ABSTRACT
Clinical Relevance
Pathophysiology of pseudoexfoliation syndrome (XFS) can be influenced by environmental factors such as solar exposure/occupational factors and genetic factors.
Background
The study aims to assess the association of lifetime ocular UV exposure and its impact on the risk of development of XFS.
Methods
All eligible subjects underwent a comprehensive ocular examination. XFS was defined as precipitates on the pupillary border, cornea, and angle of anterior chamber or lens in at least one eye without any clinical signs of glaucoma. A standardised questionnaire was administered to assess the lifetime UV exposure. Conjunctival ultraviolet autofluorescence (CUVAF) photography was taken to detect the conjunctival changes with exposure to UV radiation. Ascorbic acid concentration in the aqueous humour was measured.
Results
A total of 404 subjects of which 274 (controls) and 130 (XFS cases) were studied. There were 204 males (50.5%) and 200 females (49.5%).Lifetime UV exposure (OR: 1.14, 95% CI: 1.02–1.30, p: 0.032), CUVAF damage (OR: 1.03, 95% CI: 1.01–1.06, p: 0.008) and outdoor worker (OR: 1.87, 95% CI: 1.18–3.00, p: 0.008) were positively associated with XFS. Usage of spectacles (OR: 0.63, 95% CI: 0.39–0.95, p: 0.030) and ascorbic acid concentration in aqueous (OR: 0.47, 95% CI: 0.23–0.99, p: 0.038) were found to be protective against XFS.
Conclusion
Besides genetic factors, environmental factors such as lifetime ocular UV exposure and outdoor work are significantly associated with the risk of XFS. CUVAF can be used as a non-invasive tool to detect preclinical sun damage in outdoor workers.
Acknowledgement
The Glaucoma Foundation, USA, funded this study.
Disclosure statement
No potential conflict of interest was reported by the author(s).