Correlation of Clinical Aqueous Flare Grading to Semi-Automated Flare Measurements Using Laser Flare Photometry.

PURPOSE: To compare laser flare photometry (LFP) measurements of aqueous flare with Standardization of Uveitis Nomenclature (SUN) and modified SUN grading. METHODS: In this prospective study with multicenter design, uveitis patients were classified according to SUN and modified SUN grading scales. LFP was performed with Kowa FM-700 flaremeter. Mean LFP values were compared with SUN and MSUN scores. RESULTS: The study included 475 LFP measurements, of which 216, 48, 150, 31, 28 and 2 had 0, 0.5+, 1+, 1.5+, 2+ and 3+ flare, respectively. LFP values were significantly different between each two consecutive steps for both clinical gradings (all P < .05). Cut-off values for modified SUN grading steps were defined as 5.7, 9.7, 15.7 and 43.2 for 0/0.5+, 0.5+/ 1+, 1+/1.5+ and 1.5/2+ borders of clinical flare, respectively. CONCLUSIONS: LFP proves to be an objective measurement in analyzing aqueous flare comparable to both SUN and MSUN clinical grading systems.

Effects of consumption of coffee, tea, or soft drinks on open-angle glaucoma: Korea National Health and Nutrition Examination Survey 2010 to 2011.

We sought to investigate the association between consumption of coffee, tea, or soft drinks and risk of open-angle glaucoma (OAG) among Koreans using nationwide population-based data. This cross-sectional survey was performed through the Korea National Health and Nutrition Examination Survey 2010 to 2011. Participants older than 19 years were included in the sample for analysis after excluding those with any missing data. The diagnosis of OAG was based on the International Society of Geographical and Epidemiological Ophthalmology criteria, and participants without glaucomatous optic neuropathy served as controls. The frequency of beverage consumption during the past 12 months was obtained through a questionnaire. Multivariate logistic regression models were used to determine the relationship between consumption of each type of beverage and prevalence of OAG. A total of 6,681 participants was included in the analysis. The prevalence of OAG was 4.4% (n = 323), including 5.4% (n = 169) among men and 3.5% (n = 154) among women. After adjusting for multiple covariates, coffee consumption was significantly associated with OAG, while no significant association was found between consumption of tea or soft drinks and OAG. Participants who drank coffee had a higher risk of having OAG compared with those who did not drink coffee (odds ratio [OR], 2.40; 95% confidence interval [CI], 1.22-4.72; p = 0.011). In sex-stratified analyses, the robust association of coffee consumption with OAG was observed in men (OR, 3.98; 95% CI, 1.71-9.25; p = 0.001) but not in women. Our results suggest that coffee consumption may affect the risk of OAG, particularly in men.

Adult body height and age-related macular degeneration in healthy individuals: A nationwide population-based survey from Korea.

We sought to evaluate the relationship between adult body height and risk of age-related macular degeneration (AMD) among healthy Koreans using nationwide population-based data. We analyzed data derived from the Korea National Health and Nutrition Examination Survey 2008-2011. Participants over 40 years of age were included in the sample after excluding individuals with systemic comorbidities or missing relevant data. The presence and severity of AMD were graded using fundus photographs. The relationship between body height and risk of AMD was determined using multiple logistic regression analyses. Among a total of 8,435 participants, 544 (6.45%) had AMD: 502 (5.95%) with early AMD and 42 (0.5%) with late AMD. In multivariate-adjusted analyses, taller body height was significantly associated with a lower prevalence of AMD (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.81-0.99), while body mass index (BMI) was not associated with AMD. An inverse association between body height and risk of AMD was observed most frequently in participants under 65 years of age (OR, 0.81; 95% CI, 0.70-0.94). Furthermore, body height showed an inverse association with risk of AMD among obese participants (BMI ≥25.0 kg/m2) (OR, 0.75; 95% CI, 0.60-0.93). Subgroup analysis by AMD type disclosed a significant inverse association between body height and early AMD (OR, 0.87; 95% CI, 0.79-0.97) but not late AMD. Our results suggest that shorter body height is independently associated with increased risk of AMD, especially early AMD, in a dose-response manner in people who are obese or under 65 years of age.

Surgical Therapy for Macular Edema: What We Have Learned through the Decades.

Macular edema is a leading cause of functional visual loss in retinal vascular or ocular inflammatory diseases. Because persistent macular edema can lead to irreversible retinal damage, multi-approached treatment should be considered to achieve complete resolution of macular edema. With an enhanced understanding of its pathophysiology, numerous therapeutic options have been developed for the management of macular edema over the decades. Although medical therapies account for the mainstay of treatment, surgical approaches with vitrectomy can play an important role in the management of macular edema, depending on its mechanism of fluid accumulation. The index review focuses on the efficacy of surgical therapy for macular edema secondary to various ocular diseases including diabetic retinopathy, uveitis, and retinal vein occlusion, and consequently provides the evidences that may expand the knowledge and support the employment of surgical options.

Relationship between body fat and diabetic retinopathy in patients with type 2 diabetes: a nationwide survey in Korea.

PURPOSE: To evaluate the association of body mass index (BMI), waist circumference, and body fat with diabetic retinopathy (DR) in Korean patients with type 2 diabetes. METHODS: Among the 1130 participants 19 years of age or older with type 2 diabetes enrolled in the nationwide survey, a total of 887 participants were included in the analyses after excluding patients with ungradable fundus images. The presence and severity of DR were graded with seven-field fundus photographs. The associations between DR and anthropometric parameters and total body fat, which was assessed by dual-energy X-ray absorptiometry, were analysed using multivariate logistic regression models. RESULTS: Patients were divided into three groups according to severity of DR: no DR (n = 702, 79.1%), mild/moderate DR (n = 130, 14.7%), and vision-threatening DR (n = 55, 6.2%). In multivariate-adjusted analyses, higher BMI (adjusted odds ratio [aOR], 0.80; 95% confidence interval [CI], 0.70-0.92; P = 0.001), larger waist circumference (aOR, 0.96; 95% CI, 0.91-1.00; P = 0.047), and higher total body fat (aOR, 0.86; 95% CI, 0.79-0.92; P < 0.001) were significantly associated with a lower risk of vision-threatening DR. In sex-stratified analyses, however, only total body fat in women showed a significant inverse association with the presence of DR (aOR, 0.93; 95% CI, 0.88-0.98; P < 0.001) and independently with the severity of DR (P for trend = 0.004). CONCLUSION: In Korean patients with type 2 diabetes, obese patients might be less likely to have vision-threatening DR. Total body fat in women appears to be inversely and independently associated with DR prevalence and progression.

FIVE-YEAR INCIDENCE AND RISK FACTORS FOR IDIOPATHIC EPIRETINAL MEMBRANES.

PURPOSE: The aim of this was to determine the 5-year incidence of idiopathic epiretinal membrane (ERM) and its risk factors in Korean adults. METHODS: A total of 2,152 participants aged 50 years or older enrolled in a health screening program. All participants underwent baseline ophthalmic and systemic examinations in 2006, and were reexamined after 5 years. Epiretinal membranes were diagnosed using fundus photographs taken at baseline and at the 5-year follow-up. The incidence of idiopathic ERM was calculated in this study cohort, and then age-standardized to the 2010 Korean Census. Epiretinal membranes were classified as preretinal macular fibrosis with prominent retinal folds or cellophane macular reflex without retinal folds. Associated risk factors for idiopathic ERM were also analyzed. RESULTS: Idiopathic ERM developed in 82 of 2,152 participants who had no previous ERM in either eye at baseline. The overall age-standardized incidence was 3.8% (95% confidence interval, 2.8-4.8), including 2.3% with cellophane macular reflex and 1.5% with preretinal macular fibrosis. Multivariate logistic regression analyses revealed that the factors related to the development of idiopathic ERM were age (adjusted odds ratio, 1.04; 95% confidence interval, 1.00-1.08) and hypertriglyceridemia (250 mg/dL or more; adjusted odds ratio, 3.16; 95% confidence interval, 1.54-6.49) after adjusting for confounding factors. CONCLUSION: Our results suggest that the 5-year incidence of idiopathic ERM in Korean adults is relatively similar to that in similar-aged white persons. Age and hypertriglyceridemia may increase the risk of developing idiopathic ERM.

Associations Among Pregnancy, Parturition, and Open-angle Glaucoma: Korea National Health and Nutrition Examination Survey 2010 to 2011.

PURPOSE: The purpose of this study was to investigate the association between factors associated with parturition and open-angle glaucoma (OAG) in Korean females. METHODS: A population-based, cross-sectional survey was performed from the Korean National Health and Nutrition Examination Survey from 2010 to 2011 and enrolled postmenopausal female participants (n=1798). We obtained information on demographics, comorbidities, and health-related behaviors and performed comprehensive ophthalmic examinations. Multivariate regression analysis was used to assess the correlation between pregnancy and delivery and the prevalence of OAG in all enrolled subjects. RESULTS: The prevalence of OAG among study participants was 6.42%. There was a significant difference in the number of deliveries and age at first delivery between the OAG group and the nonglaucoma group. In multiple linear regression models adjusted for age, hypertension, and intraocular pressure only pregnancy 1 was associated with higher risk of OAG compared with pregnancy 2 (P=0.023). Subjects who had 3 or 4 deliveries were at higher risk of OAG compared with subjects with 2 deliveries (P=0.027). An age at first delivery of 16 to 20 years or 21 to 23 years was associated with increased OAG risk compared with the reference group (P<0.05). CONCLUSIONS: A history of three or more deliveries and an age at first delivery younger than 23 years were associated with increased risk of OAG. These results suggest that changes or events during the period from pregnancy to delivery affect the development of glaucoma.

Positional Intraocular Pressure of Vitrectomized and Normal Fellow Eyes.

PURPOSE: To compare posture-induced intraocular pressure (IOP) changes in vitrectomized eyes and normal eyes of patients who had vitrectomy in one eye. METHODS: A total of 31 patients older than 20 years of age who underwent vitrectomy were enrolled in the study. At least six months after vitrectomy, we measured IOP in both eyes using a rebound tonometer 10 minutes after the patient assumed sitting, supine, right lateral decubitus, and left lateral decubitus positions. Patients with a history of ocular surgery (not including vitrectomy) or recent medication use associated with IOP were excluded. IOP and ocular parameters of vitrectomized and normal fellow eyes were compared. For the decubitus position, IOP values of dependent and nondependent eyes were compared. RESULTS: No significant difference was observed in IOP between vitrectomized and normal eyes in the sitting and supine positions. The IOP for dependent eyes (on the lower side in the lateral decubitus position) was significantly higher than the IOP for nondependent eyes in both right lateral decubitus (right vitrectomized eye 19.31 ± 4.20 vs. 16.71 ± 4.02 mmHg, p < 0.001; left vitrectomized eye 18.35 ± 1.75 vs. 16.04 ± 3.02 mmHg, p = 0.003) and left lateral decubitus (right vitrectomized eye 17.32 ± 4.63 vs. 19.15 ± 3.83 mmHg, p = 0.004; left vitrectomized eye 16.19 ± 1.81 vs. 18.12 ± 2.29 mmHg, p < 0.001) positions. CONCLUSIONS: IOP was higher in the dependent than the nondependent eye in the lateral decubitus position, for both vitrectomized and nonoperated eyes.

Intravitreal itraconazole inhibits laser-induced choroidal neovascularization in rats.

Choroidal neovascularization (CNV) is a major cause of severe visual loss in patients with age-related macular degeneration (AMD). Recently, itraconazole has shown potent and dose-dependent inhibition of tumor-associated angiogenesis. We evaluated the anti-angiogenic effect of itraconazole in a rat model of laser-induced CNV. After laser photocoagulation in each eye to cause CNV, right eyes were administered intravitreal injections of itraconazole; left eyes received balanced salt solution (BSS) as controls. On day 14 after laser induction, fluorescein angiography (FA) was used to assess abnormal vascular leakage. Flattened retinal pigment epithelium (RPE)-choroid tissue complex was stained with Alexa Fluor 594-conjugated isolectin B4 to measure the CNV area and volume. Vascular endothelial growth factor receptor 2 (VEGFR2) mRNA and protein expression was determined 1, 4, 7, and 14 days after intravitreal injection by quantitative RT-PCR or Western blot. VEGF levels were analyzed by enzyme-linked immunosorbent assay (ELISA). Intravitreal itraconazole significantly reduced leakage from CNV as assessed by FA and CNV area and volume on flat mounts compared with intravitreal BSS (p = 0.002 for CNV leakage, p<0.001 for CNV area and volume). Quantitative RT-PCR showed significantly lower expression of VEGFR2 mRNA in the RPE-choroid complexes of itraconazole-injected eyes than those of BSS-injected eyes on days 7 and 14 (p = 0.003 and p = 0.006). Western blots indicated that VEGFR2 was downregulated after itraconazole treatment. ELISA showed a significant difference in VEGF level between itraconazole-injected and BSS-injected eyes on days 7 and 14 (p = 0.04 and p = 0.001). Our study demonstrated that intravitreal itraconazole significantly inhibited the development of laser-induced CNV in rats. Itraconazole had anti-angiogenic activity along with the reduction of VEGFR2 and VEGF levels. Itraconazole may prove beneficial for treating CNV as an alternative or adjunct to other therapies.

Effect of Influenza Vaccination on Risk of Stroke: A Systematic Review and Meta-Analysis.

BACKGROUND: Despite the presence of a strong association between influenza infection and stroke, whether influenza vaccination reduces the risk of stroke is yet a matter of controversy. We conducted a meta-analysis to determine whether influenza vaccination protects against stroke. METHODS: We searched PubMed, EMBASE, and the Cochrane Library from database inception date to November 18, 2016, without language restrictions, to identify studies investigating the effect of influenza vaccination on subsequent risk of stroke. We conducted a meta-analysis to quantify the risk of stroke in overall and subgroup analyses and calculated a pooled OR for developing stroke with a 95% CI. Publication bias was assessed by Begg's rank correlation test. RESULTS: Eleven studies fulfilled our inclusion criteria. In a random-effects model, vaccinated individuals had a decreased risk of stroke compared with unvaccinated individuals (OR 0.82; 95% CI 0.75-0.91; p < 0.001). The relationship between influenza vaccination and stroke risk remained robust in subgroup analyses. The significant effect of influenza vaccination was associated with ascertainment of vaccination status and stage of prevention. CONCLUSION: Vaccination against influenza is associated with a lower risk of stroke. Well-designed prospective studies are needed to provide stronger evidence of the protective effect of influenza vaccination against stroke.

Risk Prediction Model for Progression of Age-Related Macular Degeneration.

AIMS: The aim of this paper was to develop a risk prediction model for the progression of age-related macular degeneration (AMD) in Koreans using systemic and environmental factors. METHODS: The study sample included 10,890 individuals 50 years of age or older; 318 (2.92%) presented with early AMD findings in baseline examinations. Re-examinations were performed in 157 (49.37%) who were followed up for 4.4 years. The multivariate analysis of covariates included demographic and environmental factors. After using these data to develop a risk prediction model, the individual algorithm was made, and receiver operating characteristic curves were calculated to assess the predictive ability of the risk model for AMD progression. RESULTS: The individual algorithm to predict the AMD progression risk based on systemic and ocular factors was as follows: Y = -9.565 + 1.709 (drusen locationcenter) + 0.795 (drusen locationparacentral) + 1.074 (both eyes) + 0.094 (drusen sizeintermediate) + 0.034 (drusen sizelarge) + 0.614 (drusen number10-20) + 2.278 (drusen number>20) + 0.577 (hyperpigmentation) + 0.725 (hypopigmentation) + 0.079 (male) - 0.025 (age) - 0.921 (SMKex) + 1.574 (SMKcurrent) + 0.363 (total protein) + 1.626 (globulin), where SMK means smoking status. The C statistics for the model was 0.84 (0.75-0.92) indicating a good predictive power. CONCLUSION: A comprehensive risk prediction model for AMD progression was made to calculate the individual AMD progression risk using personal systemic and environmental factors.

Risk Factors for Progression of Early Age-Related Macular Degeneration in Koreans.

PURPOSE: To identify risk factors for the progression of early age-related macular degeneration (AMD) in Koreans. METHODS: This study was conducted at a health-screening center and followed a prospective cohort study design. Of 10,890 participants older than 50 years, 318 (2.92%) presented with early AMD. Among these 318 participants, we re-examined 172 participants after a mean duration of 4.4 years. Progression was defined by the Age-Related Eye Disease Study (AREDS) simplified AMD severity scale. Multivariable logistic regression was used to examine associations between AMD progression and baseline physical, demographic, behavioral, and ocular characteristics. RESULTS: Of the 172 participants with early AMD who were re-examined, 34 (19.8%) had progression. Multivariable analyses revealed that current smoking (odds ratio, OR, 7.0, 95% confidence interval, CI, 1.4-34.4, adjusted for age, alcohol consumption, body mass index, BMI, blood pressure, BP, total cholesterol, and high density lipoprotein, HDL, cholesterol) and hypertension (OR 10.3, 95% CI 1.9-55.7, adjusted for age, smoking status, alcohol consumption, BMI, total cholesterol, and HDL cholesterol) were independently associated with progression of early AMD. Additionally, the presence of a central drusen lesion within one-third disc diameter of the macula (age-adjusted OR 4.8, 95% CI 1.3-17.6) and 20 or more drusen (age adjusted OR 7.8, 95% CI 2.5-24.0) were independently associated with progression of early AMD. CONCLUSION: Current smoking, hypertension, central drusen location, and increasing number of drusen were associated with an increased risk of early AMD progression in Koreans.

Risk of cancer among patients with depressive disorder: a meta-analysis and implications.

OBJECTIVE: The question of cancer risk in individuals with depression is unclear, primarily because of the heterogeneity of the assessment of depression in the published literature. To clarify the mixed findings, this analysis was limited to articles that used a reliable method of ascertaining depressive disorder. METHODS: We searched PubMed, EMBASE, and the Cochrane Library to identify studies investigating the effect of depression on subsequent risk of cancer, defining depression based on the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and/or the International Classification of Disease (ICD). We calculated a pooled odds ratio (OR) for developing cancer with the 95% confidence interval (CI). RESULTS: Nine studies fulfilled the eligibility criteria. In a random-effects model, patients with depressive disorder were at increased risk for cancer (OR, 1.26; 95% CI, 1.06-1.50, P = 0.01). However, a significant effect was observed only in low-quality studies (OR, 1.31; 95% CI, 1.05-1.63, P = 0.018), and not in high-quality studies (OR, 1.15; 95% CI, 0.85-1.56, P = 0.366). CONCLUSION: Our results did not demonstrate that people with depressive disorder are at increased risk for developing cancer. Well-designed prospective studies of recurrent or persistent depressive disorder that control for lifestyle factors including smoking are warranted. Copyright © 2016 John Wiley & Sons, Ltd.

The Role of Systemic Arterial Stiffness in Open-Angle Glaucoma with Diabetes Mellitus.

PURPOSE: To investigate the role of systemic arterial stiffness in glaucoma patients with diabetes mellitus (DM). DESIGN: Retrospective, cross-sectional study. PARTICIPANTS: DM subjects who underwent brachial-ankle pulse wave velocity (baPWV) were recruited. METHODS: Glaucoma patients (n = 75) and age-matched control subjects (n = 92) were enrolled. Systemic examination including BaPWV and detailed eye examination were performed. The glaucoma group was divided into subgroups of normal tension glaucoma (NTG, n = 55) and primary open-angle glaucoma (POAG) based on an IOP of 21 mmHg. BaPWV was used to stratify the population into 4 groups based on the rate. Stepwise multiple logistic regression analysis by baPWV quartiles was used to compare the glaucoma group with the control group. MAIN OUTCOME MEASURES: BaPWV in glaucoma with DM patients. RESULTS: Faster baPWV was positively associated with glaucoma (odds ratio: 3.74; 95% CI: 1.03-13.56, stepwise multiple logistic regression analysis) in patients with DM. Increasing baPWV was also positively associated with glaucoma (p for trend = 0.036). The NTG subgroup showed similar results to those of the glaucoma group. CONCLUSIONS: In this study, increased arterial stiffness was shown to be associated with glaucoma and may contribute to the pathogenesis of glaucoma in DM patients.

Association of IOP with Systemic Factors in a Korean Cohort.

PURPOSE: To assess the relationship of intraocular pressure (IOP) to age, sex, and other demographic and health characteristics in a Korean cohort. METHODS: This retrospective cross-sectional study included subjects (n = 155,198) without glaucoma. All participants underwent health screening at the Kangbuk Samsung Hospital from August 2012 to July 2013. Anthropometric measurements, systemic health characteristics, and ocular examination including noncontact tonometry were performed on all participants. Additionally, sociodemographic and behavioral questionnaires were obtained. The systemic variables were analyzed by multiple regression analysis to identify their relationship with IOP. RESULTS: The mean IOP tended to be highest in subjects in their 50s and lowest in subjects in their 20s and 60s for both Korean men and women. This pattern remained the same after adjusting for several demographic and health characteristics. The mean IOP for men was significantly higher than that for women (p < 0.001), but the difference between sexes decreased with increasing age. In the univariate analysis, almost all systemic factors showed a positive association with IOP except for high-density lipoprotein cholesterol. By multiple regression analysis, IOP was positively associated with sex (male), current smoking status, systolic blood pressure, fasting plasma glucose, body mass index, total cholesterol, and high-density lipoprotein (p ≤ 0.001). CONCLUSIONS: In a Korean cohort, the mean IOP was highest in subjects in their 50s. The mean IOP for men was significantly higher than that for women. Several systemic factors were significantly correlated with IOP.

Associations between Optic Cup-to-disc Ratio and Systemic Factors in the Healthy Korean Population.

PURPOSE: To assess the relationships between optic cup-to-disc ratio (CDR) and age, sex, and other demographic and health characteristics in the healthy Korean population. METHODS: The study design was retrospective and population-based. A total of 28,377 subjects who participated in the Korea National Health and Nutrition Examination Survey between 2008 and 2011 were enrolled in this study. Participants underwent structured interviews as well as systemic and ophthalmic examinations. Patients with glaucoma who were diagnosed using the International Society of Geographical and Epidemiological Ophthalmology classification were excluded. Changes in vertical CDR were examined by age in relation to systemic variables on multiple regression analysis. RESULTS: The mean vertical CDR was 0.34 ± 0.12. The vertical CDR increased with age from subjects in their 20s to those in their 80s (p < 0.001). The mean CDR in males was significantly higher than that of females (p < 0.001). On multiple regression analysis, the vertical CDR was positively associated with age (p < 0.001), male sex (p < 0.001), diastolic blood pressure (p = 0.009), and intraocular pressure (p < 0.001) but was negatively associated with body mass index (p < 0.001). CONCLUSIONS: Greater vertical CDR was related to age, male sex, higher diastolic blood pressure, higher intraocular pressure, and lower body mass index in healthy Koreans.

Diurnal intraocular pressure changes in eyes affected with acute primary angle closure and fellow eyes after laser peripheral iridotomy.

PURPOSE: To evaluate diurnal curves of intraocular pressure (IOP) in eyes affected with unilateral acute primary angle closure (APAC) after laser peripheral iridotomy (LPI), and fellow eyes. METHODS: The medical records of 22 female patients (44 eyes) with unilateral APAC and LPI performed OU were reviewed along with those of 48 normal control subjects (48 eyes). None of the subjects used glaucoma medications after LPI. IOP was measured with a Goldman applanation tonometer during waking hours and in a sitting position every 2 h between 09:00 and 23:00. IOP profiles were compared including the means, peaks, trough IOPs, and IOP fluctuations of the affected, fellow, and normal eyes. RESULTS: The IOPs of the affected eyes were significantly higher than those of normal eyes at every time point measured, including peak and trough IOPs. The diurnal IOPs of fellow eyes were higher than those of normal eyes, though not significantly. There were no significant differences in IOP fluctuation between the affected, fellow, and normal eyes. IOP diurnal curves for APAC affected, fellow, and normal eyes were not statistically different (repeated measures ANOVA, p = 0.865). The mean coefficient of IOP in affected and fellow eyes ranged from 0.486 to 0.604. CONCLUSIONS: There were no clinically significant differences among the three groups in terms of IOP diurnal curves, and thus LPI did not have a significant effect on diurnal patterns of IOP. Though the diurnal IOPs of affected eyes after LPI was significantly higher than those of normal eyes, the IOP range was not acute.

Sodium Intake and Socioeconomic Status as Risk Factors for Development of Age-Related Cataracts: The Korea National Health and Nutrition Examination Survey.

PURPOSE: Cataract is a very prevalent ocular disorder, and environmental risk factors for age-related cataracts have been widely investigated. We aimed to evaluate an association of dietary sodium intake and socioeconomic factors with the development of age-related cataracts. METHODS: A cross-sectional case-control study based on the 2008-2011 Korea National Health and Nutrition Examination Survey. Dietary sodium intake was estimated using urinary sodium to creatinine ratio (U[Na+]/Cr). RESULTS: Among a total 12,693 participants, 2,687 (21.1%) had cataracts and 10,006 patients without cataracts served as controls. The prevalence of cataracts increased with age and quartiles of U[Na+]/Cr (p for trend < 0.001). Multivariate logistic regression analyses revealed that factors related to the development of cataracts were age ≥ 50 years (adjusted odds ratio [aOR] 15.34, 95% confidence interval [CI] 13.31‒17.69), low income (aOR 1.85, 95% CI 1.64-2.09), low educational attainment (aOR 1.76, 95% CI 1.57-1.96), and high sodium intake (U[Na+]/Cr > 16.4 mmol/mmol; aOR 1.29, 95% CI 1.16-1.44). In a subgroup analysis, a robust effect on cataracts across U[Na+]/Cr quartiles was observed in patients ≥ 50 years of age (aOR 1.11, 95% CI 1.04-1.18), though not in younger patients (aOR 1.06, 95% CI 0.96-1.17). CONCLUSIONS: Our results suggest that high sodium intake and low socioeconomic status may affect the development of cataracts, and that a low-salt diet could be helpful for the prevention of cataracts in an older population. Furthermore, efforts to close gaps in health services due to socioeconomic factors may contribute to a reduction in the prevalence of cataracts.