Ambient Air Pollution and Age-Related Eye Disease: A Systematic Review and Meta-Analysis

Abstract

PURPOSE. To compare the burden of age-related eye diseases among adults exposed to higher versus lower levels of ambient air pollutants. METHODS. MEDLINE, EMBASE, and Scopus were searched for relevant articles until September 30, 2021. Inclusion criteria included studies of adults, aged 40+ years, that provided measures of association between the air pollutants (nitrogen dioxide, carbon monoxide [CO], sulfur dioxide, ozone [O3], particulate matter [PM] less than 2.5 μm in diameter [PM2.5], and PM less than 10 μm in diameter [PM10]) and the age-related eye disease outcomes of glaucoma, age-related macular degeneration (AMD), or cataract. Pooled odds ratio (OR) estimates and 95% confidence intervals (CIs) were calculated using a random-effects meta-analysis model. PROSPERO registration ID: CRD42021250078. RESULTS. A total of eight studies were included in the review. Consistent evidence for an association was found between PM2.5 and glaucoma, with four of four studies reporting a positive association. The pooled OR for each 10-μg/m3 increase of PM2.5 on glaucoma was 1.18 (95% CI, 0.95–1.47). Consistent evidence was also found for O3 and cataract, with three of three studies reporting an inverse association. Two of two studies reported a null association between PM2.5 and cataract, while one of one studies reported a positive association between PM10 and cataract. One of one studies reported a positive relationship between CO and AMD. Other relationships were less consistent between studies. CONCLUSIONS. Current evidence suggests there may be an association between some air pollutants and cataract, AMD, and glaucoma.