The Lens Opacities Case-Control Study:  Risk Factors for Cataract

M. Cristina Leske, MD, MPH; Leo T. Chylack Jr, MD; Suh-Yuh Wu, MA
Arch Ophthalmol. 1991;109(2):244-251. doi:10.1001/archopht.1991.01080020090051.
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• The Lens Opacities Case-Control Study evaluated risk factors for age-related nuclear, cortical, posterior subcapsular, and mixed cataracts. The 1380 participants were ophthalmology outpatients, aged 40 to 79 years, classified into the following groups: posterior subcapsular only, 72 patients; nuclear only, 137 patients; cortical only, 290 patients; mixed cataract, 446 patients; and controls, 435 patients. In polychotomous logistic regression analyses, low education increased risk (odds ratio [OR]= 1.46) and regular use of multivitamin supplements decreased risk (OR =0.63) for all cataract types. Dietary intake of riboflavin, vitamins C, E, and carotene, which have antioxidant potential, was protective for cortical, nuclear, and mixed cataract; intake of niacin, thiamine, and iron also decreased risk. Similar results were found in analyses that combined the antioxidant vitamins (OR =0.40) or considered the individual nutrients (OR =0.48 to 0.56). Diabetes increased risk of posterior subcapsular, cortical, and mixed cataracts (OR =1.56). Oral steroid therapy increased posterior subcapsular cataract risk (OR = 5.83). Females (OR =1.51) and nonwhites (OR = 2.03) were at increased risk only for cortical cataract. Risk factors for nuclear cataract were a nonprofessional occupation (OR =1.96), current smoking (OR = 1.68), body mass index (OR = 0.76), and occupational exposure to sunlight (OR =0.61). Gout medications (OR =2.48), family history (OR =1.52), and use of eyeglasses by age 20 years, which is an indicator of myopia (OR = 1.44), increased risk of mixed cataract. The results support a role for the nutritional, medical, personal, and other factors in cataractogenesis. The potentially modifiable factors suggested by this study merit further evaluation.


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