Cataract prevalence and prevention in Europe: a literature review

Abstract

. This literature review is aimed at the evaluation of the potential for cataract prevention in Europe. It was performed using PubMed with Mesh and free‐text terms. Studies included were (i) performed on a population of Caucasian origin at an age range of 40–95 years, (ii) cataract was clinically verified, (iii) drug record of prescriptions, their indication, a record of every diagnosis, dosage and quantity of prescribed medicine were available, (iv) sample size >300 and (v) published between 1990 and 2009. The results of 29 articles were reviewed. Former [3.75 (2.26–6.21)] or current smoking [2.34 (1.07–5.15)], diabetes of duration >10 years [2.72 (1.72–4.28)], asthma or chronic bronchitis [2.04 (1.04–3.81)], and cardiovascular disease [1.96 (1.22–3.14)] increased the risk of cataract. Cataract was more common in patients taking chlorpromazine during ≥90 days with a dosage ≥300 mg [8.8 (3.1–25.1)] and corticosteroids >5 years [3.25 (1.39–7.58)] in a daily dose >1600 mg [1.69 (1.17–2.43)]. Intake of a multivitamin/mineral formulation [2.00 (1.35–2.98)] or corticosteroids [2.12 (1.93–2.33)] also increased the risk of cataract. Corticosteroids applied orally [3.25 (1.39–7.58)], parenteral [1.56 (1.34–1.82)] or inhalational [1.58 (1.46–1.71)] lead to cataract more frequently than those applied topically: nasal [1.33 (1.21–1.45)], ear [1.31 (1.19–1.45)] or skin [1.43 (1.36–1.50)]. Outpatient cataract surgery was negatively associated with total cataract surgery costs, and chlorpromazine, corticosteroids and multivitamin/mineral formation increase the risk of posterior subcapsular cataract dependent on dose, treatment application and duration. This review presented a comprehensive overview of specific and general cataract risk factors and an update on most recent experimental studies and randomized control trials directed at cataract prevention.

The Prediction and Monitoring of Toxicity Associated with Long-Term Systemic Glucocorticoid Therapy

“…Cataract surgery costs €700 per eye in Europe [ 35 ] and €5000 per quality-adjusted life year gained with both eyes operated on [ 36 ]. For glaucoma, the annual average cost per patient is €700-1000 based on disease severity [ 37 ].…”

The Role of Ultraviolet Radiation in the Ocular System of Mammals

“…This leads to caspase-3 activation followed by apoptosis in the lens epithelial cells, which creates a disturbance of transmittance of the lens [71]. With increasing age, the lens nucleus becomes more susceptible to oxidation and less able to repair oxidative damage [70].…”

“…Opacification of the crystalline lens that causes reduced passage of light is called a cataract. High sunlight exposure has consistently been associated with an increased risk of cataract formation [70]. Oxidative damage is an important etiological factor for nuclear and cortical cataracts.…”

Patterns of Cataract in Patients Reporting to Christian Hospital, Taxila, Pakistan

“…Cataracts are now associated with syndromes such as Cohen syndrome, Degos disease, and Dubowitz syndrome. In some cases, the formation of cataracts may lead to initial diagnosis of a systemic condition [28,29]. Traumatic cataracts Trauma may result in clouding of the lens.…”