title: The relationship of cataract and cataract extraction to age-related macular degeneration: the Beaver Dam Eye Study.
abstract: OBJECTIVE
  To examine the associations of cataract and cataract surgery with early and late age-related macular degeneration (AMD) over a 20-year interval.
  
  
  METHODS
  Longitudinal population-based study of age-related eye diseases.
  
  
  METHODS
  Beaver Dam Eye Study participants.
  
  
  METHODS
  Persons aged 43 to 86 years participated in the baseline examination in 1988-1990. Participants were followed up at 5-year intervals after the baseline examination. Examinations consisted of ocular examination with lens and fundus photography, medical history, measurements of blood pressure, height, and weight. Values of risk variables were updated, and incidences of early and late AMD were calculated for each 5-year interval. Odds ratios were computed using discrete linear logistic regression modeling with generalized estimating equation methods to account for correlation between the eyes and multiple intervals.
  
  
  METHODS
  Age-related macular degeneration.
  
  
  RESULTS
  After adjusting for age and sex, neither cataract nor cataract surgery was associated with increased odds for developing early AMD. Further adjusting for high-risk gene alleles (CFH and ARMS2) and other possible risk factors did not materially affect the odds ratio (OR). However, cataract surgery was associated with incidence of late AMD (OR 1.93; 95% confidence interval [CI], 1.28-2.90). This OR was not materially altered by further adjusting for high-risk alleles (CFH Y402H, ARMS2) or other risk factors. The OR for late AMD was higher for cataract surgery performed 5 or more years prior compared with less than 5 years prior.
  
  
  CONCLUSIONS
  These data strongly support the past findings of an association of cataract surgery with late AMD independent of other risk factors, including high-risk genetic status, and suggest the importance of considering these findings when counseling patients regarding cataract surgery. These findings should provide further impetus for the search for measures to prevent or delay the development of age-related cataract.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA. kleinb@epi.ophth.wisc.edu
authors.forename: Barbara E K
authors.initials: BE
authors.lastname: Klein
authors.forename: Kerri P
authors.initials: KP
authors.lastname: Howard
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Lee
authors.forename: Sudha K
authors.initials: SK
authors.lastname: Iyengar
authors.forename: Theru A
authors.initials: TA
authors.lastname: Sivakumaran
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology; D001824:Body Constitution; D002386:Cataract / Q000150:complications* / Q000453:epidemiology / Q000235:genetics; D002387:Cataract Extraction; D017242:Complement Factor H / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008268:Macular Degeneration / Q000150:complications* / Q000453:epidemiology / Q000235:genetics; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011506:Proteins / Q000235:genetics; D012307:Risk Factors; D014792:Visual Acuity / Q000502:physiology; D014922:Wisconsin / Q000453:epidemiology
chemical_list: C514392:ARMS2 protein, human; C493495:CFH protein, human; D011506:Proteins; D017242:Complement Factor H