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Chen C, Wei L, He W, Zhang Y, Xiao J, Lu Y, Wang F, Zhu X. Associations of severe liver diseases with cataract using data from UK Biobank: a prospective cohort study. EClinicalMedicine 2024; 68:102424. [PMID: 38304745 PMCID: PMC10831806 DOI: 10.1016/j.eclinm.2024.102424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/23/2023] [Accepted: 01/03/2024] [Indexed: 02/03/2024] Open
Abstract
Background Liver disease is linked to series of extrahepatic multisystem manifestations. However, little is known about the associations between liver and eye diseases, especially cataract, the global leading cause of blindness. We aimed to investigate whether severe liver diseases, including non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease (ALD), viral hepatitis, and liver fibrosis and cirrhosis, were associated with an increased risk of the cataract. Methods A total of 326,558 participants without cataract at baseline enrolled in the UK Biobank between 2006 and 2010 were included in this prospective study. The exposures of interest were severe liver diseases (defined as hospital admission), including NAFLD, ALD, viral hepatitis and liver fibrosis and cirrhosis. The outcome was incident cataract. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). Each liver disease was first treated as a binary time-varying variable to investigate its association with cataract, and then was treated as a ternary time-varying variable to examine the recent (liver disease within 0-5 years) vs. long-term (liver disease > 5 years) state associations with the risk of cataract. Findings After a median follow-up of 13.3 years (interquartile range, 12.5-14.0 years), 37,064 individuals were documented as developing cataract. Higher risk of cataract was found in those with severe NAFLD (HR, 1.47; 95% CI, 1.33-1.61), ALD (HR, 1.57; 95% CI, 1.28-1.94) and liver fibrosis and cirrhosis (HR, 1.58; 95% CI, 1.35-1.85), but not in individuals with viral hepatitis when exposure was treated as a binary time-varying variable (P = 0.13). When treating exposure as a ternary time-varying variable, an association between recently diagnosed viral hepatitis and cataract was also observed (HR, 1.55; 95% CI, 1.07-2.23). Results from the combined model suggested they were independent risk factors for incident cataract. No substantial changes were found in further sensitivity analyses. Interpretation Severe liver diseases, including NAFLD, ALD, liver fibrosis and cirrhosis and recently diagnosed viral hepatitis, were associated with cataract. The revelation of liver-eye connection suggests the importance of ophthalmic care in the management of liver disease, and the intervention precedence of patients with liver disease in the early screening and diagnosis of cataract. Funding National Natural Science Foundation of China, Science and Technology Innovation Action Plan of Shanghai Science and Technology Commission, Clinical Research Plan of Shanghai Shenkang Hospital Development Center, Shanghai Municipal Key Clinical Specialty Program, the Guangdong Basic and Applied Basic Research Foundation and Shenzhen Science and Technology Program.
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Affiliation(s)
- Chao Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Ling Wei
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Wenwen He
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Ye Zhang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Jia Xiao
- Changsha Aier Eye Hospital, Changsha, Hunan Province 410015, China
- Aier Eye Institute, Changsha, Hunan Province 410015, China
- Shandong Provincial Key Laboratory for Clinical Research of Liver Diseases, Qingdao Hospital, University of Health and Rehabilitation Sciences, Qingdao 266001, China
| | - Yi Lu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Fei Wang
- Division of Gastroenterology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, China
| | - Xiangjia Zhu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
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Christopher KL, Patnaik JL, Penland KJ, Pantcheva MB, Lynch AM, Ifantides C. Outcomes and Risk Factors for Complications in Cataract Patients with Hepatitis C Virus Infection. Ophthalmic Epidemiol 2023; 30:492-498. [PMID: 36196031 DOI: 10.1080/09286586.2022.2131836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 09/09/2022] [Accepted: 09/26/2022] [Indexed: 10/10/2022]
Abstract
PURPOSE To describe outcomes of patients with hepatitis C virus (HCV) seropositivity undergoing cataract surgery, as well as investigate risk factors for surgical complications. METHODS This is a retrospective cohort study of all consecutive patients who underwent cataract surgery at a tertiary care hospital in the United States between 2014 and 2019. The exposure of interest was HCV seropositivity and outcomes included surgical complications and associated risk factors, visual acuity, and post-operative complications. RESULTS A total of 11,276 eyes of 6,858 patients were included in the study, of which 122 patients (1.78%) and 210 eyes (1.86%) were HCV positive. Average age at surgery was 63.4 (8.4) years for HCV positive patients and 69.1 (10.6) years for HCV negative patients. Patients with HCV were more likely to suffer a complication during cataract surgery, 2.9% versus 1.2% (OR 2.27, 95% CI 1.03 to 5.01, p = .0415). Postoperative best corrected visual acuity was excellent: median and range 0.00 (-0.13, 3.00) logMAR for HCV positive eyes versus 0.00 (-0.30, 3.00) logMAR for HCV negative eyes. Among HCV positive patients, elevated alanine transaminase (>52 U/L) was associated with a higher intraoperative complication rate (10.0% vs 1.8%, OR 5.53, 95% CI 1.05 to 29.2, p = .044). CONCLUSION While patients with HCV are more likely to have complications during cataract surgery, final best corrected visual acuity was excellent regardless of HCV status. Patients with HCV are more likely to undergo cataract surgery at a younger age, and those with elevated alanine transaminase are at highest risk for complications.
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Affiliation(s)
- Karen L Christopher
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, United States
| | - Jennifer L Patnaik
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, United States
| | - Kylie J Penland
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, United States
| | - Mina B Pantcheva
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, United States
| | - Anne M Lynch
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, United States
| | - Cristos Ifantides
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, United States
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Congenital Infection and Congenital Cataract in Tanzania: A Case Control Study. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2020. [DOI: 10.5812/pedinfect.101087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Cataract is the commonest cause of childhood blindness in sub Saharan Africa (SSA). The significance of congenital rubella and human cytomegalovirus (HCMV) infection in the etiology is not known. Objectives: We aimed to investigate prevalence of both viruses in cases of congenital cataract and controls. Methods: Lens tissue was collected (from cases), blood and saliva from cases and controls. Using ELISA, we tested blood samples for rubella and cytomegalovirus IgM. Quantitative polymerase chain reaction (qPCR) was also used for detection of the viruses. Results: Cytomegalovirus was detected using qPCR in 72.9% saliva specimens of cases compared to 38.5% of controls (P = 0.0001). Cytomegalovirus IgM was also detected in 10.8% blood specimens of cases and only 1.5% control (P = 0.01). Rubella IgM was detected in 13.8% blood specimens of cases and only 3.1% controls (P = 0.01). In lens aspirates of cases, 12.7% were HCMV positive and 11.1% were rubella positive by qPCR. Cases had lower birth weights (mean = 2.8 kg) than controls (mean = 3.2 kg), independent of viral status (P = 0.004). Conclusions: Although most of the children in the study presented too late to be sure that infection was congenital, our study strongly suggests that HCMV and rubella infection appear important causes of congenital cataract in Tanzania hence virology testing of infantile cataract cases may be useful in assessing effectiveness of immunization programs as they are established throughout SSA.
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Chen HY, Lin CL. Comparison of medical comorbidity between patients with primary angle-closure glaucoma and a control cohort: a population-based study from Taiwan. BMJ Open 2019; 9:e024209. [PMID: 30904848 PMCID: PMC6475178 DOI: 10.1136/bmjopen-2018-024209] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To determine the prevalence and risk of systemic comorbidities in primary angle-closure glaucoma in Taiwan population. METHODS We included 3322 primary angle-closure glaucoma (PACG) subjects and randomly selected patients without PACG from the Taiwan National Health Insurance Research Database and frequency matched four of them (n=13 288) to each PACG patient, based on age and sex. The univariable and multivariable unconditional logistic regression models were used to estimate the effect of comorbidities on the risk of PACG as indicated by the OR with 95% CI. RESULTS The mean age of the PACG group was 65.2±12.7 years, and 61.1% of the patients were female. The risk of PACG was greater for patients with the comorbidities of hyperlipidaemia (ORs: 1.11), headaches (ORs: 1.13), liver diseases (ORs: 1.14), peptic ulcers (ORs: 1.10) and cataract (ORs: 3.80). For the male group, diabetes (ORs: 1.19), liver diseases (ORs: 1.29) and cataract (ORs: 4.30) were significantly associated with increasing PACG risk. For the female group, hyperlipidaemia (ORs: 1.13), headaches (ORs: 1.15), peptic ulcers (ORs: 1.14) and cataract (ORs: 3.54) were significantly associated with increasing PACG risk. For the age group of 64 years and younger, patients with comorbidity of hyperlipidaemia (ORs: 1.20), peptic ulcers (ORs: 1.21) and cataract (ORs: 5.91) were significantly associated with increasing PACG risk. For the age group of 65 years and older, patients with cataract were significantly associated with increasing PACG risk (ORs: 5.07). CONCLUSIONS Clinicians should be aware of slightly increased PACG risk in the subjects with the medical comorbidities of hyperlipidaemia, headaches, liver diseases and peptic ulcers. However, cataract is the strongest risk factor of PACG.
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Affiliation(s)
- Hsin-Yi Chen
- Ophthalmology, China Medical University, Taichung, Taiwan
- Ophthalmology, Fu-Jen Catholic University Hospital, New Taipei, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University, Taichung, Taiwan
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