Elsevier

Ophthalmology

Volume 111, Issue 3, March 2004, Pages 483-490
Ophthalmology

Original article
Nine-year incidence of lens opacities in the Barbados Eye Studies

https://doi.org/10.1016/j.ophtha.2003.06.016Get rights and content

Abstract

Objective

To provide 9-year cumulative incidence of age-related lens opacities in a predominantly black population.

Design

Population-based cohort study, after 9 years of follow-up (n = 2793; 81% participation).

Main outcome measures

Nine-year cumulative incidence and progression of lens opacities, by type, based on the Lens Opacities Classification System II at the slit lamp.

Results

Black participants had a higher 9-year incidence of overall lens changes than white participants (age- and gender-adjusted relative risk [RR], 1.8; 95% confidence interval [CI], 1.2–2.8), as well as of cortical opacities (RR, 3.2; 95% CI, 1.7–6.2). In black participants, incidence rates of any cortical and any nuclear opacities were 33.8% and 42.0%, respectively, and higher than for any posterior subcapsular (PSC) opacities (6.3%). The incidence increased with age for all 3 types, and women had a higher risk of cortical and nuclear opacities (P<0.05). Single cortical opacities were the most frequent type to develop by the 9-year follow-up (23.2%), followed by nuclear-only opacities (17.1%) and mixed opacities (15.3%). Progression rates of pre-existing opacities were 22.0% for cortical, 17.8% for nuclear, and 25.8% for PSC opacities.

Conclusions

The 9-year follow-up of this cohort indicated a high incidence and progression of cortical and nuclear opacities, highlighting the public health importance of cataract in black populations.

Section snippets

Materials and methods

The BESs, funded by the National Eye Institute, are a series of population-based investigations on the prevalence, incidence, progression, and risk factors for major eye diseases in the predominantly black population of Barbados. The studies began with a prevalence phase, The Barbados Eye Study15 (BES; 1987–1992), which included a random sample of Barbadian-born citizens, 40 to 84 years of age, with 84% participation. Of the 4631 BES participants completing examinations at the study site, 4314

Results

The mean age of the 2793 BISED II participants at baseline was 56 years, and 41% were male. Table 1 compares baseline characteristics between the BISED II participants and those who did not participate because of death or other reason. As compared with the participants, nonparticipants were older (mean age, 69.6 and 58.0 years for the deceased and other group, respectively), as expected. Results from univariate analyses indicated that these groups also had lower education and were more likely

Discussion

The BESs provide the first data, to our knowledge, on the long-term patterns and occurrence of lens opacities in a predominantly black population. Our results revealed a significantly higher 9-year incidence of all lens changes, and particularly cortical opacities, in black than in white participants, despite the small number in the latter group. After 9 years of follow-up, approximately one third of the black participants developed cortical opacities and over two fifths developed nuclear

Acknowledgements

The authors thank the Barbados Eye Studies participants and the Ministry of Health, Barbados, for their roles in the study.

References (25)

  • B. Munoz et al.

    Causes of blindness and visual impairment in a population of older AmericansThe Salisbury Eye Evaluation Study

    Arch Ophthalmol

    (2000)
  • B.E. Klein et al.

    Cataracts and macular degeneration in older Americans

    Arch Ophthalmol

    (1982)
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    Manuscript no. 230094.

    Supported by the National Eye Institute, Bethesda, Maryland (grant nos.: EY07625 and EY07617).

    *

    See Appendix for Study Group membership.

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