Portal de Periódicos da CAPES

Geographic and Climatic Factors Associated With Exfoliation Syndrome

2011; American Medical Association; Volume: 129; Issue: 8 Linguagem: Inglês

10.1001/archophthalmol.2011.191

1538-3601

Joshua D. Stein, Louis R. Pasquale, Nidhi Talwar, Denise S. Kim, David M. Reed, Bin Nan, Jae H. Kang, Janey L. Wiggs, Julia E. Richards,

melanin and skin pigmentation

Objective To identify geographic and climatic risk factors associated with exfoliation syndrome (ES). Methods A retrospective study of 626 901 eye care recipients, dating from 2001 to 2007 from 47 US states in a managed care network. Incident ES cases-patients (N = 3367) were identified by using billing codes. We assessed the risk of ES by geographic latitude tier in the continental United States and assigned state-level climatic data (eg, ambient temperature, elevation, and sun exposure) according to patients' residential location. The hazard of ES was calculated by using multivariable-adjusted Cox proportional hazards regression models. Results Compared with middle-tier residence, northern-tier residence (above 42°N) was associated with an increased hazard of ES (adjusted hazard ratio [HR], 2.14; 95% confidence interval [CI], 1.94-2.35). Southern-tier (below 37°N) was associated with a reduced hazard of ES (HR, 0.83; 95% CI, 0.75-0.93). Excluding whites did not change these associations. After adjustment for joint environmental effects, for every 1° increase in July high temperature, the hazard of ES decreased by 9% (HR, 0.91; 95% CI, 0.89-0.93); for every 1° increase in January low temperature, the hazard decreased 3% (0.97; 0.96-0.98). For each additional sunny day annually, the hazard increased by 1.5% (HR, 1.02; 95% CI, 1.01-1.02) in locations with average levels of other climatic factors. Conclusion Ambient temperature and sun exposure may be important environmental triggers of ES.