Clinical Ophthalmology (Oct 2022)

Pseudophakia and Lens Opacities in 70-Year-Olds in Gothenburg, Sweden; Gender Differences, Impact on Self-Reported Visual Function and Validation of Self-Reported Cataract and Pseudophakia

  • Nordström M,
  • Holm M,
  • Havstam Johansson L,
  • Rydberg Sterner T,
  • Ahlner F,
  • Falk Erhag H,
  • Skoog I,
  • Zetterberg M

Journal volume & issue
Vol. Volume 16
pp. 3269 – 3281

Abstract

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Moa Nordström,1,2 Mathias Holm,3 Lena Havstam Johansson,1,2 Therese Rydberg Sterner,4 Felicia Ahlner,4 Hanna Falk Erhag,4 Ingmar Skoog,4,5 Madeleine Zetterberg1,2 1Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 2Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden; 3Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 4Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 5Department of Psychiatry Cognition and Old Age Psychiatry, Sahlgrenska University Hospital, Mölndal, SwedenCorrespondence: Moa Nordström, Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, SE-431 80, Sweden, Tel +46 31 342 10 00, Fax +46 31 41 29 04, Email [email protected]: The study aimed at determining the prevalence and sex differences in cataract, pseudophakia, lens opacities and self-reported cataract in 70-year-old people in Gothenburg, Sweden. The purpose was also to identify correlations between lens opacities, visual acuity and subjective visual function, and to validate self-reported cataract and cataract surgery.Patients and Methods: Population-based cross-sectional study where participants (n=1182) answered questions about self-reported diagnosis of cataract and cataract surgery. A total of 1139 subjects completed the National Eye Institute Visual Functioning Questionnaire‐25 (NEI VFQ‐25), 560 subjects underwent ophthalmic examination including visual acuity and lens photography. t-test, Pearson chi-square and Mann–Whitney U-test were used for obtaining p-values. ANOVA (analysis of variances, Kruskal–Wallis, one-way) was used to compare VFQ-25 between 3 groups; no cataract, cataract and pseudophakia. To clarify the differences between specific pairs of groups post-hoc test (Bonferroni) was used after ANOVA.Results: Self-reported cataract was more common in women than in men (27.2% vs 19.1%, p=0.001, chi-square). Cataract surgery was reported by 16.3% of women and 12.6% of men (p=0.072). Upon eye examination, the prevalence of pseudophakia was 16.9% in women compared to 10.2% in men (p=0.020). The prevalence of cataract, including pseudophakia, was 31.9% in women versus 23.8% in men (p=0.033). Significant correlations (Spearman’s rho) were found between lens opacities and visual acuity. Self-reported cataract surgery showed a very high specificity and high sensitivity. The composite score from NEI VFQ‐25 was lower in people with pseudophakia than in people with/without cataract (p=0.012, Kruskal–Wallis).Conclusion: The prevalence of cataract including pseudophakia in 70-year-olds in Gothenburg is higher compared to previous studies in similar geographical areas. Also, it is more common in women than in men. The lack of significant sex differences in lens opacities may be due to cataract surgery at an earlier stage. Validation showed very good agreement between pseudophakia and self-reported cataract surgery.Keywords: cataract, cataract surgery, cross-sectional study, gender differences, lens opacities, vision-related quality of life

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