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Exfoliation syndrome in the Reykjavik Eye Study: risk factors for baseline prevalence and 5-year incidence
  1. Arsaell Arnarsson1,2,
  2. Fridbert Jonasson1,
  3. Karim F Damji3,
  4. Maria S Gottfredsdottir1,
  5. Thordur Sverrisson1,
  6. Hiroshi Sasaki4
  1. 1Department of Ophthalmology, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
  2. 2Neuroscience Research, University of Akureyri, Akureyri, Iceland
  3. 3Department of Ophthalmology, University of Alberta, Edmonton, Alberta, Canada
  4. 4Department of Ophthalmology, Kanazawa Medical University, Uchinada, Japan
  1. Correspondence to Professor Fridbert Jonasson, University of Iceland, Landspitali-Haskolasjukrahus, 101 Reykjavik, Iceland; fridbert{at}


Aim To examine the age- and gender-specific prevalent and 5-year incident risk of developing exfoliation syndrome (XFS).

Methods and participants In a population-based random sample of citizens 50 years and older, 1045 persons had baseline examination in 1996; 846 of the 958 survivors (88.2%) had a follow-up examination in 2001. Following maximum dilatation of pupils, a diagnosis of exfoliation was established on slit-lamp examination. An extensive questionnaire was administered at baseline and follow-up. Prevalent and incident risk was then calculated using a multivariate analysis.

Results The following variables were found to correlate significantly with prevalence risk of XFS at baseline: age, female gender, increased iris pigmentation, moderate use of alcohol and self-reported asthma. We also found that, compared with those who consumed dietary fibre-rich vegetables, green or yellow vegetables, and fruit less than once a month in their 20s and 40s, those consuming the same food items once or twice every 2 weeks were found to be less likely to have XFS. The same applied to those consuming dietary fibre rich once or twice every 2 weeks in their 40s and 60s.

Conclusion Food items that are possibly surrogates for antioxidative effect may correlate with decreased risk of XFS and increased iris pigmentation may correlate with increased risk. Given the large number of comparisons, these findings require validation through additional clinical studies. Increased age and female gender increase the likelihood of XFS.

  • Exfoliation
  • pseudoexfoliation
  • risk factors
  • prevalence
  • incidence
  • lens and zonules
  • optic nerve
  • epidemiology

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  • Funding Financial support was received as an open grant from: St Joseph's Hospital, Landakot Foundation, Reykjavik, Iceland; University National Hospital and University of Iceland Research Grant; and Helga Jonsdottir and Sigurlidi Kristjansson Memorial Research Fund.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the National Bioethics Committee, Iceland.

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

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