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Pseudoexfoliation and cataract surgery: a population-based 30-year follow-up study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology. (Per Söderberg)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology. (Per Söderberg)ORCID iD: 0000-0002-9938-2808
2015 (English)In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 93, no 8, 774-777 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE:

To study the relationship between pseudoexfoliation (PEX) and cataract surgery in a population in which PEX is a common finding.

METHODS:

Survival analyses were performed in a cohort of 760 residents 65-74 years of age, examined in a population survey in the municipality of Tierp, Sweden, during 1984-1986. To expand the cohort, participants in other studies in Tierp were enrolled. Additionally, subjects were recruited by means of glaucoma case records established at the Eye Department in Tierp in 1978-2007. In total, the cohort comprised 1471 individuals, representing more than 15 900 person-years of risk. Information on cataract surgery was obtained from the glaucoma case records and from medical records.

RESULTS:

By the end of the study in August 2014, 564 subjects had undergone cataract surgery. Of these cases, 224 were affected by PEX at baseline. In multivariate analyses, PEX was the second most important predictor for cataract surgery after lens opacities, accounting for a 2.38-fold (95% confidence interval 2.01-2.84) increased risk.

CONCLUSION:

The results strongly suggest that PEX is a predictor for cataract surgery in the population under study.

Place, publisher, year, edition, pages
John Wiley & Sons, 2015. Vol. 93, no 8, 774-777 p.
Keyword [en]
cataract, cataract surgery, epidemiology, exfoliation syndrome, pseudoexfoliation, risk factor
National Category
Ophthalmology
Research subject
Ophtalmology
Identifiers
URN: urn:nbn:se:uu:diva-260948DOI: 10.1111/aos12789ISI: 000367654500034OAI: oai:DiVA.org:uu-260948DiVA: diva2:848915
Available from: 2015-08-26 Created: 2015-08-26 Last updated: 2017-12-04Bibliographically approved
In thesis
1. Molecular and epidemiological studies on eyes with pseudoexfoliation syndrome
Open this publication in new window or tab >>Molecular and epidemiological studies on eyes with pseudoexfoliation syndrome
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Pseudoexfoliation (PEX) syndrome is an age-related condition characterized by the production and accumulation of extracellular fibrillary material in the anterior segment of the eye. PEX predisposes for several pathological conditions, such as glaucoma and complications during and after cataract surgery. The pathogenesis of PEX is not yet fully understood. It is multifactorial with genetics and ageing as contributing factors.

We aimed to study the proteome in aqueous humor (AH) in PEX in order to increase the knowledge about its pathophysiology. Therefore, we developed sampling techniques and evaluated separation methods necessary for analyzing small sample volumes. Other objectives were to study the lens capsule in eyes with PEX regarding small molecules, and to investigate the association between PEX and cataract surgery in a population-based 30-year follow-up study.

Samples of AH from eyes with PEX and control eyes were collected during cataract surgery. In pooled, and individual samples, various liquid based separation techniques and high resolution mass spectrometry were utilized. For quantitation, various methods for labeling, and label free techniques were applied. Lens capsules were collected from some of the patients, and analysed by imaging mass spectrometry. A cohort of 1,471 elderly individuals underwent a comprehensive ophthalmological examination at baseline. Medical information was obtained by questionnaires, and from medical records. Incident cases of cataract surgery were identified by review of medical records.

In the initial study, several techniques were explored for protein detection, and a number of proteins were identified as differentially expressed. In the individually labelled samples, changes in the proteome were observed. Eyes with PEX contained higher levels of proteins involved in inflammation, oxidative stress, and coagulation, suggesting that these mechanisms are involved in the pathogenesis in PEX. The levels of β/γ-crystallins were significantly increased in PEX, which is a novel finding. In the lens capsules from individuals with PEX, changes in the lipid composition was observed with time-of-flight secondary ion mass spectrometry. These changes remain to be elucidated. By multivariate analysis, lens opacities were the first, and PEX the second most important predictor for cataract surgery, the later accounting for a 2.38-fold increased risk for cataract surgery.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 54 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1130
Keyword
Pseduoexfoliation syndrome, PEX, aqueous humor, cataract, cataract surgery, lens capsule, proteomics, mass spectrometry, MS, MALDI TOF MS/MS, quantitative proteomics, iTRAQ, dimethyl labeling, imaging mass spectrometry, IMS, time of flight secondary ion mass spectrometry, TOF-SIMS, crystallin, epidemiology, risk factor
National Category
Ophthalmology
Research subject
Ophtalmology
Identifiers
urn:nbn:se:uu:diva-260714 (URN)978-91-554-9312-7 (ISBN)
Public defence
2015-10-15, Fåhreussalen,ingång C5, Rudbecklaboratoriet, Akademiska sjukhuset, Dag Hammarskjölds väg 20, 751 85 Uppsala, Uppsala, 13:15 (English)
Opponent
Supervisors
Available from: 2015-09-24 Created: 2015-08-24 Last updated: 2015-10-01

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Ekström, CurtBotling Taube, Amelie

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