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Relationship of 10-year change in refraction to nuclear cataract and axial length findings from an older population.
Ophthalmology. 2008 Aug; 115(8):1273-8, 1278.e1.O

Abstract

PURPOSE

To examine 10-year changes and other influences on spherical equivalent refraction (SER) in older persons.

DESIGN

Prospective population-based study.

PARTICIPANTS

Three thousand six hundred fifty-four Blue Mountains Eye Study participants 49 or older at baseline (1992-1994) were observed after 5 years (2335; 75% of survivors) and 10 years (1952; 76% of survivors).

METHODS

At each visit, subjective refraction was performed using modified Early Treatment Diabetic Retinopathy Study protocols. Spherical equivalent refraction was calculated as sphere + half cylinder power. Axial length was measured only at the 10-year examinations, using an IOL Master. Right phakic eyes with best-corrected visual acuity > 20/40 (n = 1340) at baseline and 10-year examinations were included.

MAIN OUTCOME MEASURES

Temporal refractive change.

RESULTS

Over the decade, a hyperopic shift was observed among persons <65 years old, and a myopic shift was associated with increasing age among older subjects, with gender-adjusted mean SER changes of 0.40, 0.33, -0.02, and -0.65 diopters (D) in persons with baseline ages 49 to 54, 55 to 64, 65 to 74 and > or = 75, respectively. Apart from age, myopic refractive change was strongly associated with baseline nuclear cataract; mean changes of -0.96 and 0.26 D were observed in eyes with and without nuclear cataract, respectively (P<0.001). A birth cohort effect on refraction was also observed. After adjusting for age and nuclear cataract, baseline refractive status (P = 0.58), education (P = 0.34), and diabetes (P = 0.16) were not associated with changing SER. A 10% increase in against-the-rule astigmatism was observed over the 10-year period. Axial length showed an age-related reduction in 10-year cross-sectional data, from a mean of 23.61 mm (95% confidence interval [CI], 23.50-23.73) in 59- to 64-year-olds to a mean of 23.15 mm (95% CI, 22.83-23.47) in > or = 85-year-olds. After adjusting for age, education, and nuclear cataract, axial length measured 10 years later was not associated with change in SER (P = 0.34).

CONCLUSIONS

This longitudinal study confirms a hyperopic shift in persons younger than 65 and a myopic shift for older ages. Although underlying causes for this age-related hyperopic shift are unknown, it does not appear related to axial length. The myopic shift, however, is most likely caused by increasing nuclear cataract.

Authors+Show Affiliations

Department of Ophthalmology, University of Sydney (Centre for Vision Research, Westmead Millennium Institute, Westmead Hospital), Sydney, Australia.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18222002

Citation

Fotedar, Reena, et al. "Relationship of 10-year Change in Refraction to Nuclear Cataract and Axial Length Findings From an Older Population." Ophthalmology, vol. 115, no. 8, 2008, pp. 1273-8, 1278.e1.
Fotedar R, Mitchell P, Burlutsky G, et al. Relationship of 10-year change in refraction to nuclear cataract and axial length findings from an older population. Ophthalmology. 2008;115(8):1273-8, 1278.e1.
Fotedar, R., Mitchell, P., Burlutsky, G., & Wang, J. J. (2008). Relationship of 10-year change in refraction to nuclear cataract and axial length findings from an older population. Ophthalmology, 115(8), 1273-8, e1. https://doi.org/10.1016/j.ophtha.2007.11.003
Fotedar R, et al. Relationship of 10-year Change in Refraction to Nuclear Cataract and Axial Length Findings From an Older Population. Ophthalmology. 2008;115(8):1273-8, 1278.e1. PubMed PMID: 18222002.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship of 10-year change in refraction to nuclear cataract and axial length findings from an older population. AU - Fotedar,Reena, AU - Mitchell,Paul, AU - Burlutsky,George, AU - Wang,Jie Jin, Y1 - 2008/01/25/ PY - 2007/06/26/received PY - 2007/11/05/revised PY - 2007/11/05/accepted PY - 2008/1/29/pubmed PY - 2008/8/20/medline PY - 2008/1/29/entrez SP - 1273-8, 1278.e1 JF - Ophthalmology JO - Ophthalmology VL - 115 IS - 8 N2 - PURPOSE: To examine 10-year changes and other influences on spherical equivalent refraction (SER) in older persons. DESIGN: Prospective population-based study. PARTICIPANTS: Three thousand six hundred fifty-four Blue Mountains Eye Study participants 49 or older at baseline (1992-1994) were observed after 5 years (2335; 75% of survivors) and 10 years (1952; 76% of survivors). METHODS: At each visit, subjective refraction was performed using modified Early Treatment Diabetic Retinopathy Study protocols. Spherical equivalent refraction was calculated as sphere + half cylinder power. Axial length was measured only at the 10-year examinations, using an IOL Master. Right phakic eyes with best-corrected visual acuity > 20/40 (n = 1340) at baseline and 10-year examinations were included. MAIN OUTCOME MEASURES: Temporal refractive change. RESULTS: Over the decade, a hyperopic shift was observed among persons <65 years old, and a myopic shift was associated with increasing age among older subjects, with gender-adjusted mean SER changes of 0.40, 0.33, -0.02, and -0.65 diopters (D) in persons with baseline ages 49 to 54, 55 to 64, 65 to 74 and > or = 75, respectively. Apart from age, myopic refractive change was strongly associated with baseline nuclear cataract; mean changes of -0.96 and 0.26 D were observed in eyes with and without nuclear cataract, respectively (P<0.001). A birth cohort effect on refraction was also observed. After adjusting for age and nuclear cataract, baseline refractive status (P = 0.58), education (P = 0.34), and diabetes (P = 0.16) were not associated with changing SER. A 10% increase in against-the-rule astigmatism was observed over the 10-year period. Axial length showed an age-related reduction in 10-year cross-sectional data, from a mean of 23.61 mm (95% confidence interval [CI], 23.50-23.73) in 59- to 64-year-olds to a mean of 23.15 mm (95% CI, 22.83-23.47) in > or = 85-year-olds. After adjusting for age, education, and nuclear cataract, axial length measured 10 years later was not associated with change in SER (P = 0.34). CONCLUSIONS: This longitudinal study confirms a hyperopic shift in persons younger than 65 and a myopic shift for older ages. Although underlying causes for this age-related hyperopic shift are unknown, it does not appear related to axial length. The myopic shift, however, is most likely caused by increasing nuclear cataract. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/18222002/Relationship_of_10_year_change_in_refraction_to_nuclear_cataract_and_axial_length_findings_from_an_older_population_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(07)01227-4 DB - PRIME DP - Unbound Medicine ER -