Systemic medications and cortical cataract: the Singapore Epidemiology of Eye Diseases Study.
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.
['Dai|Wei|W|', 'Tham|Yih Chung|YC|', 'Chee|Miao Li|ML|', 'Majithia|Shivani|S|', 'Poh|Stanley|S|', 'Tan|Ava Grace|AG|', 'Tao|Yijin|Y|', 'Wang|Jie Jin|JJ|', 'Cheng|Ching-Yu|CY|0000-0002-4916-6074']
D000368:Aged D057911:Angiotensin Receptor Antagonists D000806:Angiotensin-Converting Enzyme Inhibitors D002386:Cataract D015897:Comorbidity D003430:Cross-Sectional Studies D005006:Ethnicity D005260:Female D058607:Fibric Acids D006801:Humans D008297:Male D008875:Middle Aged D015995:Prevalence D011379:Prognosis D012189:Retrospective Studies D012307:Risk Factors D012846:Singapore D012923:Social Class
epidemiology lens and zonules