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Nutrition supplements and the eye

Authors:
Natesha Brown at Northern Caribbean University
Natesha Brown
Anthony J Bron at University of Oxford
Anthony J Bron
John J Harding
John J Harding
John J Harding
  • This person is not on ResearchGate, or hasn't claimed this research yet.
Helen M Dewar
Helen M Dewar
Helen M Dewar
  • This person is not on ResearchGate, or hasn't claimed this research yet.
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Abstract and Figures

A review of the role of vitamins, minerals, carotenoids and essential fatty acids in relation to eye health. The mode of action may be directly on the eye or by promoting bodily health on which the eye depends. The lens and retina suffer oxidative damage and the anti-oxidant vitamins A, C and E are implicated as protective. Studies in man give indifferent support to the role of nutrition in the development of cataract. In the elderly, vitamin intake may be inadequate, so that a vitamin supplement may be reasonable. Zinc has a role in retinal metabolism and may be beneficial in macular degeneration. Selenium has an anti-oxidant role. Other minerals including copper have a less defined role. Carotenoids are concentrated at the macula and have an anti-oxidant role. A reduced risk of macular degeneration is found in relation to a high serum level. The essential fatty acid, gamma-linolenic acid (GLA), is useful in Sjögren's syndrome and may help in other dry eye conditions. Omega-3 fatty acids are important in retinal development and have a role in preventing cardiovascular disease. All persons should be encouraged to maintain healthy nutrition. Middle-aged and elderly patients may benefit from a supplement. An intake in excess of the recommended daily intake may be beneficial, but this is not proven. Further clinical trials are indicated to define the advisability of vitamin, mineral and other supplements. Dosages for recommended intake and for supplements are given.
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Nutrition supplements
and the eye
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   
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
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
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



 

 

 
 


    

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 
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 
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

   
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  
 
 
 

 

 
 
  

 
 
  
  
  


 

  
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 
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
 

  

  


 
  


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 
 


   

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   
 

  



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

   
   

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 
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
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      
 

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 
  

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

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 
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  
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 
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 
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 
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  
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  
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 
 
 
 


   


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 

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 
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
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 
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
 
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 
 
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 


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   
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
  
 

 



 
 




 



 

 

 
 


    
  
  

    




 

 
 




 
 

   





 


 





   



 








 

  
 

 


 
 


 


 


 
 
 


 

 
 
 
 
 
 



 
 

 


 
 


 

 









 

 

 
   

            




 



 

 
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 
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

 

 


  
   
 
  
    
  
 


     
      
 
 
  
 
    
     
  

     
 

     
       
    
        

   
   
     
    
    
 
  
  

 
    
 
    
 
  
  
   

   
  
 
     
   
    


      
      
   
    
     
  
 
    



     

  
    
   

 

 
  


       
  

     
         
 
     
       
  
   
    

        
      
   
   
        
      
  
    
  



    
  
 

       
    

      


      
    

        
        
 
     
    

        

 
    

  
    

   
    
   
  

 
   
   
     
   
   
   
   

    
 
 
    
 
 


       

    
   
   

        

      
      

   
  

    
    
    

   

      
      
        
   
    
  
      

   
       
     
    
 

       
     
 
    
    

   
 

   
      
    
  
   


  

     
   
       

    
   
 
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... "Increased consumption of energydense foods such as refined grains, processed meats, added sugar and saturated fatty foods might increase the risk of obesity" [2]. "The health of the eye is dependent on the health of the body" [3]. ...
... "The lens is under threat by oxidation. Biochemical evidence demonstrates that proteins and lipids undergo oxidative damage by free radicals" [3]. ...
... "Lipid peroxidation (LPO) as well as significant increase in superoxide dimutase activity and protein level have been proposed as a causative factor of cataract (nuclear cataracts)" [11]. "The development of cataract has been associated with a number of systemic diseases, including cardiovascular, diabetic, renal and gastrointestinal (diarrhoea), and with increased mortality" [3]. ...
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... Selenium Phelps Brown N.A. et al., 1998 [33] Excessive selenium supplementation may increase the glaucoma incidence Prasad A.S. et al., 2014 [34] High plasma selenium concentration and middle concentration of aqueous humour selenium was significantly associated with glaucoma. Prasanna G. et al., 2002 [35] The mean selenium levels in aqueous humor and in serum of patients with PEX syndrome were lower than in the control group. ...
... As reviewed by Brown et al. [33], zinc has a role in retinal metabolism and may be beneficial in macular degeneration. Research cited in this review showed that altered serum levels of some trace elements, e.g., copper and zinc, may impact the incidence and progression of glaucoma disease. ...
Evaluating Retinal and Choroidal Perfusion Changes after Isometric and Dynamic Activity Using Optical Coherence Tomography Angiography
Article
Full-text available
  • Apr 2021
Optical coherence tomography angiography (OCTA) is a non-invasive tool for imaging and quantifying the retinal and choroidal perfusion state in vivo. This study aimed to evaluate the acute effects of isometric and dynamic exercise on retinal and choroidal sublayer perfusion using OCTA. A pilot study was conducted on young, healthy participants, each of whom performed a specific isometric exercise on the first day and a dynamic exercise the day after. At baseline and immediately after the exercise, heart rate (HR), mean arterial pressure (MAP), superficial capillary plexus perfusion (SCPP), deep capillary plexus perfusion (DCPP), choriocapillaris perfusion (CCP), Sattlers’s layer perfusion (SLP), and Haller’s layer perfusion (HLP) were recorded. A total of 34 eyes of 34 subjects with a mean age of 32.35 ± 7.87 years were included. HR as well as MAP increased significantly after both types of exercise. Both SCPP and DCPP did not show any significant alteration due to isometric or dynamic exercise. After performing dynamic exercise, CCP, SLP, as well as HLP significantly increased. Changes in MAP correlated significantly with changes in HLP after the dynamic activity. OCTA-based analysis in healthy adults following physical activity demonstrated a constant retinal perfusion, supporting the theory of autoregulatory mechanisms. Dynamic exercise, as opposed to isometric activity, significantly changed choroidal perfusion. OCTA imaging may represent a novel and sensitive tool to expand the diagnostic spectrum in the field of sports medicine.
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... RF deficiency can also occur when the intestines cannot properly absorb vitamins. There are several indications of RF deficiency: anaemia, itching, fatigue, cracked lips, dry skin, tongue inflammation, mouth ulcers, pain in the throat, loss of growth and eyes that are sensitive to bright light, itchy, watery, burning and bloodshot [11][12][13][14][15]. ...
Silver nanoparticle based selective, sensitive and instantaneous electrochemical nanosensors for the analysis of riboflavin
Article
  • Jan 2023
  • MAT SCI SEMICON PROC
Silver nanoparticles (AgNPs) are versatile and utilised in numerous ways, for instance as catalysts, solar cells, fuels and hydrogen fuels in the evolution of energy solutions. Their versatile nature provides opportunities not only in optoelectronic areas, but also in human health and protection against antimicrobial, antifungal, anticancer and other toxic agents. There have been limited studies conducted on the ability of AgNPs to sense the vital biological molecule riboflavin (RF). Hence, the current work was undertaken to further examine AgNPs and their potential as RF sensing materials. We have synthesised AgNPs via the citrate method and determined a range of properties using various instruments and techniques. The AgNPs were then tested as a sensing material to determine the exposure of RF via an electrochemical process. For this, an AgNP slurry was transformed into an organic adhesive, pasted onto a glassy carbon electrode (GCE) and dried well to ensure the sensing efficiency in a three-electrode system. RF was prepared at a range of concentrations (0.976 × 10⁻⁶ μM, 1.953 × 10⁻⁶ μM, 3.906 × 10⁻⁶ μM, 7.812 × 10⁻⁶ μM, 15.625 × 10⁻⁶ μM and 31.25 × 10⁻⁶ μM) in phosphate-buffered saline (PBS). The current ranged from −1.5 to +1.5 V, and the electrode efficiency and effect of the potential (5, 10, 20, 50 and 100 mV/s) of the AgNP-based GCE (AgNPs/GCE) were determined in PBS. The ampherometric response over time was also analysed (0–600 s). The processed sensors’ cyclic response and electrochemical impedance (between 0.01 and 10 kHz) were also analysed. In addition to this, ion interference (Al³⁺, Ba²⁺, Ca²⁺, Co²⁺, Cu²⁺, Mg²⁺, Mn²⁺, Ni²⁺, Sr²⁺, Zn²⁺ and PBS), and real samples collected from different places were examined with and without the analyte (RF) respectively. A probable mechanism has also been established based on the obtained results and is presented.
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... Os efeitos colaterais são pouco observados (Ono et al., 2004;Petrone et al., 2002). Modulação da resposta imune: diminuir a produção de auto-anticorpos e a lifo-proliferação por meio de agentes imuno-moduladores, que irão amenizar a resposta imune gerada (Brown et al., 1998). ...
A Síndrome Crônica De Sjögren: Uma Revisão Bibliográfica The Sjögren's Chronic Syndrome: A Review
Article
Full-text available
  • Apr 2019
A Síndrome de Sjögren (SS) pode ser definida como uma doença inflamatória sistêmica crônica do tecido conjuntivo que afeta glândulas salivares e lacrimais. Pode ser caracterizada como primária, na ausência de doenças do tecido conjuntivo e secundária na associação com outras doenças deste tecido. Os sintomas mais frequentes manifestados são a xerofitalmia (olhos secos) e xerostomia (boca seca). A patogenia da doença caracteriza-se pela infiltração linfo-plasmocitária nas glândulas, e o tratamento varia de acordo com o caso clínico, mas tem como finalidade diminuir os sintomas e proporcionar uma melhor qualidade de vida aos pacientes. Portanto, caracteriza-se como uma doença de acompanhamento rigoroso e minucioso e que necessita de um diagnóstico imediato para aprimorar o tratamento. O principal objetivo deste trabalho foi elaborar um artigo de revisão bibliográfica a partir de estudos prévios acerca desta síndrome. Palavras chave: síndrome seca, doença autoimune, lesões glandulares, Síndrome de Sjögren diagnóstico e tratamento.
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... Vitamin A is important in maintaining the health of the ocular surface and necessary for the proliferation, differentiation, and maturation of healthy epithelial cells (32). Vitamin A deficiency has been associated with keratomalacia in humans (33,34). ...
Equine Umbilical Cord Serum Composition and Its Healing Effects in Equine Corneal Ulceration
Article
Full-text available
  • Mar 2022
Background Human autologous serum (AS) and umbilical cord serum (UCS) both contain growth and neurotrophic factors that promote corneal healing. Aim Our objectives were to compare equine AS and UCS cytokine and growth factor profiles and to assess the safety and clinical feasibility of the therapeutic use of UCS eye drops in cases of spontaneous complex ulcers. Study Design Prospective clinical trial. Methods Vitamin A insulin growth factor, platelet-derived growth factor-BB, transforming growth factor (TGF)-β1 (enzyme-linked immunosorbent assay), interleukin (IL)-1β, IL-6, interferon-γ, and monocyte chemoattractant protein 1 concentrations were determined in 10 AS collected from different horses and 10 UCS sampled at delivery. Six client-owned horses presenting with complex non-healing corneal defects of >5 mm² were included in a clinical trial and treated with conventional therapy and conditioned UCS drops for 8–15 days. Ulcer surface and time to complete epithelialization were recorded. Results Median concentrations of vitamin A, insulin growth factor, and platelet-derived growth factor-BB were not significantly different in AS compared with UCS (respectively, 14.5 vs. 12.05 μg/ml; 107.8 vs. 107.3 pg/ml; and 369.1 vs. 924.2 pg/ml). TGF-β1 median concentration in UCS was significantly higher than in AS (3,245 vs. 2571pg/ml) (p = 0.04). IL-1β, IL-6, interferon-γ, and monocyte chemoattractant protein 1 concentrations were variable in AS and undetectable in UCS. The corneal median ulcerative area was 37.2 mm² (6.28–57.14 mm²) and had a duration of 4–186 days (median 19 days). All lesions healed within 13–42 days (median 17 days). No adverse effects nor recurrences within 1 month were noticed. Limitations The sample size was small. Spontaneous corneal epithelial defects presented with variable clinical characteristics. There were no age-matched control horses to assess corneal healing time and rate. Conclusion and Clinical Significance Equine UCS may be beneficial, as it contains no pro-inflammatory cytokines and a greater concentration of TGF-β1 compared with AS. Topical UCS appears safe and may potentially be used as adjunctive therapy for equine complex non-healing ulcers.
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Natural Product Isolation of the Extract of Cleome Rupicola Fruits Exhibiting Antioxidant Activity
Article
  • Feb 2024
  • CHEM BIODIVERS
Cataracts are the leading cause of blindness worldwide, however, there is currently no drug‐based treatment. Plants that exhibit antioxidant properties have shown promising anticataract effects, likely because they supplement the activity of glutathione, the major antioxidant in lens cells. An extract of Cleome rupicola, a desert plant found in the United Arab Emirates, has traditionally been used to treat cataracts. Phytochemical screening of the aqueous extract established the presence of flavonoids, tannins, steroid derivatives, and reducing sugars. Fractioning of extracts from inflorescences, leaves, and buds using high‐performance liquid chromatography (HPLC) yielded the isolation of the anthelmintic compound cleomin, and its structure was confirmed using mass spectrometry (MS) and nuclear magnetic resonance (NMR) spectroscopy.
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Zinc status in public health: exploring emerging research trends through bibliometric analysis of the historical context from 1978 to 2022
Article
Full-text available
  • Jan 2023
  • ENVIRON SCI POLLUT R
The current study aims to provide a roadmap for future research by analyzing the research structures and trends in scholarly publications related to the status of zinc in public health. Only journal articles published between 1978 and 2022 are included in the refined bibliographical outputs retrieved from the Web of Science (WoS) database. The first section announces findings based on WoS categories, such as discipline heterogeneity, times cited and publications over time, and citation reports. The second section then employs VoSViewer software for bibliometric analysis, which includes a thorough examination of co-authorship among researchers, organizations, and countries and a count of all bibliographic databases among documents. The final section discusses the research’s weaknesses and strengths in zinc status, public health, and potential future directions; 7158 authors contributed to 1730 papers (including 339 with publications, more than three times). “Keen, C.L.” is a researcher with the most publications and a better understanding of zinc status in public health. Meanwhile, the USA has been the epicenter of research on the status of zinc in public health due to the highest percentage of publications with the most citations and collaboration with the rest of the world, with the top institution being the University of California, Davis. Future research can be organized collaboratively based on hot topics from co-occurrence network mapping and bibliographic couplings to improve zinc status and protect public health.
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Zinc Status in Public Health: Exploring Emerging Research Trends Through Bibliometric Analysis of the Historical Context from 1978 to 2022
Preprint
Full-text available
  • Oct 2022
The current study aims to provide a roadmap for future research by analyzing the research structures and trends in scholarly publications related to the status of zinc in public health. Only journal articles published between 1978 and 2022 are included in the refined bibliographical outputs retrieved from the Web of Science (WoS) database. The first section announces findings based on WoS categories, such as discipline heterogeneity, times cited and publications over time, and citation reports. The second section then employs VoSViewer software for bibliometric analysis, which includes a thorough examination of co-authorship among researchers, organizations, and countries and a count of all bibliographic databases among documents. The final section discusses the research's weaknesses and strengths in zinc status, public health, and potential future directions. 7158 authors contributed to 1730 papers (including 339 with publications, more than three times). "Keen, C.L." is a researcher with the most publications and a better understanding of zinc status in public health. Meanwhile, the United States has been the epicenter of research on the status of zinc in public health due to the highest percentage of publications with the most citations and collaboration with the rest of the world, with the top institution being the University of California, Davis. Future research can be organized collaboratively based on hot topics from co-occurrence network mapping and bibliographic couplings to improve zinc status and protect public health.
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Breast-Feeding and Optimal Visual Development
Article
Full-text available
  • Jan 1993
  • J PEDIAT OPHTH STRAB
The goal of the present study was to determine whether dietary supply of w-3 essential fatty acid (EFA) influences visual development in healthy pre-term and full-term infants. Visual status was examined in human milk-fed infants (ample dietary w-3 EFA supply) and corn oil-based formula-fed infants (no dietary w-3 EFAi stan­ dard formula prior to 1987). At 57 weeks postconception (4 months adjusted age), both pre-term and full-term human milk-fed infants had significantly better visual evoked potential (VEP) and forced-choice preferential­ looking (FPL) acuity than formula-fed infants. Acuity was correlated with a dietary w-3 sufficiency index from red blood cell membranes obtained at 57 weeks postconcep­ tion. At36 months, full-term human milk-fed children had significantly better random dot stereo acuity and letter matching ability than formula-fed children. Stereo acuity and performance on the letter matching test were corre­ lated with a dietary w-3 sufficiency index from red blood cell membranes obtained at 4 months. These results suggest that dietary w-3 fatty acids play an important role in visual development.
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Increased Mortality Rates after Cataract Surgery
Article
  • Sep 1988
  • OPHTHALMOLOGY
One hundred ninety-three patients 50 to 89 years of age had cataract surgery between January 1, 1979, and December 31, 1980, at West Virginia University Medical Center, Morgantown. In comparison with 182 patients who elected one of three other surgical procedures, cataract surgery patients had a significantly higher mortality rate (P = 0.0005) than control group patients, according to life-table analysis estimates adjusted for age and sex. Patients with adult onset diabetes mellitus had slight increased survival and did not alter relative mortality. The authors' results support the hypothesis that senile cataracts may reflect systemic factors in addition to localized ocular disease.
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The Lens Opacities Case-Control Study
Article
  • Feb 1991
  • ARCH OPHTHALMOL-CHIC
• The Lens Opacities Case-Control Study evaluated risk factors for age-related nuclear, cortical, posterior subcapsular, and mixed cataracts. The 1380 participants were ophthalmology outpatients, aged 40 to 79 years, classified into the following groups: posterior subcapsular only, 72 patients; nuclear only, 137 patients; cortical only, 290 patients; mixed cataract, 446 patients; and controls, 435 patients. In polychotomous logistic regression analyses, low education increased risk (odds ratio [OR]= 1.46) and regular use of multivitamin supplements decreased risk (OR =0.63) for all cataract types. Dietary intake of riboflavin, vitamins C, E, and carotene, which have antioxidant potential, was protective for cortical, nuclear, and mixed cataract; intake of niacin, thiamine, and iron also decreased risk. Similar results were found in analyses that combined the antioxidant vitamins (OR =0.40) or considered the individual nutrients (OR =0.48 to 0.56). Diabetes increased risk of posterior subcapsular, cortical, and mixed cataracts (OR =1.56). Oral steroid therapy increased posterior subcapsular cataract risk (OR = 5.83). Females (OR =1.51) and nonwhites (OR = 2.03) were at increased risk only for cortical cataract. Risk factors for nuclear cataract were a nonprofessional occupation (OR =1.96), current smoking (OR = 1.68), body mass index (OR = 0.76), and occupational exposure to sunlight (OR =0.61). Gout medications (OR =2.48), family history (OR =1.52), and use of eyeglasses by age 20 years, which is an indicator of myopia (OR = 1.44), increased risk of mixed cataract. The results support a role for the nutritional, medical, personal, and other factors in cataractogenesis. The potentially modifiable factors suggested by this study merit further evaluation.
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The Linxian Cataract Studies
Article
  • Sep 1993
  • ARCH OPHTHALMOL-CHIC
Objective: To determine whether the vitamin/mineral supplements used in two cancer intervention trials affected the risk of developing age-related cataracts. Design: Two randomized, double-masked trials with a duration of 5 to 6 years and end-of-trial eye examinations. Setting: Rural communes in Linxian, China. Participants: In trial 1, 2141 participants aged 45 to 74 years, and, in trial 2, 3249 participants aged 45 to 74 years. Interventions: Multivitamin/mineral supplement or matching placebo in trial l; factorial design to test the effect of four different vitamin/mineral combinations in trial 2 (retinol/zinc, riboflavin/niacin, ascorbic acid/molybdenum, and selenium/alpha-tocopherol/beta carotene). Main Outcome Measures: Prevalence of nuclear, cortical, and posterior subcapsular cataracts in treatment groups at end of trials. Results: In the first trial, there was a statistically significant 36% reduction in the prevalence of nuclear cataract for persons aged 65 to 74 years who received the supplements. In the second trial, the prevalence of nuclear cataract was significantly lower in persons receiving riboflavin/niacin compared with persons not receiving these vitamins. Again, persons in the oldest group, 65 to 74 years, benefited the most (44% reduction in prevalence). No treatment effect was noted for cortical cataract in either trial. Although the number of posterior subcapsular cataracts was very small, there was a statistically significant deleterious effect of treatment with riboflavin/niacin. Conclusions: Findings from the two trials suggest that vitamin/mineral supplements may decrease the risk of nuclear cataract. Additional research is needed in less nutritionally deprived populations before these findings can be translated into general nutritional recommendations.
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Are Antioxidants or Supplements Protective for Age-Related Macular Degeneration?
Article
  • Feb 1994
  • ARCH OPHTHALMOL-CHIC
Objectives: The relationships between fasting plasma levels of retinol, ascorbic acid, α-tochopherol, and β-carotene and age-related macular degeneration (AMD) were studied in a population enrolled in the Baltimore Longitudinal Study of Aging (BLSA), in which most of the data were collected 2 or more years before assessment of macular status.Design: A total of 976 participants in the study were scheduled for a biennial examination from January 1988 through January 1,1990, which included taking lens and macular photographs. A total of 827 (85%) of the participants had fundus photographs taken, and most plasma data were available for 82% of those subjects with fundus photographs. Age-related macular degeneration was defined as neovascular changes, geographic and nongeographic atrophy, large or confluent drusen, or hyperpigmentation. A total of 226 cases of AMD were available for analysis.Results: Logistic regression analyses suggested that α-tocopherol was associated with a protective effect for AMD, adjusted for age, sex, and nuclear opacity. An antioxidant index, including ascorbic acid, α-tocopherol, and β-carotene, was also protective for AMD. Our conclusions must be tempered with the knowledge that the population under study was basically well nourished, and few individuals had any clinically deficient status. The study cannot exclude the possibility that quite low levels of micronutrients, lower than those observed in this study, might be risk factors for AMD.Conclusions: The data suggest a protective effect for AMD of high plasma values of α-tocopherol. An antioxidant index, composed of plasma ascorbic acid, α-tocopherol, and β-carotene, was also protective. The use of vitamin supplements to prevent AMD is not supported by these data, which showed no protective effect of vitamin use.
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Serum Antioxidants and Age-Related Macular Degeneration in a Population-Based Case-Control Study
Article
  • Dec 1995
  • ARCH OPHTHALMOL-CHIC
Objective: To investigate relationships between levels of tocopherols and carotenoids in the serum and age-related macular degeneration (ARMD).Design: A nested case-control study within a population-based cohort.Participants: Cases included a sample of subjects with retinal pigment abnormalities with the presence of soft drusen (n=127) or with late ARMD (geographic atrophy [n=9]) or neovascular and exudative macular degeneration (n=31). An equal number of controls (167 pairs) were selected from among participants in the Beaver Dam Eye Study. The controls had no photographic evidence of soft drusen, retinal pigment abnormalities, or late ARMD and were matched with cases for age, sex, and current smoking status.Data Collection: Presence and severity of ARMD were determined from masked grading of fundus photographs obtained from 1988 to 1990. Levels of individual carotenoids and tocopherols were determined in serum collected at the same time.Results: Average levels of individual carotenoids were similar in cases and controls. Average levels of vitamin E (α-tocopherol) were lower in people with exudative macular degeneration (P=.03). However, the difference was no longer statistically significant after controlling for levels of cholesterol in the serum. Persons with levels of lycopene, the most abundant carotenoid in the serum, in the lowest quintile were twice as likely to have ARMD. Levels of the carotenoids that compose macular pigment (lutein with zeaxanthin) in the serum were unrelated to ARMD.Conclusions: Very low levels of one (lycopene) but not other dietary carotenoids or tocopherols were related to ARMD. Lower levels of vitamin E in subjects with exudative macular degeneration compared with controls may be explained by lower levels of serum lipids.
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India-US Case-Control Study of Age-Related Cataracts
Article
  • May 1989
  • ARCH OPHTHALMOL-CHIC
• In a hospital-based case-control study of 1441 patients with age-related cataracts and 549 controls, we studied associations between types of cataract—nuclear, cortical, posterior subcapsular, and mixed—and a number of physiologic, behavioral, environmental, and biochemical variables. Using polychotomous logistic regression analysis, we found an increased risk of cataract with lower educational achievement (all types of cataract), decreased cloud cover at place of residence (all types), use of aspirin less than once a month (posterior subcapsular and mixed), diets low in selected nutrients (posterior subcapsular, nuclear, and mixed), higher blood pressure (nuclear and mixed), lower body mass index (nuclear and mixed), use of cheaper cooking fuels (cortical, nuclear, and mixed), and lower levels of an antioxidant index based on red blood cell levels of glutathione peroxidase and glucose-6-phosphate dehydrogenase and plasma levels of ascorbic acid and vitamin E (posterior subcapsular and mixed). All risks cited were significantly different from those for the other cataract types, a finding that emphasizes the need to investigate the epidemiology of specific types of cataract.
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