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Luba Robman

Publications and source records attributed to Luba Robman.

4 recordsLinked to original sources

Lutein and zeaxanthin and the risk of cataract: the Melbourne visual impairment project.

PURPOSE: To evaluate the association of cortical, nuclear, or posterior subcapsular (PSC) cataract with dietary intake of lutein-zeaxanthin (LZ) in a population-based sample. METHODS: For the study, 3271 (83% of the eligible residents) permanent residents aged > or =40 years were recruited in 1992 to 1994 via a cluster random sampling. In 1997 to 1999, 2594 (79%) attended the follow-up examination including lens photography, a life-style questionnaire, and a food-frequency questionnaire (FFQ). Cases were those with cortical opacity > or =4/16, nuclear opacity grade > or =2.0, or PSC opacity > or =1 mm2. Logistic regression was used to calculate the odds ratios for cataract by daily LZ intake, or its quintile indicator with the lowest quintile as the baseline category, controlling for energy-adjusted fat intake and variables previously found to be associated with the cataract outcomes. RESULTS: Of the 2322 participants who attended the follow-up survey and completed the FFQ, 1841 (79%), 1955 (84%), and 1950 (84%) were included in the analyses of cortical, nuclear, and PSC cataract, respectively. There were 182 (9.9%), 387 (19.8%), and 177 (9.1%) cases for cortical, nuclear, and PSC cataract, respectively. Cortical and PSC cataract were not significantly associated with LZ intake. For nuclear cataract the odds ratios were 0.67 (0.46-0.96) and 0.60 (0.40-0.90) for every 1-mg increase in crude and energy-adjusted daily LZ intake, respectively. The odds ratios (95% CI) for those in the top quintile of crude LZ intake was 0.58 (0.37-0.92; P = 0.023 for trend), and it was 0.64 (0.40-1.03) for energy adjusted LZ intake (P = 0.018 for trend). CONCLUSIONS: This study found an inverse association between high dietary LZ intake and prevalence of nuclear cataract.

Adult↗

Exposure to Chlamydia pneumoniae infection and progression of age-related macular degeneration.

Recent studies have found an association between exposure to Chlamydia pneumoniae infection and risk of age-related macular degeneration (AMD). To assess a potential risk of AMD progression posed by exposure to C. pneumoniae, the authors reexamined Australian residents in 2001-2002 who were aged 51-89 years with early AMD at baseline (1992-1995). Examination included macular photography and an enzyme-linked immunosorbent assay to determine antibody titers to the elementary bodies from C. pneumoniae AR39. AMD progression was assessed quantitatively, using both coarse and fine progression steps following an international classification for AMD grading, and also qualitatively, by side-by-side comparison of baseline and follow-up macular photographs. Serologic data were available for 246 of 254 (97%) subjects. AMD progression was associated with a higher antibody titer. After adjustment for age, smoking, family history of AMD, history of cardiovascular diseases, and source study, the subjects in the upper tertiles of antibody titers were 2.1 (95% confidence interval: 0.92, 4.69), 2.6 (95% confidence interval: 1.24, 5.41), and 3.0 (95% confidence interval: 1.46, 6.37) times more at risk of progression than those in the lowest tertile, using three definitions of progression, respectively. The fact that seroreactivity to C. pneumoniae was independently associated with the risk of AMD progression suggests that C. pneumoniae infection may be an additional risk factor for AMD progression.

Aged↗

Vitamin E supplementation and cataract: randomized controlled trial.

OBJECTIVE: To determine whether treatment with vitamin E (500 IU daily) reduces either the incidence or rate of progression of age-related cataracts. DESIGN: A prospective, randomized, double-masked, placebo-controlled clinical trial entitled the Vitamin E, Cataract and Age-Related Maculopathy Trial. PARTICIPANTS: Of 1906 screened volunteers, 1193 eligible subjects with early or no cataract, aged 55 to 80 years, were enrolled and followed up for 4 years. INTERVENTION: Subjects were assigned randomly to receive either 500 IU of natural vitamin E in soybean oil encapsulated in gelatin or a placebo with an identical appearance. MAIN OUTCOME MEASURES: The incidence and progression rates of age-related cataract were assessed annually with both clinical lens opacity gradings and computerized analysis of Scheimpflug and retroillumination digital lens images obtained with a Nidek EAS-1000 lens camera. The analysis was undertaken using data from the eye with the more advanced opacity for each type of cataract separately and for any cataract changes in each individual. RESULTS: Overall, 87% of the study population completed the 4 years of follow-up, with 74% of the vitamin E group and 76% of the placebo group continuing on their randomized treatment allocation throughout this time. For cortical cataract, the 4-year cumulative incidence rate was 4.5% among those randomized to vitamin E and 4.8% among those randomized to placebo (P = 0.87). For nuclear cataract, the corresponding rates were 12.9% and 12.1% (P = 0.77). For posterior subcapsular cataract, the rates were 1.7% and 3.5% (P = 0.08), whereas for any of these forms of cataract, they were 17.1% and 16.7%, respectively. Progression of cortical cataract was seen in 16.7% of the vitamin E group and 18.4% of the placebo group (P = 0.76). Corresponding rates for nuclear cataract were 11.4% and 11.9% (P = 0.84), whereas those of any cataract were 16.5% and 16.7%, respectively. There was no difference in the rate of cataract extraction between the 2 groups (P = 0.87). Lens characteristics of the participants withdrawn from the randomized medications were not different from those who continued. CONCLUSIONS: Vitamin E given for 4 years at a dose of 500 IU daily did not reduce the incidence of or progression of nuclear, cortical, or posterior subcapsular cataracts. These findings do not support the use of vitamin E to prevent the development or to slow the progression of age-related cataracts.

Aged↗

Localization of cortical cataract in subjects of diverse races and latitude.

PURPOSE: To compare the characteristics of early cortical cataract localization in three groups in cataract epidemiologic surveys performed in Reykjavík, Melbourne, and Singapore. METHODS: Individuals who had right eyes with an area of cortical opacity less than 20% of the pupil when dilated 7 mm or more were selected as subjects. This included 197 subjects from the Reykjavík Eye Study, 231 from the Vitamin E, Cataract, and Age-Related Maculopathy (VECAT) study in Melbourne, and 92 from the Singapore-Japan Cooperative Cataract Study, all showing early-stage cataract in pupils dilated to 7 mm or more. Scheimpflug and retroilluminated photographs were used to locate opacities. Localization of cortical cataract was determined by dividing the retroillumination image into seven concentric circles with diameters of 1 through 7 mm, and eight sections of 45 degrees radial octants. The positive rate of opacification was then calculated for each quadrant. RESULTS: The highest positive rate of opacification was observed in the lower nasal quadrant in all groups. The relative risk of the prevalence of cortical opacity in the lower nasal oblique hemisphere to the upper temporal oblique hemisphere was the highest in the Singaporean subjects followed by those of Melbourne and then of Reykjavík. CONCLUSIONS: The prevalence of cortical cataract was higher in the lower nasal quadrant than in the other quadrants for all subjects of diverse race in three climatically different locations. This higher prevalence was most pronounced in subjects living at low latitude. These results support the view that solar UV exposure is a possible risk factor for development of human cortical cataract.

Aged↗