Lens retrodots and vacuoles and their associations with the prevalence and incidence of age-related cataract

Abstract

Aim To assess the prevalence of retrodots and vacuoles and their associations with the prevalence and long-term incidence of agerelated cataract in an older Australian cohort. Methods Of 3654 baseline participants of the Blue Mountains Eye Study aged 49 þ years (1992)(1993)(1994), 2335 and 1952 were re-examined after 5 and 10 years, respectively. Lens photographs were graded for cataract, retrodots, and vacuoles. Eye-specific data were used to assess the associations between retrodots or vacuoles at baseline and the prevalence and 10-year incidence of nuclear, cortical, and posterior subcapsular (PSC) cataract and cataract surgery. Results At baseline, retrodots were present in 142 persons (4%) and vacuoles in 1333 persons (40%). Prevalence of both lens features increased with increasing age (P for trend o0.0001). After adjusting for age and gender, vacuoles were associated with prevalent PSC cataract at baseline (odds ratio (OR), 1.60, 95% confidence interval (CI), 1.25-2.05). After adjusting for age, gender, smoking, hypertension, diabetes, education, and use of inhaled/oral steroids, baseline retrodots were associated with an increased incidence of cataract surgery (OR 2.90, 95% CI 1.71-4.91), while 3 þ vacuoles at baseline were associated with an increased risk of PSC cataract (OR 3.56,) and cataract surgery (OR 1.84, 95% CI 1.22-2.77). Discussion Lens retrodots and vacuoles were found to be positively associated with 10-year incidence of cataract surgery, and vacuoles associated with PSC cataract, a finding suggestive of shared risk factors or pathogenesis between these two lens features and the development of PSC cataract.

Prevalence of Lens Opacities in Asian Malays

“…7 The association between vacuoles and PSC cataract observed in this study sample is similar to that observed in the BMES. 7 Further studies are needed to confirm associations between these lens changes and cataract.…”

“…13,14 Recently, it has been shown that these two lens lesions have an association with low vision [7][8][9] and cataract development. 7 While several population-based studies have reported the prevalence of retrodots and/ or vacuoles, [7][8][9][10][11] there has been only one study conducted in an Asian population (the Monzen Eye Study, Japan 11 ).…”

Emerging issues in radiogenic cataracts and cardiovascular disease

“…These vacuoles appear to be transient in nature [ 102 ] and greatly differ in diameter (e.g. 10 µm–1.3 mm [ 103 ]), but the composition of the intravacuolar fluid with lower refractive index than the surrounding lens material is currently uncharacterized and requires elucidation.…”

Vitamin D deficiency and posterior subcapsular cataract

“…With time, the lens tissue becomes cloudy and distorted with calcium deposition; microscopically, the clear LECs turn into cloudy fibrocytes, eventually breaking down and depositing Ca 2+ on the capsule forming white lens retrodots. 37 In five patients in this series with evidence of early axial subcapsular water cleft cysts, 38 their lenses unexpectedly normalized after taking 5,000 IU of vitamin D 3 taken to treat their low vitamin D level.…”