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Prevalence and associations of cataract in a rural Chinese adult population: the Handan Eye Study

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Abstract

Background

Cataract remains the leading cause of blindness and visual impairment in the world and in China. However, data on the prevalence of cataract based on standardized lens grading protocols from mainland China are limited. This paper estimated the age- and gender-specific prevalence and risk factor for cataract

Methods

In a population-based Chinese sample, participants underwent a comprehensive ophthalmic examination, including assessment of cortical, nuclear, posterior subcapsular (PSC) and mixed lens opacities from slit-lamp grading using the Lens Opacities Classification System III.

Results

Of the 7,557 eligible subjects, 6,830 took part in the study (90.4 % response rate), and 6,544 participants (95.8 %, mean age 52.0 ± 11.8 years) had lens data for analyses. The prevalence of any cataract surgery in at least one eye was 0.8 % (95 % confidence interval [CI], 0.62, 1.06), with similar rates between men and women. The overall prevalence of any cataract or cataract surgery was 20.8 % (95 % CI, 19.8, 21.8), higher in women than in men after adjusting for age (23.6 % vs 17.6 %; OR: 1.78; 95 % CI: 1.54–2.07). When distinct lens opacity was categorized in each eye as cortical, nuclear, PSC or mixed, based on one randomly selected eye, cortical cataract was the most common distinct subtype (12.3 %), followed by mixed (3.2 %), nuclear (1.7 %), and PSC (0.2 %) cataract. The prevalence of all lens opacities increased with age (P < 0.001). After excluding other causes for visual impairment, the proportion of people with best corrected visual acuity <20/60 was 21 % among those with PSC, and 12 % among those with mixed opacities in the better-seeing eye. In multivariable logistic regression models, myopia was associated with all cataract types, while higher fasting plasma glucose and diabetes were only associated with PSC cataract.

Conclusions

Cataract affects 20 % of the population aged 30 years and older living in rural China, with cortical cataract the most common subtype. Risk factors for cataract include myopia and diabetes.

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Conflict of interest

No authors have any financial/conflicting interests to disclose.

Financial support

This study was supported by the Program of Health Policy for blindness prevention from Ministry of Health the People’s Republic of China, partially funded by the Key Technologies R&D Program No.2006-10903 from Bureau of Science and Technology of Handan city, Hebei Province, China. With additional supports from Beijing Tongren Hospital and key discipline fund of Bureau of Health, Handan city, Hebei Province, China.

The sponsor or funding organization had no role in the design or conduct of this research.

Financial disclosure(s)

The authors have no proprietary or commercial interest in any materials discussed in this article.

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Authors and Affiliations

  1. Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Lab, Capital Medical University, No. 1 Dongjiao Min Xiang, Dongcheng District, Beijing, 100730, China

    Xin Rong Duan, Yuan Bo Liang, Ning Li Wang & Xiao Hui Yang

  2. Handan Eye Hospital, Handan, Hebei Province, China

    Yuan Bo Liang, Lan Ping Sun & Rui Zhi Yuan

  3. Singapore Eye Research Institute, Singapore, Singapore

    Tien Yin Wong

  4. Singapore National Eye Centre, Singapore, Singapore

    Tien Yin Wong

  5. Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Tien Yin Wong

  6. Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia

    Tien Yin Wong

  7. Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China

    Xiao Hui Yang

  8. School of Public Health, Peking University, Beijing, China

    Qiu Shan Tao

  9. Wilmer Eye Institute, Johns Hopkins University, Baltimore, USA

    David S Friedman

  10. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA

    David S Friedman

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  1. Xin Rong Duan
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  9. David S Friedman
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Correspondence to Ning Li Wang.

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Duan, X.R., Liang, Y.B., Wang, N.L. et al. Prevalence and associations of cataract in a rural Chinese adult population: the Handan Eye Study. Graefes Arch Clin Exp Ophthalmol 251, 203–212 (2013). https://doi.org/10.1007/s00417-012-2012-x

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  • DOI: https://doi.org/10.1007/s00417-012-2012-x

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