Pseudoexfoliation in the Reykjavik Eye Study: prevalence and related ophthalmological variables.

PURPOSE: To examine the age and sex-specific prevalence of pseudoexfoliation syndrome (PEX) and its relationship with some ophthalmological variables. METHODS: We carried out a population-based study using a random sample taken from the national population census for citizens of Reykjavik, aged > or = 50 years. A total of 1045 individuals participated in all parts of the study. Pseudoexfoliation was established by slit-lamp examination with a maximally dilated pupil carried out by two experienced ophthalmologists, who were masked to one another's results except in cases of disagreement where they had to reach a consensus. RESULTS: In all, 108 (10.7%) persons were found to have PEX in at least one eye. Prevalence increased from 2.5% in those aged 50-59 years to 40.6% in those aged > or = 80 years. Women were more frequently affected than men (12.3% versus 8.7%). This difference remained statistically significant after controlling for the effect of age (p < 0.001). Eyes with PEX were found to have higher intraocular pressure (IOP) than eyes without PEX (p < 0.05). However, PEX was not found to be related to central corneal thickness, anterior chamber depth, lens thickness, nuclear lens opacifications or optic disc morphology in a multivariate model. CONCLUSIONS: Pseudoexfoliation is an age-related phenomenon commonly found in Iceland. It is more commonly found in women than in men and is associated with elevated IOP.

Risk factors for five-year incident age-related macular degeneration: the Reykjavik Eye Study.

PURPOSE: To establish risk factors for five-year incidence of age-related macular degeneration (AMD). DESIGN: Population-based, prospective cohort study, and risk analysis. METHODS: A random sample from the Reykjavik Population Census for individuals 50 years and older was selected. We took fundus stereo color photographs and used standard grading system to study the five-year incidence of drusen, pigmentary abnormalities, and AMD and to examine possible risk factors. A questionnaire including information on disease, medication, diet, and lifestyle from the Reykjavik Eye Study database provided additional information. RESULTS: Current alcohol consumption decreased the risk for drusen. Being married rather than divorced or widowed decreased the risk for soft drusen; being single decreased the risk of hypopigmentation as compared with being divorced or married. Both consuming dietary fiber-rich vegetables and meat and meat products once a week or less frequently was a risk factor for developing soft drusen and decreased the risk of pigmentary abnormalities. Those who had smoked 20 pack-years or more as compared with nonsmokers had decreased survival rate over the five years (odds ratio (OR) 0.46, 95% confidence interval (CI) 0.27 to 0.80; P = .006). CONCLUSIONS: Risk factors for drusen appear to differ from risk factors for pigmentary abnormalities. The effect of smoking on developing AMD is partly masked by selective mortality.

Exfoliation syndrome in the Reykjavik Eye Study: risk factors for baseline prevalence and 5-year incidence.

AIM: To examine the age- and gender-specific prevalent and 5-year incident risk of developing exfoliation syndrome (XFS). METHODS AND PARTICIPANTS: In a population-based random sample of citizens 50 years and older, 1045 persons had baseline examination in 1996; 846 of the 958 survivors (88.2%) had a follow-up examination in 2001. Following maximum dilatation of pupils, a diagnosis of exfoliation was established on slit-lamp examination. An extensive questionnaire was administered at baseline and follow-up. Prevalent and incident risk was then calculated using a multivariate analysis. RESULTS: The following variables were found to correlate significantly with prevalence risk of XFS at baseline: age, female gender, increased iris pigmentation, moderate use of alcohol and self-reported asthma. We also found that, compared with those who consumed dietary fibre-rich vegetables, green or yellow vegetables, and fruit less than once a month in their 20s and 40s, those consuming the same food items once or twice every 2 weeks were found to be less likely to have XFS. The same applied to those consuming dietary fibre rich once or twice every 2 weeks in their 40s and 60s. CONCLUSION: Food items that are possibly surrogates for antioxidative effect may correlate with decreased risk of XFS and increased iris pigmentation may correlate with increased risk. Given the large number of comparisons, these findings require validation through additional clinical studies. Increased age and female gender increase the likelihood of XFS.

Pseudoexfoliation in the reykjavik eye study: five-year incidence and changes in related ophthalmologic variables.

PURPOSE: To examine the 5-year incidence of pseudoexfoliation (PEX) and monitor changes in related ophthalmologic variables. DESIGN: Population-based, prospective cohort study. METHODS: A random sample from the Reykjavik Population Census for persons 50 years and older was used. At baseline 1,045 participants were examined for signs of PEX including peripheral band and/or central shield of exfoliative material on the anterior lens capsule. Five years later, 846 (88.2%) of survivors returned for a follow-up visit. RESULTS: The 5-year incidence of PEX was 3.5% in right eyes only, and 5.2% in either eye. Age increased the risk of 5-year incidence by 5% when looking at 10-year age groups (P = .02); the incidence was higher in female subjects (P = .05) than in male. A total of 27% of clinically asymmetric cases converted to clinically bilateral disease over 5 years. Intraocular pressure increased in the group that developed PEX during the 5 years, but the size of the optic cup increased most in eyes that already had PEX at baseline. CONCLUSION: This incidence study from Iceland confirms findings from previous prevalence studies that PEX is increasingly common with older age in this population. Earliest changes related to PEX may be subtle and difficult to detect, which may lead to some misclassification. Further study is needed to identify clinical features that can reliably detect patients at risk for developing PEX.

Central corneal thickness, radius of the corneal curvature and intraocular pressure in normal subjects using non-contact techniques: Reykjavik Eye Study.

PURPOSE: To establish a population profile of central corneal thickness (CCT), radius of the corneal curvature (CC) and intraocular pressure (IOP) and the relationships between them using non-contact techniques. METHODS: We used a population-based random sample of 415 male and 510 female Caucasians aged 50 years and older. CCT and the radius of CC were measured with Scheimpflug anterior segment photography. IOP was measured with air-puff tonometry. RESULTS: The mean IOP of right eyes was 15.1 mmHg (SD 3.3) among men and 15.8 mmHg among women (SD 3.1), which is a statistically significant difference. The mean radius of CC for male right eyes was 7.78 (SD 0.60) and for females 7.62 (SD 0.58) which is also statistically significant. Mean CCT for male right eyes was 0.528 mm (SD 0.041) and for females 0.526 mm (SD 0.037), which is not a significant difference. Linear regression analysis shows no relationship between the radius of CC and IOP or between age and radius of CC. Linear regression analysis of the relationship between CCT and IOP suggests higher IOP measurements with thicker corneas. There was no significant correlation between age and CCT. CONCLUSION: IOP was found to be independent of age and significantly higher in females than in males. Radius of CC was found to be age-independent and significantly steeper in females than in males. CCT appears to be independent of age and gender. Greater CCT is associated with higher mean IOP.