01.12.2018 | Research article | Ausgabe 1/2018 Open Access

Association between sunlight exposure and risk of age-related macular degeneration: a meta-analysis
- Zeitschrift:
- BMC Ophthalmology > Ausgabe 1/2018
Background
Methods
Search strategy
Inclusion and exclusion criteria
Data extraction
Statistical analysis
Results
Literature search
Study characteristics
First author, year | Study population (location) | Design | Latitude | Definition of AMD | Covariates | Exposure assessment, criteria | Main resultsa | ||
---|---|---|---|---|---|---|---|---|---|
ALL | Early AMD | Late AMD | |||||||
Eye disease case–control study group, (1992) | 421 cases and 615 controls (USA) | Case–control | 42 | Described in paper | age, sex, and clinic | summer Leisure time in the sun | 1.1 (0.7–1.7) | – | – |
occupational outdoors | 1.1 (0.6–2.1) | ||||||||
wearing sunglasses | 0.9 (0.5–1.5) | ||||||||
Taylor, (1992) | 838 watermen (USA) | Cross-sectional | 37 | Described in paper | age | average doses of blue light | Pooled | Pooled | |
1.045 (0.977–1.117) | 1.031 (0.969–1.099) | 1.36 (1–1.85) | |||||||
Delcourt, (2001) | 2584 residents (France) | Cross-sectional | 43.4 | ICGS | age and sex | average doses of sunlight | Pooled | ||
occupational outdoors | 0.704 (0.529–0.939) | 0.73 (0.54–0.98) | 0.44 (0.15–1.31) | ||||||
wearing sunglasses | 0.996 (0.748–1.325) | 1.02 (0.76–1.38) | 0.76 (0.28–2.07) | ||||||
0.818 (0.606–1.104) | 0.87 (0.71–1.07) | 0.56 (0.26–1.19) | |||||||
Tomany, (2004) | Cohort of 6448 persons (USA) | cohort | 43 | WARMGS | age, sex, smoking, iris color, et al | leisure time outdoors in summer | Pooled | ||
occupational outdoors | 1.832 (0.934–3.591) | 2.20 (1.02–4.73) | 0.99 (0.24–3.99) | ||||||
wearing hats and sunglasses | 1.163 (0.851–1.589) | 1.18 (0.85–1.64) | 1.02 (0.38–2.74) | ||||||
1.076 (0.837–1.383) | 1.09 (0.83–1.44) | 1.01 (0.55–1.86) | |||||||
Bai, (2005) | 2835 people (China) | Cross-sectional | 35 | ICGS | age, sex, smoking, drinking, et al | time outdoors | 0.52 (0.23–1.17) | – | – |
using adumbral tools | 0.68 (0.23–0.80) | ||||||||
Khan, (2006) | 446 cases and 283 controls (Britain) | Case–control | 53 | ICGS | age, sex, and smoking | Sunny climate | 1.18 (0.74–1.89) | – | – |
avoidance measures undertaken | 1.0 (0.58–1.72) | ||||||||
Fletcher, (2008) | 2283 cases and 2117 controls (Europe) | Case–control | 50 | ICGS | age and sex | average doses of blue light | 1.09 (0.84–1.41) | – | – |
Butt, (2011) | 1019 participants (USA) | Cross sectional | 35 | WARMGS | age, sex | time outdoors | 1.03 (1.01, 1.04) | – | – |
Nano, (2013) | 175 cases and 175 controls (Argentina) | Case–control | 34 | Not mention | age, race, smoking, et al | time outdoors | 3.281 (1.91–5.62) | – | – |
Ristau, (2014) | 445 cases and 1014 controls (Cologne Germany) | Case–control | 51 | Not mention | age, alcohol use, allergy, education, et al | occupational outdoors | – | – | 2.02 (1.04–3.91) “CI” was calculated |
Park, (2014) | 14,352 participants (Korean) | Cross-sectional | 34–38 | ICGS | age, sex, and smoking | time outdoors | Pooled | ||
1.057 (0.885–1.262) | 1.07 (0.89–1.28) | 0.83 (0.37–1.86) | |||||||
Huang, (2014) | 3000 residents (Taiwan) | Cross-sectional | 23 | WARMGS | age, sex, smoking, drinking, et al | time outdoors | Pooled | ||
1.768 (0.492–6.351) | 0.947 (0.578–1.551) | 3.497 (1.683–7.268) | |||||||
Schick, (2016) | 1931 cases and 1770 controls (Europe) | Case–control | 50 | Described in paper | age, sex, and smoking | time outdoors | Pooled | ||
occupational outdoors | 3.334 (1.563–7.109) | 5.54 (1.14–21.34) | 2.77 (1.25–6.16) | ||||||
1.765 (0.837–3.722) | 1.20 (0.85–1.71) | 2.57 (1.89–3.48) | |||||||
Lazreg, (2016) | 1183 cases and 827 controls (Algeria) | Case–control | 36 | ICGS | age and sex | sunny area | Pooled | ||
Usual solar protection | 0.596 (0.257–1.384) | 0.86 (0.45–1.66) | 0.36 (0.14–0.92) | ||||||
5.581 (2.269–12.72) | 4.93 (1.94–12.51) | 8.63 (2.12–35.10) |
Quantitative synthesis
Subgroup analysis | All AMD | Early stage | Late stage | ||||||
---|---|---|---|---|---|---|---|---|---|
No.a | OR(95% CI) | I2 (P) b | No. a | OR(95% CI) | I2 (P) b | No. a | OR(95% CI) | I2 (P) b | |
pooled | 14 | 1.10 (0.98–1.23) | 71.9% (0.000) | 7 | 1.02 (0.85–1.22) | 58.7% (0.024) | 7 | 1.16 (0.66–2.04) | 73.8% (0.001) |
Study design | |||||||||
Case–control | 7 | 1.50 (1.01–2.23) | 75.6% (0.000) | 2 | 1.94 (0.32–11.83) | 80.7% (0.023) | 2 | 1.01 (0.14–7.49) | 90.5% (0.001) |
Cross-sectional | 6 | 1.01 (0.94–1.09) | 52.0% (0.064) | 4 | 0.99 (0.87–1.12) | 43.5% (0.151) | 4 | 1.24 (0.63–2.46) | 75.0% (0.007) |
Exposure assessment method | |||||||||
Time work outdoors | 5 | 1.16 (0.97–1.40) | 20.5% (0.284) | 3 | 1.12 (0.93–1.35) | 0% (0.732) | 4 | 1.65 (0.96–2.84) | 61.0% (0.053) |
Quantitative data | 3 | 0.95 (0.77–1.19) | 71.9% (0.029) | 2 | 0.90 (0.64–1.25) | 79.6% (0.027) | 2 | 0.88 (0.30–2.58) | 74.1% (0.050) |
Using avoidance | 6 | 1.12 (0.76–1.67) | 78.7% (0.000) | 3 | 1.31 (0.78–2.21) | 85.1% (0.001) | 3 | 1.44 (0.44–4.69) | 82.3% (0.004) |
Study latitude | |||||||||
lower latitude | 7 | 1.07 (0.95–1.20) | 73.9% (0.001) | 4 | 1.03 (0.97–1.09) | 0% (0.903) | 4 | 1.15 (0.55–2.43) | 86.6% (0.001) |
higher latitude | 7 | 1.30 (0.93–1.81) | 73.9% (0.001) | 3 | 1.76 (0.58–5.33) | 84.6% (0.001) | 3 | 1.12 (0.34–3.70) | 73.0% (0.024) |