@article {1354356,
	title = {Relation between time spent outdoors and exfoliation glaucoma or exfoliation glaucoma suspect},
	journal = {Am J Ophthalmol},
	volume = {158},
	number = {3},
	year = {2014},
	month = {2014 Sep},
	pages = {605-14.e1},
	abstract = {PURPOSE: To evaluate the relation between time spent outdoors at various life periods and risk of exfoliation glaucoma or exfoliation glaucoma suspect. DESIGN: Retrospective cohort study in the United States. METHODS: Participants (49 033 women in the Nurses Health Study and 20 066 men in the Health Professionals Follow-up Study) were 60+ years old, were free of glaucoma and cataract, reported eye examinations, and completed questions about time spent outdoors in direct sunlight at midday at 3 life periods: high school to age 24 years, age 25-35 years, and age 36-59 years (asked in 2006 in women and 2008 in men). Participants were followed biennially with mailed questionnaires from 1980 women/1986 men to 2010. Incident cases (223 women and 38 men) were confirmed with medical records. Cohort-specific multivariable-adjusted rate ratios from Cox proportional hazards models were estimated and pooled with meta-analysis. RESULTS: Although no association was observed with greater time spent outdoors in the ages of 25-35 or ages 36-59 years, the pooled multivariable-adjusted rate ratios for >=11 hours per week spent outdoors in high school to age 24 years compared with <=5 hours per week was 2.00 (95\% confidence interval\&nbsp;= 1.30, 3.08; P for linear trend\&nbsp;= .001). In women, this association was stronger in those who resided in the southern geographic tier in young adulthood (P for interaction\&nbsp;= .07). CONCLUSIONS: Greater time spent outdoors in young adulthood was associated with risk of exfoliation glaucoma or exfoliation glaucoma suspect, supporting an etiologic role of early exposures to climatic factors.},
	keywords = {Adult, Aged, Environment, Exfoliation Syndrome, Female, Follow-Up Studies, Humans, Incidence, Intraocular Pressure, Leisure Activities, Male, Middle Aged, Ocular Hypertension, Proportional Hazards Models, Retrospective Studies, Risk Factors, Surveys and Questionnaires, Time Factors, United States, Young Adult},
	issn = {1879-1891},
	doi = {10.1016/j.ajo.2014.05.015},
	author = {Kang, Jae H and Wiggs, Janey L and Pasquale, Louis R}
}
