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Prevalence of cataract and its contributing factors in Iranian elderly population: the Gilan eye study

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Abstract

Purpose

To report the prevalence and the associated factors leading to cataract among the Iranian population living in Gilan Province, Iran.

Methods

This population-based cross-sectional study was performed from June to November 2014 on 2,975 residents aged ≥ 50 years old living in urban and rural regions of the Gilan Province in Iran. A representative sample of residents in the province was recruited into the study through door-to-door visiting, and baseline data were collected by questionnaire. All participants were referred to the medical center for comprehensive ophthalmic examination, laboratory tests, and blood pressure measurement.

Results

Among the population, 2,588 (86.99%) subjects were eligible to be included in this study, categorized either into the cataract or the non-cataract group. The mean age of participants was 62.59 ± 8.92 years, and 57.5% were female. Higher prevalence of cataract was found in individuals of older ages (odds ratio (OR) = 1.13; 95% confidence interval (CI) = 1.10 to 1.16; P < 0.001) and a history of previous ocular surgery (OR = 5.78; 95% CI = 2.28 to 14.63; P < 0.001). At the same time, a lower prevalence of cataract was seen in patients exposed to sunlight for more than 4 h per day (OR = 0.49; 95% CI = 0.32 to 0.73; P = 0.001).

Conclusion

Cataract affects 50.50% of the study population, especially those over 80. The mildest form of cataract, grade zero, is the most common. Surgery for cataract has good outcomes. The risk of cataract is higher for those older or who have had eye surgeries. People not affected by cataract tend to be exposed to more sunlight.

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References

  1. Liu YC, Wilkins M, Kim T, Malyugin B, Mehta JS (2017) Cataracts. The Lancet 390(10094):600–612

    Article  Google Scholar 

  2. Singh S, Pardhan S, Kulothungan V, Swaminathan G, Ravichandran JS, Ganesan S et al (2019) The prevalence and risk factors for cataract in rural and urban India. Indian J Ophthalmol 67(4):477–483

    Article  PubMed  PubMed Central  Google Scholar 

  3. Hashemi H, Pakzad R, Yekta A, Aghamirsalim M, Pakbin M, Ramin S et al (2020) Global and regional prevalence of age-related cataract: a comprehensive systematic review and meta-analysis. Eye 34(8):1357–1370. https://doi.org/10.1038/s41433-020-0806-3

    Article  PubMed  PubMed Central  Google Scholar 

  4. Shahdadi H, Aminifard MN, Balouchi A, Rafiemanesh H, Allahyari J (2018) Frequency of cataract in Iran: a meta-analysis and systematic review. Middle East Afr J Ophthalmol 625(1):40–46

    Google Scholar 

  5. Prokofyeva E, Wegener A, Zrenner E (2013) Cataract prevalence and prevention in Europe: a literature review. Acta Ophthalmol 91(5):395–405. https://doi.org/10.1111/j.1755-3768.2012.02444.x

    Article  PubMed  Google Scholar 

  6. Casula M, Soranna D, Corrao G, Merlino L, Catapano AL, Tragni E (2016) Statin use and risk of cataract: a nested case-control study within a healthcare database. Atherosclerosis 251:153–158

    Article  CAS  PubMed  Google Scholar 

  7. Drinkwater JJ, Davis WA, Davis TME (2019) A systematic review of risk factors for cataract in type 2 diabetes. Diabetes Metab Res Rev 35(1):e3073. https://doi.org/10.1002/dmrr.3073

    Article  PubMed  Google Scholar 

  8. Hollows F, Moran D (1981) Cataract-the ultraviolet risk factor. The Lancet 318(8258):1249–1250

    Article  Google Scholar 

  9. Roberts JE (2011) Ultraviolet radiation as a risk factor for cataract and macular degeneration. Eye Contact Lens 37(4):246–249

    Article  PubMed  Google Scholar 

  10. van Kuijk FJ (1991) Effects of ultraviolet light on the eye: role of protective glasses. Environ Health Perspect 96:177–184

    Article  PubMed  PubMed Central  Google Scholar 

  11. Vinson JA (2006) Oxidative stress in cataracts. Pathophysiology 13(3):151–162

    Article  CAS  PubMed  Google Scholar 

  12. Aune D, Norat T, Leitzmann M, Tonstad S, Vatten LJ (2015) Physical activity and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis. Eur J Epidemiol 30(7):529–542

    Article  PubMed  Google Scholar 

  13. Jiang H, Wang LN, Liu Y, Li M, Wu M, Yin Y et al (2020) Physical activity and risk of age-related cataract. Int J Ophthalmol 13(4):643–649

    Article  PubMed  PubMed Central  Google Scholar 

  14. Taylor A, Jacques PF, Epstein EM (1995) Relations among aging, antioxidant status, and cataract. Am J Clin Nutr 62(6 Suppl):1439S-1447S

    Article  CAS  PubMed  Google Scholar 

  15. Asbell PA, Dualan I, Mindel J, Brocks D, Ahmad M, Epstein S (2005) Age-related cataract. The Lancet 365(9459):599–609. https://doi.org/10.1016/S0140-6736(05)17911-2

    Article  Google Scholar 

  16. Yu X, Lyu D, Dong X, He J, Yao K (2014) Hypertension and risk of cataract: a meta-analysis. PLoS ONE 9(12):e114012–e114012

    Article  PubMed  PubMed Central  Google Scholar 

  17. Tsutsumi K, Inoue Y, Yoshida C (1999) Acceleration of development of diabetic cataract by hyperlipidemia and low high-density lipoprotein in rats. Biol Pharm Bull 22(1):37–41

    Article  CAS  PubMed  Google Scholar 

  18. Mehri N, Messkoub M, Kunkel S (2020) Trends, determinants and the implications of population aging in Iran. Ageing Int 45(4):327–343

    Article  Google Scholar 

  19. Stein AC, Gaetano JN, Jacobs J, Kunnavakkam R, Bissonnette M, Pekow J (2016) Northern latitude but not season is associated with increased rates of hospitalizations related to inflammatory bowel disease: results of a multi-year analysis of a national cohort. PLoS ONE 11(8):e0161523

    Article  PubMed  PubMed Central  Google Scholar 

  20. Behboudi H, Nikkhah H, Alizadeh Y, Katibeh M, Pakbin M, Ahmadieh H et al (2020) A population-based study on the prevalence and associated factors of age-related macular degeneration in Northern Iran the Gilan Eye Study. Ophthalmic Epidemiol 27(3):209–218. https://doi.org/10.1080/09286586.2020.1716379

    Article  PubMed  Google Scholar 

  21. Katibeh M, Behboudi H, Moradian S, Alizadeh Y, Beiranvand R, Sabbaghi H et al (2017) Rapid assessment of avoidable blindness and diabetic retinopathy in Gilan Province Iran. Ophthalmic Epidemiol 24(6):381–387. https://doi.org/10.1080/09286586.2017.1307993

    Article  PubMed  Google Scholar 

  22. Powell RA, Single HM (1996) Focus groups. Int J Qual Health Care 8(5):499–504

    Article  CAS  PubMed  Google Scholar 

  23. Katibeh M, Rajavi Z, Yaseri M, Hosseini S, Hosseini S, Akbarian S et al (2017) Association of socio-economic status and visual impairment: a population-based study in Iran. Arch Iran Med 20(1):43–48

    PubMed  Google Scholar 

  24. Thylefors B, Chylack LT Jr, Konyama K, Sasaki K, Sperduto R, Taylor HR et al (2002) A simplified cataract grading system The WHO Cataract Grading Group. Ophthalmic Epidemiol 9(2):83–95

    Article  CAS  PubMed  Google Scholar 

  25. Bedrossian CWM, Greenberg SD, Singer DB, Hansen JJ, Rosenberg HS (1976) The lung in cystic fibrosis: a quantitative study including prevalence of pathologic findings among different age groups. Hum Pathol 7(2):195–204

    Article  CAS  PubMed  Google Scholar 

  26. Fujiwara T, Yano Y, Hoshide S, Kanegae H, Kario K (2018) Association of cardiovascular outcomes with masked hypertension defined by home blood pressure monitoring in a Japanese general practice population. JAMA Cardiol 3(7):583–590

    Article  PubMed  PubMed Central  Google Scholar 

  27. Katibeh M, Moghaddam A, Yaseri M, Neupane D, Kallestrup P, Ahmadieh H (2020) Hypertension and associated factors in the Islamic Republic of Iran: a population-based study. East Mediterr Health J 26(3):304–314

    Article  PubMed  Google Scholar 

  28. Husten CG (2009) How should we define light or intermittent smoking? Does it matter? Nicotine Tob Res 11(2):111–121

    Article  PubMed  PubMed Central  Google Scholar 

  29. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002 ;106(25):3143–421.

  30. Creuzot-Garcher C, Binquet C, Daniel S, Bretillon L, Acar N, de Lazzer A et al (2016) The Montrachet Study: study design, methodology and analysis of visual acuity and refractive errors in an elderly population. Acta Ophthalmol 94(2):e90–e97

    Article  PubMed  Google Scholar 

  31. Rajavi Z, Katibeh M, Ziaei H, Fardesmaeilpour N, Sehat M, Ahmadieh H et al (2011) Rapid assessment of avoidable blindness in Iran. Ophthalmology 118(9):1812–1818

    Article  PubMed  Google Scholar 

  32. Mansouri K, Orgül S, Meier-Gibbons F, Mermoud A (2006) Awareness about glaucoma and related eye health attitudes in Switzerland: a survey of the general public. Ophthalmologica 220(2):101–108

    Article  PubMed  Google Scholar 

  33. Wong TY, Zheng Y, Jonas JB, Flaxman SR, Keeffe J, Leasher J et al (2014) Prevalence and causes of vision loss in East Asia: 1990–2010. Br J Ophthalmol 98(5):599–604

    Article  PubMed  Google Scholar 

  34. Khairallah M, Kahloun R, Flaxman SR, Jonas JB, Keeffe J, Leasher J et al (2014) Prevalence and causes of vision loss in North Africa and the Middle East: 1990–2010. Br J Ophthalmol 98(5):605–611

    Article  PubMed  Google Scholar 

  35. Ramke J, Zwi AB, Palagyi A, Blignault I, Gilbert CE (2015) Equity and blindness: closing evidence gaps to support universal eye health. Ophthalmic Epidemiol 22(5):297–307. https://doi.org/10.3109/09286586.2015.1077977

    Article  PubMed  Google Scholar 

  36. Braakhuis AJ, Donaldson CI, Lim JC, Donaldson PJ (2019) Nutritional Strategies to Prevent Lens Cataract: Current Status and Future Strategies. Nutrients 11(5):1186

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Javadi MA, Rezaei A, Karimian F, Amini H, Pakravan M, Nouri MKIA, et al. Prevalence of cataract in Tehran. 2004;

  38. Thompson J, Lakhani N (2015) Cataracts. Prim Care 42(3):409–423

    Article  PubMed  Google Scholar 

  39. Al Salem M, Ismail L (1987) Factors influencing visual outcome after cataract extraction among Arabs in Kuwait. Br J Ophthalmol 71(6):458–461

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Mönestam E, Wachmeister L (2004) Impact of cataract surgery on the visual ability of the very old. Am J Ophthalmol 137(1):145–155

    Article  PubMed  Google Scholar 

  41. Mpyet C, Langnap L, Akpan S (2007) Outcome and benefits of small incision cataract surgery in Jos. Nigeria Niger J Clin Pract 10(2):162–165

    CAS  PubMed  Google Scholar 

  42. Addisu Z, Solomon B (2011) Patients’ preoperative expectation and outcome of cataract surgery at jimma university specialized hospital-department of ophthalmology. Ethiop J Health Sci 21(1):47–56

    Article  PubMed  PubMed Central  Google Scholar 

  43. Haileselassie T, Asefa Y, Bayu S, Bejiga A (2002) Outcome of extra-capsular cataract extraction with posterior chamber intraocular lens implantation performed at a cataract surgical campaign. Ethiop J Health Dev 16(1):77–83

    Article  Google Scholar 

  44. Hussen MS, Gebreselassie KL, Seid MA, Belete GT (2017) Visual outcome of cataract surgery at Gondar university hospital tertiary eye care and training center, North West Ethiopia. Clin Optom (Auckl) 9:19

    Article  PubMed  Google Scholar 

  45. Leske MC, Chylack LT Jr, Wu SY (1991) The lens opacities case-control study: risk factors for cataract. Arch Ophthalmol 109(2):244–251. https://doi.org/10.1001/archopht.1991.01080020090051

    Article  CAS  PubMed  Google Scholar 

  46. Robman L, Taylor H (2005) External factors in the development of cataract. Eye 19(10):1074–1082. https://doi.org/10.1038/sj.eye.6701964

    Article  CAS  PubMed  Google Scholar 

  47. Alshamrani AZ (2018) Cataracts pathophysiology and managements. Egypt J Hosp Med 70(1):151–154

    Article  Google Scholar 

  48. Brown CJ, Akaichi F (2015) Vitamin D deficiency and posterior subcapsular cataract. Clin Ophthalmol 9:1093–1098

    Article  PubMed  PubMed Central  Google Scholar 

  49. Abdellah MM, Mohamed Mostafa E, Salama EH, Roshdy ME (2019) Association of serum 25-hydroxyl vitamin D deficiency and age-related cataract: a case-control study. J Ophthalmol 2019:9312929

    PubMed  PubMed Central  Google Scholar 

  50. Holick MF (2008) Deficiency of sunlight and vitamin D. Br Med J Publ Group. 336:1318–1319

    Article  Google Scholar 

  51. Öktem Ç, Aslan F (2021) Vitamin D levels in young adult cataract patients: a case-control study. Ophthalmic Res 64(1):116–120

    Article  PubMed  Google Scholar 

  52. Bandeira F, Griz L, Dreyer P, Eufrazino C, Bandeira C, Freese E (2006) Vitamin D deficiency: a global perspective. Arquivos Brasileiros de Endocrinologia & Metabologia 50:640–646

    Article  Google Scholar 

  53. Patel HY, Danesh-Meyer HV (2013) Incidence and management of cataract after glaucoma surgery. Curr Opin Ophthalmol 24(1):15–20

    Article  PubMed  Google Scholar 

  54. Hylton C, Congdon N, Friedman D, Kempen J, Quigley H, Bass E et al (2003) Cataract after glaucoma filtration surgery. Am J Ophthalmol 135(2):231–232

    Article  PubMed  Google Scholar 

  55. Hsuan JD, Brown NA, Bron AJ, Patel CK, Rosen PH (2001) Posterior subcapsular and nuclear cataract after vitrectomy. J Cataract Refract Surg 27(3):437–444

    Article  CAS  PubMed  Google Scholar 

  56. Petermeier K, Szurman P, Bartz-Schmidt UK, Gekeler F (2010) Pathophysiology of cataract formation after vitrectomy. Klin Monbl Augenheilkd 227(3):175–180

    Article  CAS  PubMed  Google Scholar 

  57. Lam D, Rao SK, Ratra V, Liu Y, Mitchell P, King J et al (2015) Cataract. Nat Rev Dis Primers 1:15014

    Article  PubMed  Google Scholar 

  58. Kiziltoprak H, Tekin K, Inanc M, Goker YS (2019) Cataract in diabetes mellitus. World J Diabetes 10(3):140

    Article  PubMed  PubMed Central  Google Scholar 

  59. Bron AJ, Brown NAP, Harding JJ, Ganea E (1998) The lens and cataract in diabetes. Int Ophthalmol Clin 38(2):37–67

    Article  CAS  PubMed  Google Scholar 

  60. Wang YX, Bin WW, Xu L, Jonas JB (2019) Physical activity and eye diseases. The Beijing eye study. Acta Ophthalmol 97(3):325–331. https://doi.org/10.1111/aos.13962

    Article  PubMed  Google Scholar 

  61. Pirie A (1965) Epidemiological and biochemical studies of cataract and diabetes. Invest Ophthalmol Vis Sci 4(4):629–637

    CAS  Google Scholar 

  62. Janghorbani M, Jones RB, Allison SP (2000) Incidence of and risk factors for cataract among diabetes clinic attenders. Ophthalmic Epidemiol 7(1):13–25

    Article  CAS  PubMed  Google Scholar 

  63. Jones WL (1991) Traumatic injury to the lens. Optom Clin 1(2):125–142

    CAS  PubMed  Google Scholar 

  64. Agrawal R V, Desai S. Traumatic cataract

  65. Fagerholm PP (1982) The response of the lens to trauma. Trans Ophthalmol Soc U K 102:369–374

    PubMed  Google Scholar 

  66. Lundström M, Stenevi U, Thorburn W (1999) Gender and cataract surgery in Sweden 1992–1997. A retrospective observational study based on the Swedish national cataract register. Acta Ophthalmol Scand 77(2):204–208

    Article  PubMed  Google Scholar 

  67. Vashist P, Talwar B, Gogoi M, Maraini G, Camparini M, Ravindran RD et al (2011) Prevalence of cataract in an older population in India: the India study of age-related eye disease. Ophthalmology 118(2):272

    Article  PubMed  Google Scholar 

  68. Harding JJ, Egerton M, van Heyningen R, Harding RS (1993) Diabetes, glaucoma, sex, and cataract: analysis of combined data from two case control studies. Br J Ophthalmol 77(1):2–6

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. McCarty CA, Mukesh BN, Fu CL, Taylor HR (1999) The epidemiology of cataract in Australia. Am J Ophthalmol 128(4):446–465

    Article  CAS  PubMed  Google Scholar 

  70. Minassian DC, Mehra V, Reidy A (2002) Childbearing and risk of cataract in young women: an epidemiological study in central India. Br J Ophthalmol 86(5):548–550

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Razi S, Enayatrad M, Mohammadian-Hafshejani A, Salehiniya H, Soltani S (2015) The epidemiology of skin cancer and its trend in Iran. Int J Prev Med 6:64

    Article  PubMed  PubMed Central  Google Scholar 

  72. Olafsdottir E, Andersson DKG, Stefánsson E (2012) The prevalence of cataract in a population with and without type 2 diabetes mellitus. Acta Ophthalmol 90(4):334–340

    Article  PubMed  Google Scholar 

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Funding

While preparing this manuscript, the authors declare that no funds, grants, or other support were received from any source.

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Author notes

  1. Amirreza Ramezani and Hamideh Sabbaghi have contributed equally to this work.

Authors and Affiliations

  1. Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Amirreza Ramezani & Koorosh Etemad

  2. School of Medicine, Shahid Beheshti University of Medical Sciences, Velenjak Street, Tehran, 198353-5511, Iran

    Amirreza Ramezani

  3. Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Hamideh Sabbaghi

  4. Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Hamideh Sabbaghi

  5. Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark

    Marzieh Katibeh

  6. Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Hamid Ahmadieh, Bahareh Kheiri & Siamak Moradian

  7. Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran

    Mehdi Yaseri

  8. Department of Ophthalmology, Guilan University of Medical Sciences, Namjoo Avenue, Rasht, Gilan, Iran

    Yousef Alizadeh, Reza Soltani Moghadam, Abdolreza Medghalchi & Hassan Behboudi

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  1. Amirreza Ramezani
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Contributions

All authors contributed to the study’s conception and design. HB, BK, YA, RSM, and AM performed material preparation, data collection, and analysis. AR and HS wrote the first draft of them all authors commented on previous versions. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Koorosh Etemad or Hassan Behboudi.

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Conflict of interest

The authors have no conflict of interest with the subject matter of this manuscript. The authors have not disclosed financial or non-financial interests.

Ethical approval

The study protocol was approved by the Ethics Committee of the Ophthalmic Research Center affiliated with Shahid Beheshti University of Medical Sciences via the approval number of IR.SBMU.REC.1391.002.

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All individuals included in the study provided informed consent before they participated in the study.

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The authors affirm that human research participants provided informed consent to publish the images in Figs. 1, 2, and 3.

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Ramezani, A., Sabbaghi, H., Katibeh, M. et al. Prevalence of cataract and its contributing factors in Iranian elderly population: the Gilan eye study. Int Ophthalmol 43, 4503–4514 (2023). https://doi.org/10.1007/s10792-023-02851-7

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