Is sunlight exposure a risk factor for age-related macular degeneration? A systematic review and meta-analysis
Background Epidemiologists have recently investigated sunlight exposure as a risk factor for age-related macular degeneration (AMD), but there remains an ongoing dispute over this association due to insufficient evidence and unreliable data. Objectives To analyse comprehensively the epidemiological...
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Published in | British Journal of Ophthalmology Vol. 97; no. 4; pp. 389 - 394 |
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Main Authors | , , , , , , , |
Format | Journal Article Book Review |
Language | English |
Published |
BMA House, Tavistock Square, London, WC1H 9JR
BMJ Publishing Group Ltd
01.04.2013
BMJ Publishing Group LTD |
Subjects | |
Online Access | Get full text |
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Summary: | Background Epidemiologists have recently investigated sunlight exposure as a risk factor for age-related macular degeneration (AMD), but there remains an ongoing dispute over this association due to insufficient evidence and unreliable data. Objectives To analyse comprehensively the epidemiological literature concerning the association between AMD and sunlight exposure. Methods We systematically reviewed the epidemiological literature concerning the association between AMD and sunlight exposure. An electronic search was performed of PubMed, Web of Science and CNKI, which was supplemented by hand searching. The selection of studies, data abstraction and quality assessment were performed independently by three reviewers. After these steps, we performed a random-effects meta-analysis, followed by subgroup analysis and sensitivity analysis, including a random-effects meta-regression for study-specific covariates. Results Fourteen studies were identified. Twelve studies identified an increasing risk of AMD with greater sunlight exposure, six of which reported significant risks. The pooled OR was 1.379 (95% CI 1.091 to 1.745). The subgroup of non-population-based studies revealed a significant risk (OR 2.018, 1.248 to 3.265, p=0.004). We identified the gross domestic product (GDP) per capita (p=0.048), but not the latitude (p=0.21), as a factor that led to heterogeneity according to the meta-regression. Conclusions The epidemiological literature published to date indicates that individuals with more sunlight exposure are at a significantly increased risk of AMD. The OR significantly decreased with increasing GDP per capita. |
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Bibliography: | G-CL contributed equally with G-YS, and is the co-first author of this article. istex:68A0092FD74CE3B57673F8450B71685C2E000233 href:bjophthalmol-97-389.pdf local:bjophthalmol;97/4/389 PMID:23143904 ark:/67375/NVC-BD0HJ243-6 ArticleID:bjophthalmol-2012-302281 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-Review-4 content type line 23 ObjectType-Undefined-3 |
ISSN: | 0007-1161 1468-2079 |
DOI: | 10.1136/bjophthalmol-2012-302281 |