title: Lens retrodots and vacuoles and their associations with the prevalence and incidence of age-related cataract.
abstract: OBJECTIVE
  To assess the prevalence of retrodots and vacuoles and their associations with the prevalence and long-term incidence of age-related cataract in an older Australian cohort.
  
  
  METHODS
  Of 3654 baseline participants of the Blue Mountains Eye Study aged 49+ years (1992-1994), 2335 and 1952 were re-examined after 5 and 10 years, respectively. Lens photographs were graded for cataract, retrodots, and vacuoles. Eye-specific data were used to assess the associations between retrodots or vacuoles at baseline and the prevalence and 10-year incidence of nuclear, cortical, and posterior subcapsular (PSC) cataract and cataract surgery.
  
  
  RESULTS
  At baseline, retrodots were present in 142 persons (4%) and vacuoles in 1333 persons (40%). Prevalence of both lens features increased with increasing age (P for trend <0.0001). After adjusting for age and gender, vacuoles were associated with prevalent PSC cataract at baseline (odds ratio (OR), 1.60, 95% confidence interval (CI), 1.25-2.05). After adjusting for age, gender, smoking, hypertension, diabetes, education, and use of inhaled/oral steroids, baseline retrodots were associated with an increased incidence of cataract surgery (OR 2.90, 95% CI 1.71-4.91), while 3+ vacuoles at baseline were associated with an increased risk of PSC cataract (OR 3.56, 95% CI 2.13-5.95) and cataract surgery (OR 1.84, 95% CI 1.22-2.77).
  
  
  CONCLUSIONS
  Lens retrodots and vacuoles were found to be positively associated with 10-year incidence of cataract surgery, and vacuoles associated with PSC cataract, a finding suggestive of shared risk factors or pathogenesis between these two lens features and the development of PSC cataract.
authors.affiliation: Centre for Vision Research, Westmead Millennium Institute and Department of Ophthalmology, University of Sydney, Sydney, NSW, Australia.
authors.forename: A G
authors.initials: AG
authors.lastname: Tan
authors.forename: P
authors.initials: P
authors.lastname: Mitchell
authors.forename: E
authors.initials: E
authors.lastname: Rochtchina
authors.forename: T
authors.initials: T
authors.lastname: Hong
authors.forename: R G
authors.initials: RG
authors.lastname: Cumming
authors.forename: J J
authors.initials: JJ
authors.lastname: Wang
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D001315:Australia / Q000453:epidemiology; D002386:Cataract / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007908:Lens, Crystalline / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D014792:Visual Acuity / Q000502:physiology