Ambient Air Pollution and Age-Related Eye Disease: A Systematic Review and Meta-Analysis

Abstract

Purpose To compare the burden of age-related eye diseases among adults exposed to higher versus lower levels of ambient air pollutants. Methods MEDLINE, EMBASE, and Scopus were searched for relevant articles until September 30, 2021. Inclusion criteria included studies of adults, aged 40+ years, that provided measures of association between the air pollutants (nitrogen dioxide, carbon monoxide [CO], sulfur dioxide, ozone [O 3 ], particulate matter [PM] less than 2.5 µm in diameter [PM 2.5 ], and PM less than 10 µm in diameter [PM 10 ]) and the age-related eye disease outcomes of glaucoma, age-related macular degeneration (AMD), or cataract. Pooled odds ratio (OR) estimates and 95% confidence intervals (CIs) were calculated using a random-effects meta-analysis model. PROSPERO registration ID: CRD42021250078. Results A total of eight studies were included in the review. Consistent evidence for an association was found between PM 2.5 and glaucoma, with four of four studies reporting a positive association. The pooled OR for each 10-µg/m 3 increase of PM 2.5 on glaucoma was 1.18 (95% CI, 0.95–1.47). Consistent evidence was also found for O 3 and cataract, with three of three studies reporting an inverse association. Two of two studies reported a null association between PM 2.5 and cataract, while one of one studies reported a positive association between PM 10 and cataract. One of one studies reported a positive relationship between CO and AMD. Other relationships were less consistent between studies. Conclusions Current evidence suggests there may be an association between some air pollutants and cataract, AMD, and glaucoma.

Ambient Air Pollution and Vision Disorder: A Systematic Review and Meta-Analysis

“…To our knowledge, this study is the first to thoroughly evaluate the link between exposure to air pollution and vision disorder. Although a similar systematic review has been conducted, it compares the age-related burden of eye disease in adults exposed to ambient air pollutants [ 28 ]. Our study differs from previous studies in that we included literature on children and adolescents in addition to adults, and estimated the combined effect of ambient air pollution on their vision disorders.…”

Changing Trends in the Global Burden of Cataract Over the Past 30 Years: Retrospective Data Analysis of the Global Burden of Disease Study 2019

“…This study illustrated that exposure to PM 2.5 and solar UVR accelerated cataract development. Current evidence suggests that air pollution may affect ocular diseases, including cataracts, age-related macular degeneration, and glaucoma [ 22 ]. After exposure to air pollutants such as PM 2.5 , NO 2 (nitrogen dioxide), and NO x (nitrogen oxide), the risk of cataract surgery increased by 5%, but the effects were relatively small [ 49 ].…”

“…Cataract is a multifactorial disease manifested by transparency loss of the eye lens, owing to tissue degradation and protein clumping, as well as pathogenic environmental and genetic factors [7]. Previous publications have reported risk factors such as aging, female sex, diabetes, excess weight, diet and nutritional status, smoking, drinking, exposure to ultraviolet light, socioeconomic status, and air pollution [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. In addition, cataracts can also be innate, owing to a variety of genetic and molecular mechanisms [7].…”

Association between ambient air pollution and age-related macular degeneration: a meta-analysis

“…Due to the small number of studies eligible for analysis, a statistical evaluation of publication bias was not feasible [20]. NOS was used to assess the quality of the included studies (Additional file 1); one study was classified as having moderate quality [15], whereas the others were classified as having high quality [7,8,13,14,[16][17][18].…”