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Clinical science
Systemic medications and cortical cataract: the Singapore Epidemiology of Eye Diseases Study
  1. Wei Dai1,
  2. Yih Chung Tham1,
  3. Miao Li Chee1,
  4. Shivani Majithia1,
  5. Stanley Poh1,
  6. Ava Grace Tan2,
  7. Yijin Tao1,3,
  8. Jie Jin Wang4,
  9. Ching-Yu Cheng1,5,6
  1. 1 Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
  2. 2 Centre for Vision Research,Department of Ophthalmology, The Westmead Institute for Medical Research, University of Sydney, Westmead Hospital, Westmead, New South Wales, Australia
  3. 3 Department of Ophthalmology, The First AffiliatedHospital of Kunming Medical University, Kunming, China
  4. 4 Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
  5. 5 Department of Ophthalmology, Yong Loo Lin School of Medicine, National Universityof Singapore, Singapore, Singapore
  6. 6 Ophthalmology & Visual Sciences Academic Clinical Program (EyeACP), Duke-NUS Medical School, Singapore, Singapore
  1. Correspondence to Dr Ching-Yu Cheng, Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore 169856, Singapore; chingyu.cheng{at}duke-nus.edu.sg

Abstract

Background/aims To evaluate the association between systemic medications and cortical cataract prevalence in an Asian population.

Methods The Singapore Epidemiology of Eye Diseases Study recruited 10 033 Chinese, Malay and Indian residents aged 40+ years living in Singapore. Information on medication use was collected at interview using questionnaires. The presence and severity of cortical cataract were assessed from lens photographs using the modified Wisconsin Cataract Grading System. Associations between medications and the presence of cortical cataract were assessed using logistic regression. Associations between medications and greater severity of cortical cataract (none, minimal, early and late) were assessed using ordinal logistic regression.

Results A total of 8965 participants were included, the mean age was 57.6 (SD=9.8) years, and 4555 (50.8%) were women. After adjusting for age, gender, ethnicity, body mass index, smoking status, socioeconomic status, hypertension, hyperlipidaemia, diabetes, duration of diabetes and cardiovascular disease, ACE inhibitors (OR=1.27; 95% CI 1.05 to 1.55), fibrates (OR=1.57; 95% CI 1.05 to 2.35), alpha-glucosidase inhibitors (AGIs) (OR=1.85; 95% CI 1.13 to 3.02) and insulin (OR=1.80; 95% CI 1.11 to 2.93) were significantly associated with the presence of cortical cataract. Further adjusting for concurrent medication use did not alter these associations. Consistently, the four medications were also associated with a greater severity level of cortical cataract.

Conclusion ACE inhibitors, fibrates and AGIs were associated with increased prevalence of cortical cataract in this Asian population, independent of the presence of hypertension, hyperlipidaemia and diabetes, respectively. Whether they contribute to the risk of cortical cataract needs confirmation in longitudinal studies.

  • epidemiology
  • lens and zonules

https://doi.org/10.1136/bjophthalmol-2019-314256

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    Footnotes

    • Contributors WD: substantial contributions to the conception and design of the study, the analysis and interpretation of data, drafting the work and revising it critically for important intellectual content and final approval of the version to be published. YCT, MLC, SM, SP, AGT, YT and JJW: substantial contributions to analysis and interpretation of data, revising the article critically for important intellectual content and final approval of the version to be published. C-YC: substantial contributions to the conception and design of the study, analysis and interpretation of data, revising the article critically for important intellectual content, final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding This work was funded by grants from the National Medical Research Council (grant number: NMRC/0796/2003) and the Agency for Science, Technology and Research (grant number: 08/1/35/19/550).

    • Disclaimer The sponsor or funding organisation had no role in the design or conduct of this research.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This study was approved by the SingHealth Centralised Institutional Review Board, and the conduct of the study adhered to the Declaration of Helsinki.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No data are available.

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