Accelerometer-Derived Moderate-to-Vigorous Physical Activity and the Risk of Four Common Vision-Threatening Ocular Diseases.
Level 3 - non-randomized controlled study
Prospective cohort study with follow-up linked to electronic health records
PubMed 42329076 · doi:10.1167/tvst.15.6.24
What was done
Researchers analyzed data from 77,644 UK Biobank participants who wore accelerometers to measure moderate-to-vigorous physical activity (MVPA). MVPA was categorized according to WHO guidelines: <150, 150-299, and ≥300 min/week. Incident cases of cataract, diabetic retinopathy (DR), age-related macular degeneration (AMD), and glaucoma were identified from linked hospital and primary care records over a median follow-up of 6.2 years. Cox proportional hazards models and restricted cubic splines estimated hazard ratios (HRs), and mediation analyses examined potential inflammatory and metabolic pathways.
What was found
During follow-up, 4,283 cataract, 248 DR, 891 AMD, and 762 glaucoma events occurred. Compared with <150 min/week MVPA, risk was significantly lower for cataract at 150-299 min/week (HR = 0.91, 95% CI: 0.84-0.98) and ≥300 min/week (HR = 0.88, 95% CI: 0.82-0.95), showing an L-shaped association (P < 0.001). For DR, risk was lower at 150-299 min/week (HR = 0.62, 95% CI: 0.45-0.86) and ≥300 min/week (HR = 0.51, 95% CI: 0.37-0.71), partially mediated by inflammatory and metabolic markers. AMD showed a modest negative association (P = 0.028), while glaucoma had no significant association.
Why it matters
This study provides objective, device-measured evidence that meeting or exceeding recommended physical activity guidelines is associated with reduced incidence of cataract and diabetic retinopathy, highlighting MVPA as a potentially modifiable behavioral target for eye health.
Limits
The observational design cannot establish causality, leaving potential for residual confounding or reverse causation. MVPA was assessed via accelerometer over a single baseline measurement period, which may not capture long-term activity changes. Disease ascertainment relied on diagnostic codes in electronic records, potentially missing milder or undiagnosed cases. Additionally, the UK Biobank cohort exhibits healthy-volunteer bias and is predominantly of European ancestry, which may limit generalizability.
Cited by
- partial Lack of exercise accelerates age-related vision loss.