Purpose: To determine the prevalence of exfoliation syndrome (XFS) and some of its related factors in an Iranian population aged 45-69 years.

Methods: In the first phase of the Shahroud Eye Cohort Study, 5190 people in 300 clusters from Shahroud city in the northeast of Iran participated in the study. The second phase of the study was conducted 5 years later in 2014. Vision testing, refraction, slit lamp examination, and fundus examination were performed for all participants. In this study, XFS was determined by an ophthalmologist using slit lamp biomicroscopy.

Results: Of the 5190 first phase study participants, 4737 participated in the second phase (response rate 91.3%). In this study, the prevalence of XFS was 0.46% (95% confidence interval, CI, 0.24-0.68%) and the prevalence of bilateral XFS was 0.20% (95% CI 0.07-0.33%). XFS prevalence in men was 0.74% (95% CI 0.28-1.20%) and in women 0.26% (95% CI 0.07-0.45%). In a multivariable-adjusted logistic regression model, age, sex, diabetes, smoking status, dyslipidemia, and hypertension were entered into the model as covariables, where older age (odds ratio, OR, 1.18, 95% CI 1.08-1.28) was the only variable that remained significantly associated with XFS prevalence.

Conclusion: The prevalence of XFS in this study was very low. Similar to other studies, age was a factor associated with this syndrome.