摘要：Objectives. To review the contribution of the Nurses’ Health Study (NHS) to understanding the genetic and lifestyle factors that influence the risk of cataract, age-related macular degeneration, and glaucoma. Methods. We performed a narrative review of the publications of the NHS between 1976 and 2016. Results. The NHS has helped to elucidate the roles of genetics, lifestyle factors (e.g., cigarette smoking associated with cataract extraction and age-related macular degeneration), medical conditions (e.g., diabetes associated with cataract extraction and glaucoma), and dietary factors (e.g., greater carotenoid intake and lower glycemic diet associated with lower risk of age-related macular degeneration) in the etiology of degree and progression of lens opacities, cataract extraction, age-related macular degeneration, primary open-angle glaucoma, and exfoliation glaucoma. Conclusions. The findings from the NHS, combined with those of other studies, have provided compelling evidence to support public health recommendations for helping to prevent age-related eye diseases: abstinence from cigarette smoking, maintenance of healthy weight and diabetes prevention, and a healthy diet rich in fruits and vegetables. Loss of vision is a major cause of disability in the United States that substantially compromises quality of life and is feared by many. 1 The number of Americans aged 65 years or older will double by 2050, 2 and consistent with this, the major causes of blindness and visual impairment, such as cataract, age-related macular degeneration, and glaucoma, are also projected to increase dramatically, because these are strongly age-related conditions. 3 By 2020, a projected 5.5 million adults in the United States will be visually impaired. 3 The economic costs of major vision disorders is tremendous (> $138 billion annually, including direct costs and lost productivity 4 ) and will grow considerably. Major advances have been made in treatments, and there has been a parallel research effort resulting in major advances in the understanding of these diseases for primary prevention. The Nurses’ Health Study (NHS) has provided compelling results that inform important topics in the epidemiology of cataract, age-related macular degeneration, and glaucoma. We have summarized some of the major contributions, and the Appendix (available as a supplement to the online version of this article at http://www.ajph.org ) provides a list of the relevant NHS publications reviewed here.
