Background: Exposure to light may be an important risk factor for the development of cataracts. Objective: To present the relation of ambient solar radiation and professional and leisure exposures to light with the different types of cataracts. Methods: Pathologies Oculaires Liées à l'Age (POLA) is a population-based study on cataract and age-related macular degeneration and their risk factors in 2584 residents of Sète (southern France). Cataract classification was based on lens examination at slitlamp according to Lens Opacities Classification System III. A questionnaire about light exposure was administered. Results: After multivariate adjustment, participants who had higher ambient solar radiation had a 2.5-fold (95% confidence interval [CI], 1.2-5.0), 4.0-fold (95% CI, 2.0-8.0), and 2.9-fold (95% CI, 1.5-5.3) increased risk of cortical and mixed cataract and cataract surgery, respectively. Solar ambient radiation was not significantly associated with posterior subcapsular and nuclear cataracts. By contrast, posterior subcapsular cataracts were significantly associated with professional exposure to sunlight (odds ratio [OR], 1.63; 95% CI, 1.01-2.63) and frequent use of sunglasses (OR, 0.62; 95% CI, 0.43-0.90). Mixed cataract was also associated with professional exposure to artificial light (OR, 3.02; 95% CI, 1.03-8.82). Conclusion: Our study further confirms the role of sunlight exposure in the pathogenesis of cataract, in particular in its cortical localization.
To assess the associations between agerelated macular degeneration (ARMD) and smoking. Methods: The POLA study is a population-based study taking place in the town of Sète, located on the French Mediterranean Sea border. The presence of early and late ARMD was assessed in 2196 participants on the basis of 50°color fundus photographs using an international classification system. Results: After adjustment for age and sex, current and former smokers showed an increased prevalence of late ARMD (odds ratio [OR] = 3.6, 95% confidence interval [CI] = 1.1-12.4; OR = 3.2, 95% CI = 1.3-7.7, respectively). An increased risk was present in participants who smoked more than 20 pack-years (OR = 3.0, 95% CI = 0.9-9.5 for 20-39 pack-years; OR = 5.2, 95% CI = 2.0-13.6 for 40 pack-years and more). In addition, the risk of late ARMD remained increased until 20 years after cessation of smoking (OR = 9.0, 95% CI = 3.0-27.0 for 1-9 years; OR = 4.0, 95% CI = 1.3-12.0 for 10-19 years; OR = 1.3, 95% CI = 0.4-4.3 for 20 years and more). Smoking was not significantly associated with early signs of ARMD. Conclusions: This study further confirms the adverse effect of tobacco on late ARMD. Former smokers seem to remain at high risk for ARMD.
Background:The role of light exposure in the development of age-related macular degeneration (ARMD) has been questioned. We present the relationship between lifetime light exposure and ARMD as examined in the Pathologies Oculaires Liées à l'Age (POLA) study. Methods:The POLA study is a population-based study on cataract and ARMD and their risk factors. It included 2584 residents of the town of Sète, located in the South of France. The presence of early and late ARMD was assessed on the basis of 50°color fundus photographs using an international classification system. A questionnaire about light exposure was administered.Results: Late ARMD (n = 38) was not significantly associated with any light exposure variable. Subjects ex-posed to high ambient solar radiation and those with frequent leisure exposure to sunlight had a decreased risk of pigmentary abnormalities (odds ratio [OR]=0.61; 95% confidence interval [CI], 0.39-0.93, and OR=0.70; 95% CI, 0.52-0.95, respectively) and of early signs of ARMD (OR=0.73; 95% CI, 0.54-0.98, and OR=0.80; 95% CI, 0.64-1.00, respectively). Subjects who had used sunglasses regularly had a decreased risk of soft drusen (OR=0.81; 95% CI, 0.66-1.00). These relationships were not modified by further adjustments for potential confounders. Conclusion:Our study does not support a deleterious effect of sunlight exposure in ARMD.
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