Risk factors for lens opacities - The Barbados Eye Study

Purpose. Limited data are available on risk factors for lens opacities in black populations. The Barbados Eye Study (BES) evaluated associations with single (PSC, nuclear, cortical) and mixed types of lens opacities in a population-based sample of Barbados-born citizens aged 40-84 years. Methods. Lenses were classified at the slit lamp by the Lens Opacities Classification System II (LOCS II) and a score ≥2 was used to define opacities. High reproducibility of gradings was achieved (k̂=0.68 to 0.95). Among 4314 black BES participants, 17 (0.4%) had PSC only, 229 (5.3%) nuclear only, 851 (19.7%) cortical only, and 548 (12.7%) had mixed opacities. Logistic regression analyses were used to evaluate factors associated with each opacity type. Results. In addition to age, female gender was positively associated with all cataract types (OR=1.3 to 1.7) but PSC. Regular use of nutritional supplements decreased risk (OR=0.8) of cortical opacities, while higher waist-hip ratio (OR=1.4), high diastolic blood pressure (OR=1.3) and family history of cataract (OR=1.5) increased risk. Steroid use increased risk of PSC (OR=11.1). Diabetes increased risk of cortical and mixed opacities (OR=1.9, 2.0). High intraocular pressure was associated with nuclear and mixed types (OR=1.4, 1.6). Non-professional occupation increased risk of cortical (OR=1.4) and mixed types (OR=1.8) Conclusions. Using a standardized system to classify lens opacities, the BES found that lens opacities in a black population were associated with personal, medical, and nutritional factors. Results suggest the need for further evaluations of the possible role of nutritional factors in this population.