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Solar exposure and residential geographic history in relation to exfoliation syndrome in the United States and Israel

Pasquale, LR, Jiwani, AZ, Zehavi-Dorin, T, Majd, A, Rhee, DJ, Chen, T, Turalba, A, Shen, L, Brauner, S, Grosskreutz, C, Gardiner, M, Chen, S, Borboli-Gerogiannis, S, Greenstein, SH, Chang, K, Ritch, R, Loomis, S, Kang, JH, Wiggs, JL and Levkovitch-Verbin, H (2014) Solar exposure and residential geographic history in relation to exfoliation syndrome in the United States and Israel. JAMA Ophthalmology. pp. 1439-1445.


IMPORTANCE: Residential (geographic) history and extent of solar exposure may be important risk factors for exfoliation syndrome (XFS) but, to our knowledge, detailed lifetime solar exposure has not been previously evaluated in XFS. OBJECTIVE: To assess the relation between residential history, solar exposure, and XFS. DESIGN, SETTING, AND PARTICIPANTS: This clinic-based case-control studywas conducted in the United States and Israel. It involved XFS cases and control individuals (all>60-year-old white individuals) enrolled from 2010 to 2012 (United States: 118 cases and 106 control participants; Israel: 67 cases and 72 control participants). MAIN OUTCOMES AND MEASURES: Weighted lifetime average latitude of residence and average number of hours per week spent outdoors as determined by validated questionnaires. RESULTS: In multivariable analyses, each degree of weighted lifetime average residential latitude away from the equator was associated with 11% increased odds of XFS (pooled odds ratio [OR], 1.11; 95%CI, 1.05-1.17; P < .001). Furthermore, every hour per week spent outdoors during the summer, averaged over a lifetime, was associated with 4%increased odds of XFS (pooled OR, 1.04; 95%CI, 1.00-1.07; P = .03). For every 1% of average lifetime summer time between 10 AM and 4 PM that sunglasses were worn, the odds of XFS decreased by 2%(OR, 0.98; 95%CI, 0.97-0.99; P < .001) in the United States but not in Israel (OR, 1.00; 95%CI, 0.99-1.01; P = .92; P for heterogeneity = .005). In the United States, after controlling for important environmental covariates, history of work over water or snow was associated withincreased odds of XFS (OR, 3.86; 95%CI, 1.36-10.9); in Israel, there were too few people with such history for analysis.We did not identify an association between brimmed hat wear and XFS (P > .57). CONCLUSIONS AND RELEVANCE: Lifetime outdoor activitiesmay contribute to XFS. The association with work over snow or water and the lack of association with brimmed hat wear suggests that ocular exposure to light from reflective surfacesmay be an important type of exposure in XFS etiology

Item Type: Article
Additional Information: NIBR author: Grosskreutz, C institute: NIBR contributor address: (Pasquale, Loomis, Kang) Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, MA, United States (Pasquale, Jiwani, Rhee, Chen, Turalba, Shen, Brauner, Grosskreutz, Gardiner, Chen, Borboli-Gerogiannis, Greenstein, Chang, Wiggs) Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA 02114, United States (Zehavi-Dorin, Majd, Levkovitch-Verbin) Goldschleger Eye Institute, Chaim Sheba Medical Center, Tel Aviv University, Israel (Rhee) Department of Ophthalmology and Visual Sciences, CaseWestern Reserve University, Cleveland, OH, United States (Grosskreutz) Novartis Institute for BioMedical Research, Cambridge, MA, United States (Ritch) Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, NY, United States
Date Deposited: 13 Oct 2015 13:11
Last Modified: 13 Oct 2015 13:11


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