Elsevier

Ophthalmology

Volume 115, Issue 12, December 2008, Pages 2153-2158
Ophthalmology

Original article
Nine-Year Incidence and Risk Factors for Pterygium in the Barbados Eye Studies

https://doi.org/10.1016/j.ophtha.2008.08.003Get rights and content

Purpose

To present 9-year incidence data and associated risk factors for pterygium among black participants in the Barbados Eye Studies.

Design

Population-based incidence study.

Participants

A total of 1888 black participants, aged 40 to 84 years, who were free of pterygium at baseline and received an ophthalmologic study examination at the 9-year follow-up.

Methods

Age and sex-specific 9-year incidence of pterygium is presented. Risk factors were initially identified using Mantel-Haenszel analyses, and significant factors (P<0.10) were subsequently included in multivariate logistic regression models. Odds ratios (OR) and 95% confidence intervals (CI) are provided.

Main Outcome Measures

Development of pterygium, defined as the presence of a raised fleshy growth that crosses the limbus and encroaches onto the clear cornea.

Results

The 9-year incidence of pterygium was 11.6% (95% CI, 10.1–13.1), with no clear pattern with increasing age and no statistically significant differences between genders. Multivariate logistic regression analyses indicated that having a lifetime outdoor job location was positively associated with the development of pterygium (OR = 1.51; 95% CI, 1.05–2.16), whereas darker skin color (OR = 0.67; 95% CI, 0.46–0.97) and use of any prescription lenses (OR = 0.58; 95% CI, 0.42–0.81) were found to be protective factors.

Conclusions

The incidence of pterygium was high in this population, for an average of 1.3% per year. Working outdoors increased the risk 1.5-fold, whereas having a darker skin complexion and using eyewear for either reading or distance substantially decreased the risk of developing pterygium. These data suggest that absorption of ultraviolet light plays a role in this condition and that preventive strategies are needed to decrease the burden of pterygium development in this and other populations.

Financial Disclosure(s)

The authors have no proprietary or commercial interest in any materials discussed in this article.

Section snippets

Materials and Methods

The Barbados Eye Studies represent a series of investigations aimed at describing the prevalence, incidence, and risk factors for major eye diseases in the predominantly black population of Barbados, West Indies. The initial Barbados Eye Studies (1988–1992) cohort was a random sample of the nation's adult population, 40 to 84 years of age, with 84% participation. A total of 4631 participants completed their baseline examination, and 93% self-reported their ancestry as being of African-origin.

Results

Of the 2612 BISED II participants of African origin, 2178 (83%) received an ophthalmologic 9-year examination and self-reported their ancestry as black. Of these, 290 participants had pterygium at baseline and were excluded from the analysis. This report is based on the remaining 1888 persons who were free of pterygium at their initial BES visit. The baseline characteristics by gender of those at risk are presented in Table 1. The median age was 56 years, and 60% were female. More than one

Discussion

To the best of our knowledge, this is the first large-scale study to report on the incidence of pterygium in any setting. It also represents the only such investigation in a predominantly African population residing in a tropical climate, where exposure to sunlight with UVB radiation is known to be high. The 9-year incidence of pterygium in this population was approximately 12% or an average of 1.3% per year, suggesting the need for preventive strategies to reduce the development of this

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    Manuscript no. 2008-307.

    Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article.

    Supported by Grants EY07625 and EY07617 from the National Eye Institute, Bethesda, Maryland.

    For group membership, see Leske MC, Wu SY, Hennis A, et al. Nine-year incidence of age related macular degeneration in the Barbados Eye Studies. Ophthalmology 2006;113:29-35.

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