analysis. RESULTS: Four tag GJA3 SNPs (rs6490519, rs9506430, rs9509053, and rs9552089) were included in the present study. None of the SNPs showed a significant relationship with an altered risk of total ARC under the dominant, recessive, or additive models. In the subgroup analysis, rs9506430 had a significant effect on the formation of a posterior subcapsular cataract (P=0.002, OR: 0.227, 95%CI: 0.088-0.590) under the recessive model. CONCLUSION: Our study indicates that GJA3 variants may influence the development of posterior subcapsular cataracts. Further studies need to be designed to confirm this possibility.     

Cardiovascular disease,vascular risk factors and the incidence of cataract and cataract surgery: The Blue Mountains Eye Study

PURPOSE To assess whether an association exists between cardiovascular disease, vascular risk factors and incident cataract and cataract surgery. METHODS The Blue Mountains Eye Study examined 3654 participants =49 years of age during 1992–4, then 2335 survivors (75.1%) after five years. Trained interviewers administered a vascular history questionnaire; height, weight and blood pressure were measured. Lens photographs from both examinations were graded for presence of cortical, nuclear or posterior subcapsular cataract. RESULTS Obesity (body mass index =30kg/m 2 ) was significantly associated with increased incidence of both cortical [odds ratio (OR) 1.6, 95% confidence interval (CI) 1.2–2.2] and posterior subcapsular cataract (OR 2.1, CI 1.2–3.7). Hypertensive participants using medication and aged less than 65 years at baseline had a higher incidence of posterior subcapsular cataract (OR 3.4, 95% CI 1.3–8.4) than normotensive subjects. A history of angina was associated with higher cataract surgery incidence (OR 2.1, 95% CI 1.3–3.5). CONCLUSIONS These longitudinal data provide some evidence supporting a relationship between cardiovascular disease, vascular risk factors and incident cataract and cataract surgery. The findings confirm a number of associations previously documented in cross-sectional data.     

Serum lipids and age-related lens opacities: a longitudinal investigation: the Framingham Studies

OBJECTIVE: To investigate whether serum lipid/lipoprotein levels are independent risk factors for nuclear, cortical, or posterior subcapsular (PSC) cataracts. DESIGN: Case-control study nested in a cohort study. PARTICIPANTS AND METHODS: Eye examinations were conducted on surviving members of the Framingham Offspring Heart Study cohort from 1989 to 1991 (Framingham Offspring Eye Study) to determine cataract case-control status. Data from the Framingham Offspring Heart Study, including fasting serum total cholesterol, high-density lipoprotein cholesterol, and triglyceride measurements collected first in 1971, again approximately 8 years later, and approximately every 4 years thereafter were used to examine associations between lipid levels (mean levels across examinations and slope of measurements over time) and the presence of specific cataract types. The multistage analyses included 1869 persons aged 45 years and older. MAIN OUTCOME MEASURES: A standardized grading system was used to grade cortical, nuclear, and PSC cataracts. RESULTS: The median age of participants was 55 years; 49% were males. In multivariable logistic regression models adjusted for potential confounders, fasting hypertriglyceridemia (>/=250 mg/dl) was associated with an increased risk of PSC cataract in men (P = 0.02). High-density lipoprotein cholesterol levels 相似文献   

Plasma antioxidant vitamins and carotenoids and age-related cataract.

OBJECTIVE: To investigate the relationships between plasma concentrations of antioxidant vitamins and carotenoids and nuclear, cortical, and posterior subcapsular cataracts in a group of elderly men and women. DESIGN: Cross-sectional survey. PARTICIPANTS: Three hundred seventy-two men and women, aged 66 to 75 years, born and still living in Sheffield, England. METHODS: The Lens Opacities Classification System (LOCS) III was used to grade nuclear, cortical, and posterior subcapsular lens opacities. Fasting blood samples were taken to assess plasma concentrations of vitamin C, vitamin E, alpha-carotene, beta-carotene, lycopene, lutein, zeaxanthin, and beta-cryptoxanthin. MAIN OUTCOME MEASURES: Logistic regression analyses of the associations between plasma vitamin concentrations and cataract subtype, adjusting for age, gender, and other risk factors. RESULTS: After adjustment for age, gender, and other risk factors, risk of nuclear cataract was lowest in people with the highest plasma concentrations of alpha-carotene (odds ratio [OR], 0.5; 95% confidence interval [CI], 0.3-0.9, P for trend 0.006) or beta-carotene (OR, 0.7; 95% CI, 0.4-1.4, P for trend 0.033). Risk of cortical cataract was lowest in people with the highest plasma concentrations of lycopene (OR, 0.4; 95% CI, 0.2-0.8, P for trend 0.003), and risk of posterior subcapsular cataract was lowest in those with higher concentrations of lutein (OR, 0.5; 95% CI, 0.2-1.0, P for trend 0.012). High plasma concentrations of vitamin C, vitamin E, or the carotenoids zeaxanthin and beta-cryptoxanthin were not associated with decreased risk. CONCLUSIONS: These findings suggest that a diet rich in carotenoids may protect against cataract development, but because they are based on observational data, they need to be confirmed in randomized controlled trials.     

Refractive errors,axial ocular dimensions,and age-related cataracts: the Tanjong Pagar survey

PURPOSE: To describe the relationship of refractive errors and axial ocular dimensions and age-related cataract. METHODS: Population-based, cross-sectional survey of ocular diseases among Chinese men and women aged 40 to 81 years (n = 1232) living in the Tanjong Pagar district in Singapore. As part of the examination, refraction and corneal curvature were determined with an autorefractor, with refraction further refined subjectively. Ocular dimensions, including axial length, anterior chamber depth, lens thickness, and vitreous chamber depth, were measured with an A-mode ultrasound device. Lens opacity was graded clinically according to the Lens Opacity Classification System (LOCS) III system. Refraction, biometry, and cataract data on right (n = 989) and left (n = 995) eyes were analyzed separately. RESULTS: In analyses controlling for age, gender, education, diabetes, and cigarette smoking, nuclear cataract was associated with myopia (-1.35 D vs. -0.11 D, P < 0.001, comparing right eyes with and without nuclear cataract), but not with any specific biometric component. Cortical cataract was associated with thinner lenses (4.67 mm vs. 4.79 mm, P = 0.001, comparing right eyes with and without cortical cataract), but not with refraction and other biometric components. Posterior subcapsular cataract was associated with myopia (-1.80 D vs. -0.39 D, P < 0.001, comparing right eyes with and without posterior subcapsular cataract), deeper anterior chamber (3.00 mm vs. 2.89 mm, P = 0.02), thinner lens (4.62 mm vs. 4.77 mm, P = 0.001), and longer vitreous chamber (15.78 mm vs. 15.57 mm, P = 0.09), but not with overall axial length and corneal curvature. Adjustment for vitreous chamber depth attenuated the association between posterior subcapsular cataract and myopia by 65.5%, but did not substantially change the association between nuclear cataract and myopia. CONCLUSIONS: These population-based data support the associations between nuclear and posterior subcapsular cataracts and myopia reported in previous studies. Posterior subcapsular cataract is also associated with deeper anterior chamber, thinner lens, and longer vitreous chamber, with vitreous chamber depth explaining most of the association between posterior subcapsular cataract and myopia.     

Relationship between dietary macronutrient intake and the risk of age-related cataract in middle-aged and elderly patients in northeast China

AIM: To examine the association between dietary macronutrient intake and the risk of age-related cataract (ARC) in middle-aged and elderly men.METHODS:A hospital-based case-control study was conducted from December 2009 to November 2011. Cases (n=360) were patients with cataract aged 45-85 years old, and controls (n=360) were patients who had been admitted to the same hospital for diseases not related with cataract. All subjects were interviewed using a structured interviewer-administrated questionnaire that included information on socio-demographic characteristics, lifestyle habits and detailed medical history, simultaneously, the dietary intakes of nutrients were collected via a valid semi-quantitative food frequency questionnaire (FFQ). The odds ratios (OR) and corresponding 95% confidence intervals (CI) of three types of ARC were estimated using multiple logistic regression models.RESULTS: After adjusting for multiple potential confounders, total dietary intake of carbohydrate was positively associated with cortical cataract, compared to controls in the lowest quartile, and the OR for cases in the highest quartile of intake was 2.471 (95%CI:1.348-6.043, P=0.027). Higher dietary intakes of protein were protective for posterior subcapsular cataract (PSC) (OR=0.528, 95%CI:0.148-0.869, P=0.023). Dietary fat intake was not associated with any type of cataract, however, participants in the highest quartile of polyunsaturated fatty acids intake had 2.7 times the risk of nuclear cataract as did those in the lowest quartile (OR=2.742, 95%CI:1.790-4.200, P=0.033).CONCLUSION: A high intake of carbohydrate and polyunsaturated fatty acid may increase the odds of cortical and nuclear cataract, respectively, whereas high intake of protein, especially animal protein, may protect against PSC cataract. It is possible that dietary changes of target population may reduce the risk of ARC.     

Relation of ocular trauma to cortical, nuclear, and posterior subcapsular cataracts: the Beaver Dam Eye Study

BACKGROUND: The consequences of minor ocular trauma in the general population are unclear. The relation of self reported ocular trauma to cortical, nuclear, and posterior subcapsular cataracts is described in a defined population. METHODS: Population based, cross sectional study involving all people aged 43 to 86 years, living in Beaver Dam, Wisconsin (n=4926). Ocular trauma was ascertained by interview and cataract was graded from lens photographs. The relation of ocular trauma to cortical, nuclear, and posterior subcapsular cataracts was examined. RESULTS: People with a history of ocular trauma were more likely to have cortical (odds ratio (OR): 1.5; 95% confidence interval (CI): 1.0 to 2.2) and posterior subcapsular (OR: 1.7; 95% CI: 1.0 to 3.1) cataracts, compared to people without a history of trauma. These associations were stronger for people with previous trauma caused by a blunt object (OR: 3.3; 95% CI: 1.6 to 6.9 for cortical cataract, and OR: 4.1; 95% CI: 1.5 to 10.8 for posterior subcapsular cataracts). However, in analyses comparing the frequencies of cataract between traumatised and non-traumatised eyes among people with unilateral ocular trauma, the ocular trauma association for cortical cataract was no longer present, although the association for posterior subcapsular cataract persisted (OR: 2.4; 95% CI: 0.8 to 7.8). CONCLUSION: The data provide evidence of a possible association between self reported ocular trauma and posterior subcapsular cataract.     

Discriminative power of reading tests to differentiate visual impairment caused by cataract and age-related macular degeneration

PURPOSE: To determine whether preoperative reading tests can be used for differentiating visual impairments with regard to the diagnosis of cataract and age-related macular degeneration (ARMD). SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: Reading performance of patients with nuclear cataract, posterior subcapsular cataract, and ARMD were evaluated with respect to reading acuity, maximum reading speed, and critical print size; normal-sighted participants were tested as controls. A multivariate discriminant analysis of the 4 groups (100 eyes of 100 participants) was performed to evaluate how many patients could be correctly diagnosed by significant differences in the tested reading parameters. Subsequently, the nuclear cataract and posterior subcapsular cataract patients were compared with cataract patients with coexisting ARMD. RESULTS: Distance visual acuity was comparable in the nuclear cataract, posterior subcapsular cataract, and ARMD groups (P>.05). Reading acuity was significantly reduced in posterior subcapsular cataract and ARMD patients compared with nuclear cataract patients and controls (P<.0001). No significant difference in maximum reading speed was found between the nuclear cataract patients and the controls (P = .07), whereas the maximum reading speed of the posterior subcapsular cataract and ARMD patients was significantly reduced (P<.0001). In the discriminant analysis, it was possible to assign the correct diagnosis to 72% of the nuclear cataract patients, 76% of the posterior subcapsular cataract patients, 72% of the ARMD patients, and 92% of the controls. Comparing the reading performance of nuclear cataract and posterior subcapsular cataract patients and cataract patients with coexisting ARMD showed that reading performance was significantly impaired in the comorbid patients (nuclear cataract and ARMD, P<.001; posterior subcapsular cataract and ARMD, P<.05). CONCLUSION: The high discriminant accuracy shows that this standardized reading test system is a valuable diagnostic tool for evaluating functional visual impairments when distance visual acuity alone cannot elucidate the origin of functional impairment. Considering the significant discrepancies in reading performance among patients with nuclear cataract, posterior subcapsular cataract, and ARMD, reading tests may relevantly improve the clinical evaluation of patients with visual loss, even of patients with ocular comorbidity.