Associations of cataract with antioxidant enzymes and other risk factors: the French Age-Related Eye Diseases (POLA) Prospective Study.

Purpose: To determine the association of potential risk factors, including antioxidant enzymes, with the incidence of cataract.

Design: Cohort study.

Participants: At baseline, the Age-Related Eye Diseases (Pathologies Oculaires Liées à l'Age, POLA) Study included 2584 residents of Sète (southern France) aged 60 years or older. From September 1998 to May 2000, a 3-year follow-up examination was performed on 1947 of the 2436 surviving participants (79.9%).

Methods: Cataract classification was based on a standardized lens examination at the slit lamp, according to Lens Opacities Classification System III. Biologic measurements were performed at baseline from fasting blood samples.

Main Outcome Measures: At baseline and follow-up, the presence of cataract was defined as: NC or nuclear opalescence (NO) > or = 4 for nuclear cataract, C > or = 4 for cortical cataract, and P > or = 2 for posterior cataract (PSC) opacities, using opacity grades corrected for interobserver variability. Incidence rates were assessed separately for right and left eyes and for each type of cataract.

Results: In the multivariate model, the incidence of cortical cataract was increased in subjects with high red blood cell superoxide dismutase activity (odds ratio [OR] 4.2 [1.5-12.1], P = 0.007). The incidence of PSC cataract was increased in subjects with a high level of plasma glutathione peroxidase (OR 1.8 [1.0-3.3], P = 0.05). In addition to age, gender, and opacities at baseline, significant risk factors for incident cataract were: long-duration diabetes (OR 5.8, P = 0.001 for cortical cataract) and lifetime heavy smoking (OR 2.9, P = 0.006 for PSC cataract).

Conclusions: Consistent with the baseline analysis, the results of this prospective study suggest that antioxidant enzymes might be implicated in the etiology of cataract.