A PROSPECTIVE-STUDY OF ALCOHOL-CONSUMPTION AND RISK OF CATARACT

The role of alcohol as a determinant of age-related cataract is largel y unexplored, although a possible influence has been suggested by prev ious retrospective and cross-sectional studies. We used the prospectiv e data base of the Physicians' Health Study to examine the association between alcohol consumption and incidence of cataract as well as cata ract extraction among U.S. male physicians. Participants in the Physic ians' Health Study, a randomized trial of aspirin and beta-carotene am ong 22,071 male physicians 40-84 years of age at entry in 1982, were i ncluded in these analyses if they did not report cataract at baseline and if they provided information about alcohol consumption and other c ataract risk factors. A total of 17,824 physicians satisfied these cri teria. An incident cataract was defined as a self-report confirmed by medical record review, first diagnosed after randomization, with an ag e-related cause, and responsible for a reduction in best corrected vis ual acuity to 20/30 or worse. During 88,565 person-years of follow-up, 371 participants had a confirmed incident cataract and 110 underwent cataract extraction. Compared to physicians consuming alcohol less tha n once per month, daily consumers of alcohol had an age-adjusted relat ive risk (RR) of cataract of 1.31 (95% confidence interval [CI] = 0.95 , 1.81). For posterior subcapsular (PSC) cataract, the most disabling subtype in terms of vision loss, the RR was 1.38 (95% CI = 0.84, 2.27) ; for PSC cataract extraction, the RR was 1.43 (95% CI = 0.71, 2.88). Comparing daily drinkers with those who consumed alcohol less than dai ly, the RR of PSC cataract extraction among daily drinkers was 1.73 (9 5% CI = 1.06, 2.83). After further control in multivariate analyses fo r cigarette smoking, diabetes, and other cataract risk factors, the RR of PSC extraction among daily drinkers was 1.65 (95% CI = 0.99, 2.72) . These prospective data suggest that increased alcohol consumption ma y be a modifiable determinant of cataract, particularly PSC. Further d ata from continued follow-up of this cohort, as well as from other ana lytic studies, are needed to corroborate these findings.