OCULAR LENS FINDINGS IN PATIENTS TREATED WITH PUVA

In some animal species, exposure of the ocular lens to 8-methoxypsoral en (8-MOP) and ultraviolet-A radiation (PUVA) induces lens opacities. Case reports have suggested that PUVA therapy in humans may be associa ted with an increased risk of ocular lens abnormalities. To examine th is risk, we compared the results of the initial and final examinations , which were performed on an average of 10 years apart in 1,235 indivi duals enrolled in the PUVA Follow-up Study. After adjustment for age a nd sex, there was no significant relation between the risk of developi ng an ocular lens abnormality or cataract and the level of exposure to PUVA. A higher incidence of cataract was noted, however, in the PUVA cohort compared to a large population-based study. In addition, rates of cataract extraction were significantly higher among male members of the PUVA study compared to enrollees in the Physician Health Study. O verall, our data strongly argue against a dose-dependent increase in t he risk of cataract or other lens abnormality in association with PUVA therapy in a cohort most of whose members we believe usually used rec ommended eye protection. Our data do not explain the higher incidence and prevalence of ocular lens pathology in our cohort compared to grou ps without psoriasis. These differences could reflect differences in c riteria for defining these abnormalities, other exposures, or PUVA.