«Важные игроки» в развитии возрастной катаракты (обзор литературы)

РЕЗЮМЕ Из-за катаракты миллионы людей по всему миру, особенно в пожилом возрасте, теряют зрение. Возрастная катаракта поражает примерно 37 млн человек в мире ежегодно, а в 51 % случаев именно она становится причиной слабовидения. Актуальной является важность идентификации факторов риска развития возрастной катаракты. Данный обзор литературы посвящен исследованиям, рассматривающим влияние различных факторов на развитие помутнения хрусталика. В работе приведены данные о влиянии возраста на развитие возрастной катаракты. Так, распространенность катаракты в возрасте 52–62 года составляет 5 %, в возрасте 60–69 лет — 30 %, в возрасте 70 лет и старше — 64 %. Освещены ее гендерные особенности: частота помутнений хрусталика у женщин значительно увеличивается с возрастом, причем ее появление совпадает с возникновением дефицита эстрогенов в климактерическом периоде. Отражены данные литературы о зависимости распространенности катаракты от расовой принадлежности (выявлена более высокая распространенность в различных азиатских популяциях по сравнению с населением западных стран). В данном обзоре показано также влияние образа жизни и вредных привычек на возникновение катаракты. Было установлено, что курильщики имеют повышенный риск возникновения именно ядерной катаракты и в меньшей степени — кортикального типа. Отмечено, что на развитие помутнения хрусталика оказывает влияние и количество употребляемого алкоголя, что увеличивает риск катаракты. Так, изучение отдельных типов катаракты показало, что употребление крепких напитков и вина связано с повышенным риском развития ядерных помутнений. Представлены результаты больших когортных исследований, в которых приводится (с использованием показателей отношения шансов и доверительного интервала) ассоциация катаракты с такими соматическими заболеваниями, как сахарный диабет, гипертоническая болезнь, а также с высоким индексом массы тела и приемом некоторых лекарственных препаратов.

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