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(Investigative Ophthalmology and Visual Science. 2003;44:1479-1485.)
© 2003 by The Association for Research in Vision and Ophthalmology, Inc.
DOI:  10.1167/iovs.02-0526
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Refractive Errors, Axial Ocular Dimensions, and Age-Related Cataracts: The Tanjong Pagar Survey

Tien Yin Wong,1,2 Paul J. Foster,2,3 Gordon J. Johnson,3 and Steve K. L. Seah2

1From the Department of Ophthalmology, National University of Singapore, Singapore; the 2Singapore National Eye Center and Singapore Eye Research Institute, Singapore; and the 3Department of Epidemiology, Institute of Ophthalmology, University College London, London, United Kingdom.

PURPOSE. To describe the relationship of refractive errors and axial ocular dimensions and age-related cataract.

METHODS. Population-based, cross-sectional survey of ocular diseases among Chinese men and women aged 40 to 81 years (n = 1232) living in the Tanjong Pagar district in Singapore. As part of the examination, refraction and corneal curvature were determined with an autorefractor, with refraction further refined subjectively. Ocular dimensions, including axial length, anterior chamber depth, lens thickness, and vitreous chamber depth, were measured with an A-mode ultrasound device. Lens opacity was graded clinically according to the Lens Opacity Classification System (LOCS) III system. Refraction, biometry, and cataract data on right (n = 989) and left (n = 995) eyes were analyzed separately.

RESULTS. In analyses controlling for age, gender, education, diabetes, and cigarette smoking, nuclear cataract was associated with myopia (-1.35 D vs. -0.11 D, P < 0.001, comparing right eyes with and without nuclear cataract), but not with any specific biometric component. Cortical cataract was associated with thinner lenses (4.67 mm vs. 4.79 mm, P = 0.001, comparing right eyes with and without cortical cataract), but not with refraction and other biometric components. Posterior subcapsular cataract was associated with myopia (-1.80 D vs. -0.39 D, P < 0.001, comparing right eyes with and without posterior subcapsular cataract), deeper anterior chamber (3.00 mm vs. 2.89 mm, P = 0.02), thinner lens (4.62 mm vs. 4.77 mm, P = 0.001), and longer vitreous chamber (15.78 mm vs. 15.57 mm, P = 0.09), but not with overall axial length and corneal curvature. Adjustment for vitreous chamber depth attenuated the association between posterior subcapsular cataract and myopia by 65.5%, but did not substantially change the association between nuclear cataract and myopia.

CONCLUSIONS. These population-based data support the associations between nuclear and posterior subcapsular cataracts and myopia reported in previous studies. Posterior subcapsular cataract is also associated with deeper anterior chamber, thinner lens, and longer vitreous chamber, with vitreous chamber depth explaining most of the association between posterior subcapsular cataract and myopia.




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