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                <title xml:lang="en">Association of Air Pollution Exposure with Incident Cataract Surgery and Neovascular Age-Related Macular Degeneration in Two French Nationwide Cohorts</title>
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              <p>Purpose : Age-related macular degeneration (AMD) and cataracts are the leading causes of blindness worldwide, with oxidative stress playing a crucial role in their development. Air pollution, known to exacerbate oxidative stress, may contribute to the progression of these diseases. This study aims at investigating the association between ambient air pollution exposure and the incidence of cataract surgery and neovascular AMD (nAMD) in two nationwide prospective French cohorts.Methods : This study included 36,140 participants aged over 53 years at inclusion, comprising 18,334 employees from the French national energy company (EDF-GDF) in 1989 in the Gazel cohort and 19,025 individuals from the general population in 2012-2019 in the Constances cohort.Incident cataract surgery and nAMD cases were identified using data from the French National Health Data System (SNDS), which exhaustively records medical procedures and reimbursed prescriptions. Exposure to nitrogen dioxide (NO2), fine particulate matter (PM2.5), and black carbon (BC) was estimated using land-use regression (LUR) models linked to residential history. Cox proportional hazards models, adjusted for age, sex, and education, assessed the associations.Results : Over the 10 years of follow-up, 5,543 cases of cataract surgery and 266 cases of nAMD were identified among the 36,140 participants. The cohort included 39% women, with a mean age of 62.3 years. In the combined Constances and Gazel populations, we estimated a significant association, among urban participants, between exposures higher than 34.8 µg/m3 of NO2 and risk of cataract surgery (HR=1.08, 95% CI: 1.01–1.16, p=0.017), but not among rural participants. We estimated a significant association between the highest quartile of exposure to BC (≥2.33 10^-5/m) and risk of nAMD compared to the lowest quartile (HR=1.88, 95% CI: 1.03–3.45, p=0.041) in the Constances cohort, but not in the combined cohorts.Conclusions : This study offers new insights into the effect of air pollution on ocular aging at a national level, showing that higher exposure to NO2– even below the current yearly EU regulation of 40 µg/m3 – is associated with an increased risk of cataract surgery, and that there are differing effects observed in urban and rural populations. Our study also suggests an association of BC with nAMD.This abstract was presented at the 2025 ARVO Annual Meeting, held in Salt Lake City, Utah, May 4-8, 2025.</p>
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