title: Pterygium and conjunctival ultraviolet autofluorescence in young Australian adults: the Raine study.
abstract: BACKGROUND
  Sun exposure is associated with several ophthalmic diseases, including pterygium which may develop in adolescence. This study reports the prevalence of pterygium and its associations in a large cohort of young Australian adults. Conjunctival ultraviolet autofluorescence, a biomarker of ocular sun exposure, has recently been characterized in some Australian populations.
  
  
  METHODS
  Cross-sectional population-based study.
  
  
  METHODS
  One thousand three hundred forty-four subjects aged 18-22 years in the Western Australian Pregnancy Cohort (Raine) Study.
  
  
  METHODS
  Standardized colour and ultraviolet autofluorescence photographs of the nasal and temporal conjunctiva were taken, and assessed for presence of pterygium and area of autofluorescence. Sun exposure and protective factors were assessed by structured questionnaire.
  
  
  METHODS
  Area of conjunctival ultraviolet autofluorescence in square millimetre (mm(2)) and presence of pterygium.
  
  
  RESULTS
  Median total conjunctival autofluorescence was 44.2 mm(2) (interquartile range 20.2-69.8 mm(2)). Median conjunctival autofluorescence was higher in nasal than in temporal quadrants (23.8 mm(2) vs. 18.9 mm(2), P < 0.001), but did not differ according to age or gender. Higher body mass index was associated with lower levels of autofluorescence. Total autofluorescence increased with increasing time spent outdoors. Prevalence of pterygium was 1.2% (95% confidence interval 0.6-1.8%), and was associated with male gender (odds ratio 6.71, P = 0.012). Participants with pterygium had significantly more conjunctival autofluorescence than those without (median 73.4 mm(2) vs. 44.0 mm(2), P = 0.001).
  
  
  CONCLUSIONS
  Conjunctival ultraviolet autofluorescence is associated with increased time spent outdoors, and increased prevalence of pterygium. The association of this biomarker with other ophthalmohelioses, including cataract, ocular surface squamous neoplasia and eyelid malignancy, has yet to be determined.
authors.affiliation: Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia.
authors.forename: Charlotte M
authors.initials: CM
authors.lastname: McKnight
authors.affiliation: Royal Victorian Eye and Ear Hospital, Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia.
authors.forename: Justin C
authors.initials: JC
authors.lastname: Sherwin
authors.affiliation: Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia.
authors.forename: Seyhan
authors.initials: S
authors.lastname: Yazar
authors.affiliation: Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia.
authors.forename: Hannah
authors.initials: H
authors.lastname: Forward
authors.affiliation: Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia.
authors.forename: Alex X
authors.initials: AX
authors.lastname: Tan
authors.affiliation: Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia.|Royal Victorian Eye and Ear Hospital, Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia.
authors.forename: Alex W
authors.initials: AW
authors.lastname: Hewitt
authors.affiliation: Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia.
authors.forename: Elliot
authors.initials: E
authors.lastname: Smith
authors.affiliation: Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Turton
authors.affiliation: Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia.
authors.forename: Pippa
authors.initials: P
authors.lastname: Byrd
authors.affiliation: Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia.|School of Women's and Infants' Health, The University of Western Australia, Perth, Australia.
authors.forename: Craig E
authors.initials: CE
authors.lastname: Pennell
authors.affiliation: Department of Ophthalmology, Prince of Wales Hospital, Sydney, Australia.
authors.forename: Minas T
authors.initials: MT
authors.lastname: Coroneo
authors.affiliation: Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia.
authors.forename: David A
authors.initials: DA
authors.lastname: Mackey
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D015992:Body Mass Index; D003228:Conjunctiva / Q000528:radiation effects*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008297:Male; D016017:Odds Ratio; D061848:Optical Imaging / Q000379:methods*; D011247:Pregnancy; D015995:Prevalence; D011625:Pterygium / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D011832:Radiation Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D013472:Sunlight; D011795:Surveys and Questionnaires; D014466:Ultraviolet Rays / Q000009:adverse effects*; D014904:Western Australia / Q000453:epidemiology; D055815:Young Adult
keywords: conjunctiva; epidemiology; pterygium; sunlight