Air Pollution Ups Risk for Ocular Complications in Adults

TOPLINE:

Researchers found a strong link between increased exposure to air pollution and ocular complications, with increased exposure to nitrogen oxides (NOx) and particulate matter with diameter less than 10 μm (PM10) associated with the risk for diabetic retinopathy and increased exposure to PM 2.5 and PM10 associated with the risk for glaucoma.

METHODOLOGY:

• Researchers in China conducted a prospective cohort study to evaluate the relationship between exposure to air pollutants and the occurrence of five common ocular diseases: Cataracts, glaucoma, macular degeneration, diabetic retinopathy, and retinal detachment.
• They included 114,930 participants from the UK Biobank with refractometry data at baseline (39,180 had myopia) and followed them for a median of 12.4 years.
• Participants with preexisting diagnoses of diabetic retinopathy, retinal detachment, macular degeneration, glaucoma, or cataracts at baseline were excluded.
• The researchers employed a land use regression model to assess annual average concentrations of NOx, nitrogen dioxide, PM2.5, and PM10.

TAKEAWAY:

• An interquartile range increase in the exposure to PM10 and NOx was associated with an increased risk for diabetic retinopathy among participants with myopia (hazard ratio [HR], 1.11; 95% CI, 1.01-1.23 and HR, 1.22; 95% CI, 1.02-1.45, respectively).
• In participants without myopia, exposure to PM2.5 was linked to an 8% (95% CI, 1.02-1.15) increase in the incidence of glaucoma while exposure to PM10 increased the risk for diabetic retinopathy by 11% (95% CI, 1.01-1.22).
• Exposure to high levels of PM10 was linked to a 61% higher risk for diabetic retinopathy in the participants with myopia, with stronger effects observed in those with low to moderate nearsightedness than in those with more severe nearsightedness.
• High levels of exposure to PM10 were associated with a 67% increased risk for retinal detachment and a 44% increased risk for macular degeneration in the population with low to moderate myopia.

IN PRACTICE:

“These discoveries reinforce the growing consensus that environmental factors are pivotal in the pathogenesis of ocular disorders, particularly amidst the escalating prevalence of myopia globally,” the authors of the study wrote. “Consequently, our findings underscore the urgency for implementing proactive intervention strategies aimed at mitigating the visual impairment and ocular disease burden attributable to air pollution exposure.”

SOURCE:

This study was led by Zhanying Wang, MD, of the Eye and ENT Hospital at Fudan University, in Shanghai. It was published online on March 6, 2025, in the American Journal of Ophthalmology.

LIMITATIONS:

The study population primarily comprised Caucasian and British individuals with a relatively low prevalence of myopia and exposure to modest levels of air pollution, potentially limiting generalizability to diverse populations in developing countries. Changes in air pollution during the follow-up period could not be considered due to the unavailability of post-2010 data. Home-based exposure assessments may not have covered exposure in participants’ work environments or that during commuting.

DISCLOSURES:

This study received support through grants from the National Natural Science Foundation of China, Shanghai Rising-Star Program, Healthy Young Talents Project of Shanghai Municipal Health Commission, and Project of Shanghai Science and Technology. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.