Risk factors for cortical, nuclear, and posterior subcapsular cataracts: the POLA study. Delcourt C* cristol J-P, tessier F, Leger CL, michel F, papoz L, and the POLA study group. Am J epidemiol 2000;151:497-504

The POLA (Pathologies Oculaires Liees a l'Age) Study is a population-based study of cataract and age-related macular degeneration and their risk factors being carried out among 2,584 residents of Sete, southern France, aged 60-95 years. Recruitment took place between June 1995 and July 1997. Cataract classification was based on a standardized lens examination by slit lamp, according to Lens Opacities Classification System III. This paper presents results obtained from cross-sectional analysis of the first phase of the study. In polytomous logistic regression analyses, an increased risk of cataract was found for female sex (cataract surgery: odds ratio (OR) = 3.03; cortical cataract: OR = 1.67), brown irises (cortical, nuclear, and mixed cataracts: OR = 1.61), smoking (cataract surgery: OR = 2.34 for current smokers and OR = 3.75 for former smokers), known diabetes of 10 or more years' duration (posterior subcapsular, cortical, and mixed cataracts and cataract surgery: OR = 2.72), use of oral corticosteroids for at least 5 years (posterior subcapsular cataract: OR = 3.25), asthma or chronic bronchitis (cataract surgery: OR = 2.04), cancer (posterior subcapsular cataract: OR = 1.92), and cardiovascular disease (cortical cataract: OR = 1.96). Decreased risk of cataract was found with higher education (all types of cataract and cataract surgery: OR = 0.59), hypertension (cataract surgery: OR = 0.57), and high plasma retinol levels (nuclear and mixed cataracts and cataract surgery: OR = 0.75 for a 1-standard-deviation increase). Most of the risk factors identified in this study confirm the findings of other studies. The association of cataract with plasma retinol level requires further investigation.

[1]  F. Ederer,et al.  Epidemiologic associations with nuclear, cortical, and posterior subcapsular cataracts. , 1986, American journal of epidemiology.

[2]  J. Arthur,et al.  Plasma concentrations of carotenoids and antioxidant vitamins in Scottish males: influences of smoking. , 1995, European journal of clinical nutrition.

[3]  M. C. Leske,et al.  Risk factors for nuclear opalescence in a longitudinal study. LSC Group. Longitudinal Study of Cataract. , 1998, American journal of epidemiology.

[4]  J. García-Sánchez,et al.  Effects of estrogen use on lens transmittance in postmenopausal women. , 1997, Ophthalmology.

[5]  R. Klein,et al.  Cardiovascular disease, selected cardiovascular disease risk factors, and age-related cataracts: the Beaver Dam Eye Study. , 1997, American journal of ophthalmology.

[6]  R. Milton,et al.  India-US case-control study of age-related cataracts. India-US Case-Control Study Group. , 1989, Archives of ophthalmology.

[7]  M. C. Leske,et al.  Prevalence of lens opacities in the Barbados Eye Study. , 1997, Archives of ophthalmology.

[8]  J. G. Bieri,et al.  Simultaneous determination of retinol and alpha-tocopherol in serum or plasma by liquid chromatography. , 1983, Clinical chemistry.

[9]  M. C. Leske,et al.  The Lens Opacities Classification System III. The Longitudinal Study of Cataract Study Group. , 1993, Archives of ophthalmology.

[10]  L T Chylack,et al.  The Lens Opacities Case-Control Study. Risk factors for cataract. , 1991, Archives of ophthalmology.

[11]  C. la Vecchia,et al.  Selected diseases and risk of cataract in women. A case-control study from northern Italy. , 1995, Annals of epidemiology.

[12]  R. Cumming,et al.  Hormone replacement therapy, reproductive factors, and cataract. The Blue Mountains Eye Study. , 1997, American journal of epidemiology.

[13]  M. Stazi,et al.  Risk factors for age-related cortical, nuclear, and posterior subcapsular cataracts. The Italian-American Cataract Study Group. , 1991, American journal of epidemiology.

[14]  S. Suissa,et al.  Association of inhaled corticosteroid use with cataract extraction in elderly patients. , 1998, JAMA.

[15]  S. Miglior,et al.  Risk factors for cortical, nuclear, posterior subcapsular and mixed cataract: a case-control study. , 1994, Ophthalmic epidemiology.

[16]  R. Klein,et al.  Cigarette smoking and lens opacities: the Beaver Dam Eye Study. , 1993, American journal of preventive medicine.

[17]  P. Wilson,et al.  Cigarette smoking and the risk of development of lens opacities. The Framingham studies. , 1997, Archives of ophthalmology.

[18]  K L Linton,et al.  Prevalence of age-related lens opacities in a population. The Beaver Dam Eye Study. , 1992, Ophthalmology.

[19]  R. Klein,et al.  Is There Evidence of an Estrogen Effect on Age-Related Lens Opacities?: The Beaver Dam Eye Study , 1994 .

[20]  M. Egerton,et al.  Diabetes, glaucoma, sex, and cataract: analysis of combined data from two case control studies. , 1993, The British journal of ophthalmology.

[21]  R. Klein,et al.  Older-onset diabetes and lens opacities. The Beaver Dam Eye Study. , 1995, Ophthalmic epidemiology.

[22]  R. Cumming,et al.  Use of inhaled corticosteroids and the risk of cataracts. , 1997, The New England journal of medicine.

[23]  J. Silver,et al.  Cataracts and cigarette smoking: The City Eye Study , 1989, Eye.

[24]  H. Luukinen,et al.  Prevalence and risk factors of lens opacities in the elderly in Finland. A population-based study. , 1995, Ophthalmology.

[25]  F Wang,et al.  Plasma Antioxidants and Risk of Cortical and Nuclear Cataract , 1993, Epidemiology.

[26]  J C Javitt,et al.  The content and cost of cataract surgery. , 1993, Archives of ophthalmology.

[27]  R. Klein,et al.  Hypertension and lens opacities from the Beaver Dam Eye Study. , 1995, American journal of ophthalmology.

[28]  M. C. Leske,et al.  Biochemical factors in the lens opacities. Case-control study. The Lens Opacities Case-Control Study Group. , 1995, Archives of ophthalmology.

[29]  R. Cumming,et al.  Diet and cataract: the Blue Mountains Eye Study. , 2000, Ophthalmology.

[30]  S. Pocock,et al.  Blood Cadmium Concentrations in the General Population of British Middle-aged Men , 1988, Human toxicology.

[31]  M. C. Leske,et al.  The Lens Opacities Classification System III , 1993 .

[32]  J. Manson,et al.  Body mass index. An independent predictor of cataract. , 1995, Archives of ophthalmology.

[33]  C. la Vecchia,et al.  Food and nutrient intake and risk of cataract. , 1996, Annals of epidemiology.

[34]  A. Rissanen,et al.  Serum antioxidant vitamins and risk of cataract. , 1992, BMJ.

[35]  F. Ederer,et al.  Epidemiologic associations with cataract in the 1971-1972 National Health and Nutrition Examination Survey. , 1983, American journal of epidemiology.

[36]  R. Cumming,et al.  Alcohol, smoking, and cataracts: the Blue Mountains Eye Study. , 1997, A M A Archives of Ophthalmology.

[37]  R. Klein,et al.  Diet and nuclear lens opacities. , 1995, American journal of epidemiology.

[38]  B Rosner,et al.  Nutrient intake and cataract extraction in women: a prospective study. , 1992, BMJ.

[39]  B. Munoz,et al.  Cigarette smoking and risk of nuclear cataracts. , 1989, Archives of ophthalmology.

[40]  J. Guilland,et al.  Validation of a micromethod for determining oxidized and reduced vitamin C in plasma by HPLC-fluorescence. , 1996, International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition.

[41]  K. N. Sulochana,et al.  Smoking of beedies and cataract: cadmium and vitamin C in the lens and blood. , 1995, The British journal of ophthalmology.

[42]  O. Çekiç Effect of cigarette smoking on copper, lead, and cadmium accumulation in human lens , 1998, The British journal of ophthalmology.

[43]  C. Delcourt,et al.  Associations of antioxidant enzymes with cataract and age-related macular degeneration. The POLA Study. Pathologies Oculaires Liées à l'Age. , 1999, Ophthalmology.

[44]  B. Munoz,et al.  Cigarette smoking and risk for progression of nuclear opacities. , 1995, Archives of ophthalmology.

[45]  J C Javitt,et al.  Blindness due to cataract: epidemiology and prevention. , 1996, Annual review of public health.