Prevalence and risk factors of lens opacities in rural populations living at two different altitudes in China

AIM： To investigate the prevalence of and risk factors for lens opacities in populations living at two different altitudes in China.·METHODS： A total of 813 subjects aged ≥40y in Lhasa（Tibet Autonomous Region, China. Altitude： 3658 m） and Shaoxing（Zhejiang Province, China. Altitude： 15 m） were underwent eye examinations and interviewed in this cross-sectional study. Participants＇ lens opacities were graded according to the Lens Opacities Classification System II（LOCS II） and the types of opacities with LOCS II scores ≥2 were determined. Univariate and stepwise logistic regression were used to evaluate the associations of independent risk factors with lens opacities.· RESULTS： Lens opacities were significantly more prevalent in the high-altitude than in the low-altitude area（χ2=10.54, P 〈0.001）. Lens opacities appear to develop earlier in people living at high than at low altitude. The main types of lens opacity in Lhasa and Shaoxing were mixed（23.81%） and cortical（17.87%）,respectively. Independent risk factors associated with all lens opacities were age, ultraviolet（UV） radiation exposure,and educational level. Compared with participants aged40-49 y, the risk of lens opacities increased gradually from 2 to 85 times per 10 y [odds ratio（OR）=2.168-84.731,P 〈0.05）. The risk of lens opacities was about two times greater in participants with the highest UV exposure than in those with the lowest exposure（OR=2.606, P =0.001）.Educational level was inversely associated with lensopacities; literacy deceased the risk by about 25%compared with illiteracy（OR=0.758, P =0.041）.·CONCLUSION： Old age, higher UV exposure and lower educational level are important risk factors for the development of lens opacities. Lens opacities are more prevalent among high-altitude than low-altitude inhabitants.