Data from: The association of outdoor activity and age-related cataract in a rural population of Taizhou Eye Study: phase 1 report

Purpose: To study the relationship between outdoor activity and risk of age-related cataract (ARC) in a rural population of Taizhou Eye Study (phrase 1 report). Method: A population-based, cross-sectional study of 2006 eligible rural adults (≥45 years old) from Taizhou Eye Study was conducted from Jul. to Sep. 2012. Participants underwent detailed ophthalmologic examinations including uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), intraocular pressure (IOP), slit lamp and fundus examinations as well as questionnaires about previous outdoor activity and sunlight protection methods. ARC was recorded by LOCSⅢ classification system. The prevalence of cortical, nuclear and posterior subcapsular cataract were assessed separately for the risk factors and its association with outdoor activity. Results: Of all 2006 eligible participants, 883 (44.0%) adults were diagnosed with ARC. The prevalence rates of cortical, nuclear and posterior subcapsular cataract per person were 41.4%, 30.4% and 1.5%, respectively. Women had a higher tendency of nuclear and cortical cataract than men (OR = 1.559, 95% CI 1.204–2.019 and OR = 1.862, 95% CI 1.456–2.380, respectively). Adults with high myopia had a higher prevalence of nuclear cataract than adults without that (OR = 2.528, 95% CI 1.055–6.062). Multivariable logistic regression revealed that age was risk factor of nuclear (OR = 1.190, 95% CI 1.167–1.213) and cortical (OR = 1.203, 95% CI 1.181–1.226) cataract; eyes with fundus diseases was risk factor of posterior subcapsular cataract (OR = 6.529, 95% CI 2.512–16.970). Outdoor activity was an independent risk factor of cortical cataract (OR = 1.043, 95% CI 1.004–1.083). The risk of cortical cataract increased 4.3% (95% CI 0.4%-8.3%) when outdoor activity time increased every one hour. Furthermore, the risk of cortical cataract increased 1.1% (95% CI 0.1%-2.0%) when cumulative UV-B exposure time increased every one year. Conclusion: Outdoor activity was an independent risk factor for cortical cataract, but was not risk factor for nuclear and posterior subcapsular cataract. The risk of cortical cataract increased 4.3% when outdoor activity time increased every one hour. In addition, the risk of cortical cataract increased 1.1% (95% CI 0.1%-2.0%) when cumulative UV-B exposure time increased every one year.

研究目的：本研究针对台州眼科研究（第一阶段报告）中的农村人群，旨在探讨户外活动与年龄相关性白内障（age-related cataract, ARC）发病风险的关联。
研究方法：本研究依托台州眼科研究开展，于2012年7月至9月期间，纳入2006名符合入组标准的年龄≥45岁农村成年居民，采用基于人群的横断面研究设计。所有受试者均接受详细眼科检查，包括裸眼视力（uncorrected visual acuity, UCVA）、最佳矫正视力（best corrected visual acuity, BCVA）、眼压（intraocular pressure, IOP）、裂隙灯检查及眼底检查，并填写关于既往户外活动情况与防晒措施的调查问卷。采用LOCSⅢ分类系统对年龄相关性白内障进行分级记录。分别针对各类危险因素及其与户外活动的关联，评估皮质性、核性及后囊下白内障的患病率。
研究结果：在2006名符合入组标准的受试者中，共883名（44.0%）成年居民被确诊为年龄相关性白内障。皮质性、核性及后囊下白内障的人均患病率分别为41.4%、30.4%及1.5%。女性患核性与皮质性白内障的风险高于男性（比值比（odds ratio, OR）=1.559，95%置信区间（95% confidence interval, 95% CI）=1.204~2.019；OR=1.862，95% CI=1.456~2.380）。高度近视成年居民的核性白内障患病率高于非高度近视人群（OR=2.528，95% CI=1.055~6.062）。多因素logistic回归分析显示，年龄是核性白内障（OR=1.190，95% CI=1.167~1.213）与皮质性白内障（OR=1.203，95% CI=1.181~1.226）的危险因素；合并眼底疾病的眼部患后囊下白内障的风险更高（OR=6.529，95% CI=2.512~16.970）。户外活动是皮质性白内障的独立危险因素（OR=1.043，95% CI=1.004~1.083）：当每日户外活动时长每增加1小时，皮质性白内障的发病风险升高4.3%（95% CI=0.4%~8.3%）。此外，当累计紫外线B（UV-B）暴露时长每增加1年，皮质性白内障的发病风险升高1.1%（95% CI=0.1%~2.0%）。
研究结论：户外活动是皮质性白内障的独立危险因素，但与核性白内障及后囊下白内障的发病风险无显著关联。当每日户外活动时长每增加1小时，皮质性白内障的发病风险升高4.3%；此外，当累计紫外线B（UV-B）暴露时长每增加1年，皮质性白内障的发病风险升高1.1%（95% CI=0.1%~2.0%）。