title: Lifetime exposure to ambient ultraviolet radiation and the risk for cataract extraction and age-related macular degeneration: the Alienor Study.
abstract: OBJECTIVE
  While exposure to ultraviolet radiation (UVR) is a recognized risk factor for cataract, its association is more controversial with age-related macular degeneration (AMD). We report the associations of lifetime exposure to ambient UVR with cataract extraction and AMD.
  
  
  METHODS
  The Alienor Study is a population-based study of 963 residents of Bordeaux (France), aged 73 years or more. Lifetime exposure to ambient UVR was estimated from residential history and Eurosun satellite-based estimations of ground UVR. It was divided in three groups (lower quartile, intermediate quartiles, upper quartile), using the intermediate quartiles as the reference. Early and late AMD was classified from retinal color photographs. Cataract extraction was defined as absence of the natural lens at slit-lamp.
  
  
  RESULTS
  After multivariate adjustment, subjects in the upper quartile of lifetime ambient UVR exposure were at increased risk for cataract extraction (odds ratio [OR] = 1.53; 95% confidence interval [CI], 1.04-2.26; P = 0.03) and for early AMD (OR = 1.59; 95% CI, 1.04-2.44; P = 0.03), by comparison with subjects in the intermediate quartiles. Subjects in the lower quartile of UVR exposure also were at increased risk for early AMD (OR = 1.69; 95% CI, 1.06-2.69; P = 0.03), by comparison with those with medium exposure. Associations of late AMD with UVR exposure was not statistically significant.
  
  
  CONCLUSIONS
  This study further confirms the increased risk for cataract extraction in subjects exposed to high ambient UVR. Moreover, it suggests that risk for early AMD is increased in subjects exposed to high UVR, but also to low UVR, by comparison with medium exposures.
authors.affiliation: Université de Bordeaux, Bordeaux, France INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Delcourt
authors.affiliation: Université de Bordeaux, Bordeaux, France INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Cougnard-Grégoire
authors.affiliation: International Prevention Research Institute, Lyon, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Boniol
authors.affiliation: Inserm, U1061, Montpellier, France University Montpellier I, Montpellier, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Carrière
authors.affiliation: Centre de Recherche en Cancérologie de Lyon, UMR Inserm U1052 - CNRS U5286, Lyon, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Doré
authors.affiliation: Université de Bordeaux, Bordeaux, France INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France CHU de Bordeaux, Service d'Ophtalmologie, Bordeaux, France.
authors.forename: Marie-Noëlle
authors.initials: MN
authors.lastname: Delyfer
authors.affiliation: CHU de Bordeaux, Service d'Ophtalmologie, Bordeaux, France.
authors.forename: Marie-Bénédicte
authors.initials: MB
authors.lastname: Rougier
authors.affiliation: Université de Bordeaux, Bordeaux, France INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Le Goff
authors.affiliation: Université de Bordeaux, Bordeaux, France INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Dartigues
authors.affiliation: Université de Bordeaux, Bordeaux, France INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Barberger-Gateau
authors.affiliation: Université de Bordeaux, Bordeaux, France INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France CHU de Bordeaux, Service d'Ophtalmologie, Bordeaux, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Korobelnik
mesh_terms: D000368:Aged; D002386:Cataract / Q000453:epidemiology* / Q000209:etiology; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007908:Lens, Crystalline / Q000528:radiation effects; D008268:Macular Degeneration / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D011379:Prognosis; D012160:Retina / Q000528:radiation effects; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors; D014466:Ultraviolet Rays / Q000009:adverse effects*
keywords: cataract; epidemiology; light exposure; macular degeneration; risk factors; ultraviolet radiation