Prevalence and risk factors on age-related cataract and surgery in adults over 50 years old in Binhu District, Wuxi, China

Association between obesity and age-related cataract: an updated systematic review and dose-response meta-analysis of prospective cohort studies

Objective

There are inconsistent findings on the association between obesity and age-related cataract (ARC). This systematic review was done to summarize available findings on the association between obesity [defined by body mass index (BMI)] and ARC by performing a dose-response meta-analysis on eligible prospective cohort studies.

Methods

We performed a systematic search in PubMed, Scopus, ISI Web of Knowledge, and Google Scholar until June 2022 to identify eligible publications.

Results

In total, 16 studies with a total sample size of 1,607,125 participants were included. Among all of these studies, there were 103,897 cases of ARC. In the follow-up periods ranging between 4 and 28 years, 4,870 cases of nuclear cataract, 1,611 cases of cortical cataract, and 1,603 cases of posterior subcapsular cataracts (PSC) were detected. By comparing the highest and lowest categories of BMI, we found that higher BMI was associated with an increased risk of ARC (RR: 1.18, 95% CI: 1.09-1.28) and PSC (RR: 1.44, 95% CI: 1.08-1.90). In the dose-response analysis, each 5 kg/m2 increase in BMI was associated with a 6 and 27% increased risk of ARC (RR: 1.06, 95% CI: 1.01-1.12) and PSC (RR: 1.27, 95% CI: 1.14-1.41), respectively. In addition, we found a positive association for cortical cataract among high-quality studies, in which higher BMI was associated with a 20% increased risk of cortical cataract (RR: 1.20, 95% CI: 1.02-1.42). In terms of nuclear cataract, we found no significant association either in the comparison between the highest and lowest categories of BMI or in the dose-response meta-analysis.

Conclusion

Obesity (defined by BMI) was associated with an increased risk of ARC, PSC, and cortical cataract in adults. However, such a positive association was not seen for nuclear cataract.

PROSPERO registration

CRD42022357132.

The Risk of Major Depressive Disorder Due to Cataracts among the Korean Elderly Population: Results from the Korea National Health and Nutrition Examination Survey (KNHANES) in 2016 and 2018

Cataracts and major depressive disorder (MDD) both have high prevalence, representing for major health burdens globally. In this study, we examined the risk of MDD due to cataracts. Data from the 2016 to 2018 Korea National Health and Nutrition Examination Survey (KNHANES) were used, including 4122 participants. Logistic regression analysis was performed to evaluate the odds ratio for MDD in association with cataracts. Controlled variables were age, gender, smoking, dyslipidemia and mobility. Subgroup analysis was performed with stratification by gender. The results reveal that cataracts are significantly correlated with MDD. Elderly people with cataracts were found to be more likely to develop MDD compared to those without cataracts (adjusted odds ratio: 1.654; 95% CI = 1.197-2.286). In subgroup analysis, men (adjusted odds ratio: 2.631; 95% CI = 1.247-5.551) were found to be more likely to develop MDD than women (adjusted odds ratio: 1.510; 95% CI = 1.061-2.150). Cataracts may be a risk factor for MDD in the elderly, especially among the male population.

Aberrant expression of COL4A1 in age-related cataract and its effect on cell proliferation, apoptosis and gene expression changes

AIM

To evaluate the regulation of the aberrant expression of collagen type IV alpha 1 chain (COL4A1) in the development of age-related cataract (ARC).

METHODS

Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and Western blot analysis were employed to evaluate the expression of COL4A1 in ARC patients and healthy controls. The proliferation, apoptosis, cell cycle and epithelial-mesenchymal transition (EMT) of human lens epithelial cell (HLE-B3) were further analyzed under the condition of COL4A1 gene silence. Alteration of gene expression at mRNA level after knockdown COL4A1 were also evaluated by qRT-PCR on HLE-B3 cells.

RESULTS

The aberrant expression of COL4A1 was identified a clinically associated with the ARC. Silencing of COL4A1 promoted the apoptosis and inhibited the proliferation of HLE-B3 by blocking the cell cycle. Moreover, COL4A1 gene silence didn't affect the cytoskeleton of HLE-B3 but down-regulated the Collagen type IV Alpha 2 Chain (COL4A2), paired box 6 (PAX6), procollagen-lysine 2-oxoglutarate 5-dioxygenases 1 (PLOD1) and procollagen-lysine 2-oxoglutarate 5-dioxygenases 2 (PLOD2) expression levels in HLE-B3 cells. Silencing the COL4A1 gene induced EMT of the HLE-B3 cells by promoting the transforming growth factor beta (TGF-β) expression.

CONCLUSION

Silencing of COL4A1 induces S-phase arrest, also inhibits the proliferation and enhance HLE-B3 apoptosis and EMT, and down-regulates the expression of COL4A2, PAX6, PLOD1 and PLOD2. Thus, the expression alteration of COL4A1 may play a critical role in the pathogenesis of ARC.

Correlation analysis between self-rated treatment effect and diagnosis and treatment of elderly poor cataract patientswith poor financial condition in rural areas of Ganzi Prefecture

OBJECTIVE

To analyze the correlation between self-rated treatment effect and diagnosis and treatment of elderly indigent cataract patients in rural areas of Ganzi Prefecture.

METHODS

In this retrospective study, senior cataract patients admitted in the Ganzi region from March 2018 to November 2021 were included. 495 indigent patients were classified into the poor group, including 400 cases who received surgical treatment and 95 who did not. The 318 patients that were not indigent were classified as the non-poor group. The basic demographic characteristics, treatment, self-assessed treatment effect, and the cost of surgery, blindness rate, and disability rate were compared between the two groups. The correlation between self-assessed treatment effect and treatment condition of patients in the poor group was analyzed by multi-factor unconditional logistic regression.

RESULTS

There were no significant differences in the basic demographic characteristics, self-assessed treatment effect, or postoperative blindness rate between the patients receiving surgery in both groups (P>0.05). The visual acuity of 400 patients after the operation was significantly higher than that before operation (P<0.05). The operation and other costs in the poor group were lower than those of the non-poor group (P<0.05). The elimination rate of disability in the non-poor group was significantly higher than in the poor group (P<0.05). Multivariate regression analysis showed that the level of the hospital, the location of the treatment institution, living alone, education level, and the number of visits were factors affecting the self-rated treatment effect of patients (P<0.05).

CONCLUSION

The self-rated treatment effect of elderly indigent cataract in rural Ganzi Prefecture was closely related to the level of the hospital, the location of treatment institutions, living alone, education level, and the number of visits. Health poverty alleviation programs should be strengthened.

Epidemiology, health policy and public health implications of visual impairment and age-related eye diseases in mainland China

The prevalence of visual impairment (VI) and age-related eye diseases has increased dramatically with the growing aging population in mainland China. However, there is limited comprehensive evidence on the progress of ophthalmic epidemiological research in mainland China to enhance our awareness of the prevention of eye diseases to inform public health policy. Here, we conducted a literature review of the population-based epidemiology of VI and age-related eye diseases in mainland China from the 1st of January 1946 to the 20th of October 2021. No language restrictions were applied. There was significant demographic and geographic variation in the epidemic of VI and age-related eye diseases. There are several factors known to be correlated to VI and age-related eye diseases, including age, gender, family history, lifestyle, biological factors, and environmental exposures; however, evidence relating to genetic predisposition remains unclear. In addition, posterior segment eye diseases, including age-related macular degeneration and diabetic retinopathy, are amongst the major causes of irreversible visual impairments in the senile Chinese population. There remains a significant prevention gap, with only a few individuals showing awareness and achieving optimal medical care with regards to age-related eye diseases. Multiple challenges and obstacles need to be overcome, including the accelerated aging of the Chinese population, the lack of structured care delivery in many underdeveloped regions, and unequal access to care. Despite the progress to date, there are few well-conducted multi-center population-based studies following a single protocol in mainland China, which findings can hopefully provide valuable cues for governmental decision-making and assist in addressing and halting the incidence of VI and age-related eye diseases in China.

Comparing Efficacy and Safety of Intracameral Injection of Marcaine and Lidocaine on Postoperative Pain and Recovery After Cataract Surgery

Background: Various topical (intracameral) analgesics are used to relieve postoperative pain after cataract surgery. Objectives: We decided to compare the effects of intracameral Marcaine and lidocaine on pain intensity after the cataract operation. Methods: In this double-blind, randomized clinical trial, 64 patients who were candidates for cataract surgery were randomly assigned to either anesthesia with lidocaine or bupivacaine (Marcaine) by intracameral injection. Study endpoints included pain score, hemodynamic status, patient satisfaction, and recovery duration. Results: The Marcaine group experienced a shorter recovery than another group (P = 0.001). The mean pain score at the different time points after the operation was significantly lower in the group receiving Marcaine than those receiving lidocaine (P < 0.001). Our study showed a higher level of patients’ satisfaction with Marcaine as compared to the lidocaine group (P = 0.026). However, postoperative hemodynamic status was similar in both groups. Conclusions: Compared with lidocaine, intracameral injection of Marcaine results in a shorter postoperative recovery period, reduced pain intensity, and higher satisfaction among patients after cataract surgery.

Visually significant cataract and associated factors among older people attending a community ophthalmic service in central Gondar Zone, Northwest Ethiopia: a cross-sectional study

Objective

In this study, we aimed to determine the prevalence of visually significant cataract and associated factors among older people attending community ophthalmic services in the central Gondar Zone, Northwest Ethiopia.

Methods

We conducted a community outreach-based cross-sectional study among adults aged ≥40 years in the central Gondar Zone from 30 May to 15 June 2021. We used systematic random sampling to select study participants. Interviewer-administered questionnaires and ocular examinations were performed and the data recorded. We applied binary logistic regression to identify factors associated with visually significant cataract.

Results

A total of 821 participants were included, with median age 57 years. The prevalence of visually significant cataract was 29.1% (95% CI: 26.1–32.0). Age ≥80 years (adjusted odds ratio [AOR] = 16.9; 95% CI: 7.5–38.4), rural residence (AOR = 1.7; 95% CI: 1.02–2.7), unmarried status (AOR = 1.9; 95% CI: 1.2–3.2), illiteracy (AOR = 2.9; 95% CI: 1.4–6.1), unemployed status (AOR = 1.7; 95% CI: 1.1–2.7), and sunlight exposure ≥5 hours per day (AOR = 1.6; 95% CI: 1.04–2.4) were significantly associated with visually significant cataract.

Conclusion

In this study, visually significant cataract was found to be high, which requires immediate public health intervention.

Ocular Signs and Ocular Comorbidities in Monoclonal Gammopathy: Analysis of 80 Subjects

Purpose

To examine the ocular signs of monoclonal gammopathy and to evaluate ocular comorbidities in subjects with monoclonal gammopathy. Patients and Methods. We analyzed patients from two large referral hematology centers in Budapest, diagnosed and/or treated with monoclonal gammopathy between 1997 and 2020. As a control group, randomly selected individuals of the same age group, without hematological disease, have been included. There were 160 eyes of 80 patients (38.75% males; age 67.61 ± 10.48 (range: 38-85) years) with monoclonal gammopathy and 86 eyes of 43 control subjects (32.56% males; age 62.44 ± 11.89 (range 37-86) years). The hematological diagnosis was MGUS in 9 (11.25%), multiple myeloma in 61 (76.25%), smoldering myeloma in 6 (7.50%), and amyloidosis or Waldenström macroglobulinemia in 2 cases (2.50%-2.50%). Before detailed ophthalmic examination with fundoscopy, 42 subjects with gammopathy (52.50%) and all controls filled the Ocular Surface Disease Index (OSDI) questionnaire.

Results

The OSDI score and best-corrected visual acuity (BCVA) were significantly worse in subjects with monoclonal gammopathy than in controls (p=0.02; p=0.0005). Among gammopathy subjects, we observed potential corneal immunoglobulin deposition in 6 eyes of 4 (3.75%) patients. Ocular surface disease (p=0.0001), posterior cortical cataract (p=0.01), and cataract (p=0.0001) were significantly more common among gammopathy subjects than in controls (χ ² test).

Conclusions

Ocular surface disease and cataract are more common, and BCVA is worse in patients with monoclonal gammopathy than in age-matched controls. Therefore, and due to the potential ocular signs and comorbidities of monoclonal gammopathy, we suggest a regular, yearly ophthalmic checkup of these patients to improve their quality of life.

Knowledge about cataract and associated factors among adults in Yirgalem town, Sidama National Regional State, southern Ethiopia, 2020: a community based cross sectional study design

BACKGROUND

Globally, at least 1 billion people have a vision impairment that could have been easily prevented or easily treated. Cataract is the leading preventable and most treatable causes of blindness and bilateral low vision among adults. Despite being the leading cause of preventable and most treatable blindness, the lack of knowledge about the disease and its option of treatment is still a major barrier in reducing the blindness owing to cataract in the developing countries particularly in Ethiopia. Hence, the aim of this study is to determine the level of knowledge about cataract and associated factors among adults in Yirgalem Town, Sidama National Regional State, Southern Ethiopia, 2020.

METHODS

A community-based cross-sectional study design was conducted among randomly selected 599 adult's age 18 years and above from May 10-30, 2020. A multi-stage sampling technique was used to select the study participants. Data were collected using pre-tested and structured face-to-face interview questionnaires. The collected data were entered to Epi data version 3.1 and then exported to SPSS version 21 for analysis. Bi-variable and multivariable logistic regression was used to identify associated factors of knowledge about cataract. Adjusted Odds Ratio (AOR) together with 95% Confidence Interval (CI) was used to declare the statistical association between dependent and independent variables.

RESULTS

Of the total study participants, 379 (64.7%), [(95% CI: 60.7-68.6%)] of them had good knowledge about cataract. Age (≥40 years) [AOR = 2.29(95% CI 1.18-4.44)], Elementary school completed [AOR = 2.31(95% CI 1.30-4.10)], High school & above [AOR = 5.55(95% CI 2.81-10.89)], governmental and non-governmental employed [AOR = 5.62 (95% CI 2.78-11.38)], Merchant [AOR = 1.72(95% CI 1.03-2.88)], Positive Attitude [AOR = 3.85(95% CI 2.94-6.47)] were positively significantly associated with knowledge about cataract. Whereas, rural residence [AOR = 0.19 (95% CI: 0.12-0.31)] was negatively associated with knowledge about cataract.

CONCLUSIONS

More than one third of the participants still had poor knowledge about cataract. This implies that health facilities should be engaged and raises the awareness of the community and empowers people about eye care needs.

Polygenetic-Risk Scores Related to Crystallin Metabolism Are Associated with Age-Related Cataract Formation and Interact with Hyperglycemia, Hypertension, Western-Style Diet, and Na Intake

Age-related cataract (ARC) development is associated with loss of crystalline lens transparency related to interactions between genetic and environmental factors. We hypothesized that polygenetic risk scores (PRS) of the selected genetic variants among the ARC-related genes might reveal significant genetic impacts on ARC risk, and the PRS might have gene-gene and gene-lifestyle interactions. We examined the hypothesis in 1972 and 39,095 subjects aged ≥50 years with and without ARC, respectively, in a large-scale hospital-based cohort study conducted from 2004 to 2013. Single nucleotide polymorphisms (SNPs) of the genes related to ARC risk were identified, and polygenetic risk scores (PRS) were generated based on the results of a generalized multifactor dimensionality reduction analysis. Lifestyle interactions with PRS were evaluated. The PRS derived from the best model included the following six SNPs related to crystallin metabolism: ULK4_rs1417380362, CRYAB_rs2070894, ACCN1_rs55785344, SSTR2_rs879419608, PTN_rs322348, and ICA1_rs200053781. The risk of ARC in the high-PRS group was 2.47-fold higher than in the low-PRS group after adjusting for confounders. Age, blood pressure, and glycemia interacted with PRS to influence the risk of ARC: the incidence of ARC was much higher in the elderly (≥65 years) and individuals with hypertension or hyperglycemia. The impact of PRS on ARC risk was greatest in middle-aged individuals with hypertension or hyperglycemia. Na, coffee, and a Western-style diet intake also interacted with PRS to influence ARC risk. ARC risk was higher in the high-PRS group than in the low-PRS group, and high Na intake, Western-style diet, and low coffee intake elevated its risk. In conclusion, ARC risk had a positive association with PRS related to crystallin metabolism. The genetic impact was greatest among those with high Na intake or hypertension. These results can be applied to precision nutrition interventions to prevent ARC.