Incidence, progression and risk factors of the different types of cataract in Japanese population

在1997-2002年第一次Monzen眼科研究的1105名50岁以上的受试者中，有632人在5年后的2002-2005年再次接受了检查。三种主要类型白内障的发病率随年龄增长而增加。皮质性、核性和后囊下白内障（PSC）的发生率分别为18.9%、3.0%和2.0%，进展率分别为68.8%、24.8%和25.6%。皮层性白内障的进展率在50岁年龄组高于60岁和70岁年龄组。手术干预的5年发生率为8.2%，以混合型白内障患者最高，尤其是基线时伴有PSC的患者。与本课题组1996年和2001年在冰岛雷克雅未克进行的眼科研究结果相比，日本人群中皮质性白内障的患病率、发病率和进展率较高，核性白内障的发病率和进展率较低。本研究首次揭示了日本人群中三种类型白内障的特点和自然病程。使用前眼段分析系统（EAS-1000， NIDEK）测量晶状体层5年的光散射强度（LSIs）变化。虽然随着年龄的增长LSI增加，但LSI的变化模式因年龄而异。50多岁的受试者皮质层LSI的增加高于60多岁和70多岁的受试者。核层中LSI与年龄无相关性。在基线时，核层低LSI的晶状体显示皮质层的LSI增加率较高。这些结果显示了通过测量lsi预测皮质性和核性白内障的可能性。我们使用CAT-2000 （NEITZ）对纤维褶皱（FF）患者的对比敏感度进行了研究，FF是一种表现为平行白线的白内障亚型，类似于皮质混浊。日本人的FF患病率高于中国人。FF晶状体常发生皮质性白内障，但若乳突区无皮质性白内障，FF眼的对比敏感度正常。由于有FF的晶状体在直接照明下检查时有时会被误诊为皮质性白内障，因此对于眼科医生来说，掌握准确的FF诊断技术并了解FF对视觉功能（包括对比敏感度）的影响很小或没有影响是非常重要的。由于本研究的目的是显示视觉功能与晶状体混浊的类型和严重程度之间的相关性，并为确定合适的白内障手术候选人建立指南，因此应进一步研究混合类型白内障眼睛的视觉功能。少

Among the 1105 subjects aged over 50yrs who participated in the first Monzen Eye Study 1997-2002, 632 were reexamined five years later in 2002-2005. Incidences of the three main types of cataract increased with aging. Incidences of cortical, nuclear and posterior subcapsular cataract (PSC) were 18.9%, 3.0% and 2.0% and progression rates were 68.8%, 24.8% and 25.6% respectively. The progression rate of cortical cataract was higher in subjects aged in their 50s than those in their 60s and 70s. The five years' incidence of surgical intervention was 8.2% and was highest in subjects with mixed type of cataract, especially that with PSC at the baseline. Compared with the results of the Reykjavik Eye Study in Iceland, which was done by our group in 1996 and 2001, the prevalence, incidence and progression rate of cortical cataract was higher and those of nuclear cataract was lower in the Japanese population This study was the first to show the characteristics and natural course of the three ma … More in types of cataract in the Japanese population.The five years' change of light scattering intensities (LSIs) in the lens layers was measured using an anterior eye segment analysis system (EAS-1000, NIDEK). Although the LSIs increased with aging, the pattern of LSI changes differed by age. The increase of LSI in cortical layers was higher in subjects aged in their 50s than those in their 60s and 70s. There was no correlation between LSI in nuclear layers and age. Lenses with low LSI in nuclear layers at the baseline showed the higher increase rate of the LSIs in cortical layers. These results showed the possibility for prediction of cortical and nuclear cataract by measuring LSIs.We investigated contrast sensitivity using CAT-2000 (NEITZ) in subjects with fiber fold (FF), which is one of the subtypes of cataract presenting as parallel white lines similar to cortical opacification.. The prevalence of FF was higher in the Japanese compared with that in the Chinese population. Lenses with FF frequently had cortical cataract, however, the contrast sensitivity of FF eyes was normal if the lenses had no cortical cataract in the papillary area. Since lenses with FF are sometimes misdiagnosed as cases of cortical cataract when examined under direct illumination, it is very important for ophthalmologists to have an accurate technique of FF diagnosis and understand that they have little or no effect on visual function, including contrast sensitivity. Since the goal of this study is to show the correlation between visual function and the types and severity of lens opacities, and to establish guidelines for identifying proper candidates for cataract surgery, further investigation should be done especially regarding visual function of eyes with mixed types of cataract. Less