Table 3.
Population-based studies assessing prevalent lens opacity outcomes, listed by lens opacity type: lens grading method, lens opacity definition, identified risk associatons and treatment of contralateral pseudophakic eye.
| CORTICAL | Ethnicity | Grading Method | Definition | Risk Associations |
|---|---|---|---|---|
| Chinese American Eye Study, 2010 – 2013 | Chinese (Urban Americans) | LOCS II 11 | LOCS II grading of ≥2 * | Gender-combined: age, height (inversely related), family history of cataract, diabetes mellitus (sex-specific provided similar results) |
| Barbados Eye Study, 1987–1992 | Afro-Caribbean | LOCS II11 | LOCS II grading of ≥2* | Gender-combined: age, lower SES status, female gender, nutritional supplement use (inversely related)22 |
| Beaver Dam Eye Study, 1988–1990 | Caucasian (Rural Wisconsin) | Wisconsin Cataract Grading System25 | Lens involvement ≥5%‡ | Gender-combined: age, sex, high density lipoprotein (women only, inversely related)56 heavy drinking, wine (inversely related), beer55 |
| Blue Mountains Eye Study, 1992–1994 | Caucasians (Urban Australia) | Wisconsin Cataract Grading System25 | Lens involvement ≥5%‡ | Gender-combined: alcohol (inversely related),42 pinguecula,43 high myopia,44 polyunsaturated fats (inversely related);62 current HRT use if ≥65 yrs (inversely related)45 |
| Salisbury Eye Evaluation, 1993–1995 | Caucasian and African American | Wilmer grading scheme28 | Graded ≥1/8* | Gender-combined: race;61 BMI;40 current HRT use (inversely related)63 |
| Tanjong Pagar, 1997–1998 | Chinese (Urban Singapore) | LOCS III14 | LOCS III score of ≥4 for NO or ≥4 for NC* | Gender-combined: age, diabetes, BMI (inversely related)21 |
| Shihpai Eye Study, 1999–2000 | Chinese (Urban Taiwan) | LOCS III14 | LOCS III score of >2* (justified as LOCS III score of >2 is close to a LOCS II score of ≥2) | Gender-combined: age, female gender, systolic blood pressure, former smoker, diabetes mellitus;20 BMI41 |
| Los Angeles Latinos Eye Study, 2000–2003 | Latinos (Urban Latino Americans) | LOCS II11 | LOCS II grading of ≥2* | Gender-combined: age, HbA1c, diabetes mellitus18 |
| Beijing Eye Study, 2001 | Chinese (Urban/Rural Chinese) | modified AREDS grading score29 | AREDS standard amount of ≥0.05† | Gender-combined: age, self-reported diagnosis diabetes mellitus;7 not alcohol48 |
| The Liwan Eye Study, 2003–2004 | Chinese (Urban Chinese) | -- | No papers identified analyzing risk associations with lens opacities (prevalent or incident cases) | |
| Singapore Malay Eye Study, 2004–2006 | Malay (Urban Muslim) | Wisconsin Cataract Grading System25 | Lens involvement ≥5%§* | Gender-combined: age, male gender (protective), current smoker;23 diabetes, hypertension, high density lipoprotein (inversely related), BMI, metabolic syndrome, increasing number of metabolic syndrome components36 |
| Handan Eye Study, 2006–2007 | Chinese (Rural Chinese) | LOCS III14 | LOCS III grading of ≥2* | Gender-combined: myopia5 |
| China Nine-Province Survey, 2006, 2014 | Chinese (Rural Chinese) | -- | Not analyzed | No papers identified analyzing risk associations with lens opacities (prevalent or incident cases) |
| Singapore Epidemiology of Eye Diseases Study | Malay (2004–2006), Indian (2007–2009), and Chinese (2009–2011) | Wisconsin Cataract Grading System25 | Lens involvement ≥5%* | Gender-combined: ACE inhibitors, fibrates, alpha-glucosidase inhibitors, insulin64 |
| NUCLEAR | Ethnicity | Grading Method | Definition | Risk Associations |
| Chinese American Eye Study, 2010 – 2013 | Chinese (Urban Americans) | LOCS II 11 | LOCS II grading of ≥2* | Gender-combined: age, marital status, alcohol consumption (inversely related), weight (inversely related), waist-to-hip ratio, diabetes mellitus, high-density lipoprotein (sex-specific provided similar results) |
| Barbados Eye Study, 1987–1992 | Afro-Caribbean | LOCS II11 | LOCS II grading of ≥2* | Gender-combined: age, lower SES status22 |
| Beaver Dam Eye Study, 1988–1990 | Caucasian (Rural Wisconsin) | Wisconsin Cataract Grading System25 | Graded at ≥4‡ | Gender-combined: age, sex, higher glycated hemoglobin (women only);56 heavy drinking, moderate liquor (inversely related), wine (inversely related)55 |
| Blue Mountains Eye Study, 1992–1994 | Caucasians (Urban Australia) | Wisconsin Cataract Grading System25 | Graded ≥3‡ | Gender-combined: ever smokers (pipe > cigarette smoking), heavy alcohol consumption in current smokers,42 pinguecula (inversely related),43 high myopia;44 higher intake of protein, vitamin A, niacin, thiamin, and riboflavin (inversely related),62 inhaled corticosteroids,57 dark brown irides60 |
| Salisbury Eye Evaluation, 1993–1995 | Caucasian and African American | Wilmer grading scheme28 | Graded ≥2* | Gender-combined: race;61 taller stature;40 BMI (inversely related), current HRT use, number of births (dose-response, inversely related)63 myopia46 |
| Tanjong Pagar, 1997–1998 | Chinese (Urban Singapore) | LOCS III14 | LOCS III score of ≥4* | Gender-combined: age, current smoker, occupation (production, laborers, clerks, home makers increased risk vs. professionals)21 |
| Shihpai Eye Study, 1999–2000 | Chinese (Urban Taiwan) | LOCS III14 | LOCS III score of >2* (justified as LOCS III score of >2 is close to a LOCS II score of ≥2) | Gender-combined: age, female gender, current smoker;20 BMI (inversely related);41 use of HRT (inversely related)20 |
| Los Angeles Latinos Eye Study, 2000–2003 | Latinos (Urban Latino Americans) | LOCS II11 | LOCS II grading of ≥2* | Gender-combined: age, spherical equivalent (inversely related), current smoker18 |
| Beijing Eye Study, 2001 | Chinese (Urban/Rural Chinese) | modified AREDS grading score29 | AREDS standard grade of ≥5† | Gender-combined: age, myopic refractive error;7 not alcohol48 |
| The Liwan Eye Study, 2003–2004 | Chinese (Urban Chinese) | -- | No papers identified analyzing risk associations with lens opacities (prevalent or incident cases) | |
| Singapore Malay Eye Study, 2004–2006 | Malay (Urban Muslim) | Wisconsin Cataract Grading System25 | Graded ≥3§* | Gender-combined: age, male gender (protective), current smoker, primary or lower education, low monthly income;23 hypertension, BMI, increasing number of metabolic syndrome components36 |
| Handan Eye Study, 2006–2007 | Chinese (Rural Chinese) | LOCS III14 | LOCS III score of ≥4* | Gender-combined: myopia, cholesterol, high-density and low-density lipoprotein (both inversely related)5 |
| China Nine-Province Survey, 2006, 2014 | Chinese (Rural Chinese) | -- | Not analyzed | No papers identified analyzing risk associations with lens opacities (prevalent or incident cases) |
| PSC | Ethnicity | Grading Method | Definition | Risk Associations |
| Chinese American Eye Study, 2010 – 2013 | Chinese (Urban Americans) | LOCS II 11 | LOCS II grading of ≥2* | Not analyzed due to small number |
| Barbados Eye Study, 1987–1992 | Afro-Caribbean | LOCS II11 | LOCS II grading of ≥2* | Not analyzed due to small number22 |
| Beaver Dam Eye Study, 1988–1990 | Caucasian (Rural Wisconsin) | Wisconsin Cataract Grading System25 | Lens involvement ≥5%‡ | Gender-combined: age, sex, higher ratios of total to high-density lipoprotein cholesterol (men only)56 heavy drinking55 |
| Blue Mountains Eye Study, 1992–1994 | Caucasians (Urban Australia) | Wisconsin Cataract Grading System25 | Any graded PSC opacity‡ | Gender-combined: ever smokers,42 ptyergium,43 myopia (dose-dependent response), high myopia, early-onset myopia,44 inhaled corticosteroids,57 dark brown irides60 increased sodium intake (dose-dependent response),58 diabetes,59
Women: (separate analysis): current use of hormone replacement therapy in women with non-surgical menopause45 |
| Salisbury Eye Evaluation, 1993–1995 | Caucasian and African American | Wilmer grading scheme28 | Any PSC* | Gender-combined: race;61 taller stature (borderline);40 past and current HRT use (inversely related);63 myopia46 |
| Tanjong Pagar, 1997–1998 | Chinese (Urban Singapore) | LOCS III14 | LOCS III score of ≥2* | Gender-combined: age, diabetes, housing type21 |
| Shihpai Eye Study, 1999–2000 | Chinese (Urban Taiwan) | LOCS III14 | LOCS III score of >2* (justified as LOCS III score of >2 is close to a LOCS II score of ≥2) | Gender-combined: higher systolic blood pressure, interaction age (≥75)*gender20 |
| Los Angeles Latinos Eye Study, 2000–2003 | Latinos (Urban Latino Americans) | LOCS II11 | LOCS II grading of ≥2* | Gender-combined: systolic blood pressure, diabetes mellitus18 |
| Beijing Eye Study, 2001 | Chinese (Urban/Rural Chinese) | modified AREDS grading score29 | AREDS standard amount of ≥0.01† | Gender-combined: age;7 not alcohol48 |
| The Liwan Eye Study, 2003–2004 | Chinese (Urban Chinese) | -- | -- | No papers identified analyzing risk associations with lens opacities (prevalent or incident cases) |
| Singapore Malay Eye Study, 2004–2006 | Malay (Urban Muslim) | Wisconsin Cataract Grading System25 | Any graded PSC opacity§ | Gender-combined: age, current smoker, public housing (SES variable);23 diabetes, hypertension36 |
| Handan Eye Study, 2006–2007 | Chinese (Rural Chinese) | LOCS III14 | LOCS III score of ≥2* | Gender-combined: myopia, hyperopia (inversely related), fasting glucose, diabetes5 |
| China Nine-Province Survey, 2006, 2014 | Chinese (Rural Chinese) | -- | Not analyzed | No papers identified analyzing risk associations with lens opacities (prevalent or incident cases) |
| ANY LENS OPACITY | Ethnicity | Grading Method | Definition | Risk Associations |
| Chinese American Eye Study, 2010 – 2013 | Chinese (Urban Americans) | LOCS II 11 | Any nuclear, cortical or PSC as specified * | Gender-combined: age, height, weight (inversely related), waist-to-hip ratio, diastolic blood pressure (inversely related), HbA1C (sex-specific provided similar results) |
| Barbados Eye Study, 1987–1992 | Afro-Caribbean | LOCS II11 | Any nuclear, cortical or PSC as specified* | Gender-combined: age, lower SES status, female gender, nutritional supplement use (inversely related)22 |
| Beaver Dam Eye Study, 1988–1990 | Caucasian (Rural Wisconsin) | Wisconsin Cataract Grading System25 | Not analyzed separately | Not analyzed separately55,56 |
| Blue Mountains Eye Study, 1992–1994; | Caucasians (Urban Australia) | Wisconsin Cataract Grading System25 | Not analyzed separately | Not analyzed separately42–45,57–60 |
| Salisbury Eye Evaluation (SEE) project, 1993–1995 | Caucasian and African American | Wilmer grading scheme28 | Any nuclear, cortical or PSC as specified* | Not analyzed separately40,61 |
| Tanjong Pagar, 1997–1998 | Chinese (Urban Singapore) | LOCS III14 | LOCS III score of ≥4 for NO or ≥4 for NC or ≥2.0 for C or ≥2.0 for P* | Gender-combined: age, occupation (production increased risk vs. professionals), current smoking; diabetes marginally significant21 |
| Shihpai Eye Study, 1999–2000 | Chinese (Urban Taiwan) | LOCS III14 | Not analyzed separately | Not analyzed separately20,41 |
| Los Angeles Latinos Eye Study, 2000–2003 | Latinos (Urban Latino Americans) | LOCS II11 | Any nuclear, cortical or PSC as specified* | Gender-combined: age, female gender, diabetes mellitus, systolic blood pressure, spherical equivalent (inversely related), large drusen18 |
| Beijing Eye Study, 2001 | Chinese (Urban/Rural Chinese) | modified AREDS grading score29 | Not analyzed separately | Gender-combined: not analyzed separately7 |
| The Liwan Eye Study, 2003–2004 | Chinese (Urban Chinese) | -- | -- | No papers identified analyzing risk associations with lens opacities (prevalent or incident cases) |
| Singapore Malay Eye Study, 2004–2006 | Malay (Urban Muslim) | Wisconsin Cataract Grading System25 | Any nuclear, cortical or PSC as specified§ | Gender-combined: age, male gender (protective), current smoker23 |
| Handan Eye Study, 2006–2007 | Chinese (Rural Chinese) | LOCS III14 | Any nuclear, cortical or PSC as specified* | Gender-combined (outcome is any lens opacity or cataract surgery): myopia5 |
| China Nine-Province Survey, 2006, 2014 | Chinese (Rural Chinese) | -- | Not analyzed |
*
If a person had unilateral cataract surgery or a non-gradable lens, the LOCS III score of the fellow eye was used
†
Analysis methods to deal with subjects with previous cataract surgery in the contralateral eye not stated
‡
Eyes with previous cataract surgery excluded from analysis, with both eyes used in analyses via generalized estimating equations
§
Persons with previous cataract surgery in the contralateral eye were excluded from analysis