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

Nemesure, Barbara; Wu, Suh-Yuh; Hennis, Anselm; Leske, M. Cristina; Barbados Eye Studies Group,

doi:10.1016/j.ophtha.2008.08.003

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

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

Barbara Nemesure, PhD
- Department of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, New York
- Correspondence: Barbara Nemesure, PhD, Department of Preventive Medicine, Stony Brook University School of Medicine, Health Sciences Center, L3 086, Stony Brook, NY 11794-8036
Suh-Yuh Wu, MA
- Department of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, New York
Anselm Hennis, PhD, FRCP
- Department of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, New York
- Ministry of Health, Bridgetown, Barbados
- Chronic Disease Research Centre, Tropical Medicine Research Institute, University of the West Indies, Barbados, West Indies
M. Cristina Leske, MD, MPH
- Department of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, New York
Barbados Eye Studies Group
- Department of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, New York
- Ministry of Health, Bridgetown, Barbados
- Chronic Disease Research Centre, Tropical Medicine Research Institute, University of the West Indies, Barbados, West Indies
- Wilmer Institute, The Johns Hopkins University, Baltimore, 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.

Received 25 March 2008; received in revised form 2 June 2008; accepted 1 August 2008. published online 20 October 2008.

Available online: October 18, 2008.

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.