Ophthalmic epidemiology最新文献

{"title":"Refractive Profiles in Children Receiving School-Based Eye Exams Following Vision Screening from a Large School-Based Vision Program in 2016 to 2022.","authors":"Andrew M Nguyen, Xinxing Guo, Xi Daisy Dai, Medha Kallem, David S Friedman, Nick Kourgialis, Michael X Repka, Megan E Collins","doi":"10.1080/09286586.2024.2422351","DOIUrl":"https://doi.org/10.1080/09286586.2024.2422351","url":null,"abstract":"<p><strong>Purpose: </strong>To describe refractive error findings and associated factors in students who received school-based eye exams following vision screenings.</p><p><strong>Methods: </strong>Cross-sectional study of pre-kindergarten through 12^th grade students who failed vision screening and underwent a school-based eye exam in the Northeast region of the United States during 2016-2022. Non-cycloplegic autorefraction and visual acuity measurements were used to categorize refractive error by type and severity. Main outcomes included any refractive error (at least -0.50D myopia, +0.50 hyperopia, 1.00D astigmatism, or 1.00D anisometropia), clinically significant refractive error (CSRE; more severe refractive error with decreased vision), and refractive amblyopia risk (RAR). Multivariable mixed-effects logistic regression was used to determine student- and school-level characteristics associated with refractive error outcomes.</p><p><strong>Results: </strong>Of 103,159 included students who failed screening, 95,875 (92.9%) were analyzed. Overall prevalence of any refractive error was 94.2%, with 81.7% having CSRE. Pre-kindergarten & kindergarten students had the highest prevalence of CSRE (85.7%), which dropped to 77.0% by 3^rd and 4^th grade before rising with each higher grade level thereafter. Prevalence of RAR was 60.9% overall and highest in pre-kindergarten and kindergarten students (73.8%). Myopia was the most prevalent refractive error, followed by astigmatism, anisometropia, then hyperopia. The odds of hyperopia, astigmatism, and anisometropia decreased with higher grade level.</p><p><strong>Conclusion: </strong>Over 80% of students who failed vision screening at a large school-based vision program had CSRE, and over 60% had RAR. Pre-kindergarten and kindergarten students had an especially high prevalence of RAR. Refractive error remained common in every grade level.</p>","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in Healthcare Access for Adults with Self-Reported Vision Difficulty - Behavioral Risk Factor Surveillance System 2019-2021.","authors":"Chidinma Onukwugha, Franz Castro, Bonnielin K Swenor, Varshini Varadaraj","doi":"10.1080/09286586.2024.2407905","DOIUrl":"https://doi.org/10.1080/09286586.2024.2407905","url":null,"abstract":"<p><strong>Purpose: </strong>Identifying barriers experienced by individuals with vision difficulty (VD) in accessing healthcare is crucial to inform public health policies to provide equitable healthcare. We examined the association between VD with healthcare access measures in the United States (U.S.).</p><p><strong>Methods: </strong>We used data on 1,258,919 participants surveyed from the 2019, 2020, and 2021 cycles of the Behavioral Risk Factor Surveillance System (BRFSS), a national telephone-based survey of U.S. adults ≥ 18 years. The following outcome of healthcare access were examined: no healthcare coverage, no healthcare provider, >1 year since last checkup, inability to afford healthcare. VD was self-reported blindness/serious difficulty seeing even when wearing glasses. Survey-weighted, multivariable logistic regression models were used to examine the relationship between VD and the outcomes of interest, adjusting for confounders.</p><p><strong>Results: </strong>Of the 1,258,919 participants surveyed from 2019 to 2021, 5.1% reported having VD. Adjusted models showed that adults with VD had greater odds of having no healthcare coverage (OR = 1.14, 95% CI = 1.04-1.24), no provider (OR = 1.12; 95% CI = 1.05-1.20), a health checkup > 1 year ago (OR = 1.12; 95% CI = 1.04-1.21), and of being unable to afford care (OR = 1.62, 95% CI = 1.52-1.73).</p><p><strong>Conclusion: </strong>Adults reporting VD faced more barriers accessing healthcare. These disparities could be explained by a differential distribution of social determinants of health, lack of accessibility of medical facilities and communication barriers. Policies aimed at strengthening provisions around accessibility of healthcare facilities might result in increased access to healthcare for this population.</p>","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Analysis of Telomere Length and Vision in a Large Community-Based Survey.","authors":"Bing Zhang, Yune Zhao","doi":"10.1080/09286586.2024.2422349","DOIUrl":"https://doi.org/10.1080/09286586.2024.2422349","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether there is a direct, age-independent association between telomere length and visual acuity decline in a large community-based cohort study.</p><p><strong>Methods: </strong>Participants older than 40 with linked leukocyte telomere length (LTL) were enrolled in NHANES. LTL was assayed using qPCR from the participants' blood samples. Best corrected visual acuity (BCVA) of the better-seeing eye was analyzed, with visual impairment (VI) defined as BCVA ≥ 20/40. LTL was grouped into quartiles, and its association with BCVA and VI was evaluated after adjusting for covariates.</p><p><strong>Results: </strong>Among the 4,480 enrolled participants, the weighted means of age, BCVA, and telomere length were 56.1 ± 11.9 years, 0.05 ± 0.08 logMAR, and 5,662 ± 36 base pairs, respectively. The proportion of VI was 2.6%. After adjusting for covariates including sex, ethnicity, education, family poverty income ratio, general health status, hypertension, diabetes, smoking, and body mass index, BCVA was significantly worse in participants with shorter LTL, with a significant trend (<i>p</i> = 0.002). However, after further adjusting for age, the association between LTL and BCVA was no longer significant, without a trend (<i>p</i> = 0.640). No significant association or trend between LTL and VI was found in the stepwise logistic model.</p><p><strong>Conclusions: </strong>No age-independent association between LTL and BCVA was found. Our study indicates LTL may not serve as a biomarker for age-related visual acuity decline.</p>","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Progression of Diabetic Retinopathy in Urban India: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study, 15yr Follow up.","authors":"Keerthana Raghu, Janani Surya R, Padmaja Kumari Rani, Tarun Sharma, Rajiv Raman","doi":"10.1080/09286586.2024.2419015","DOIUrl":"https://doi.org/10.1080/09286586.2024.2419015","url":null,"abstract":"<p><p><b><i>Purpose</i>:</b> To evaluate the 15 year incidence and progression of Diabetic Retinopathy (DR) and identify risk factors among Indian population.<b><i>Methods</i>:</b> From a cross-sectional study of 1425 subjects, 911 participants took part in the 4-year follow-up. Out of these 911 participants, 140 returned for the 15-year follow-up, with baseline examinations conducted between 2003 and 2006, and subsequent follow-ups occurring from 2007 to 2011 and the current 15-year follow-up from 2018 to 2021. Of the 140 participants, 112 were eligible for analysis after excluding individuals with ungradable fundus photographs.<b><i>Results</i>:</b> The 15-year incidence of any diabetic retinopathy (DR) was 5%, with mild NPDR and moderate NPDR at 1.57% and 2.7%, respectively. Proliferative DR was observed in 0.71% of cases, while diabetic macular edema (DME) and sight-threatening diabetic retinopathy (STDR) rates were 0.48% and 1.10%, respectively. Age-standardized rates revealed a significant association with increasing age and incident any DR and STDR. DR progression over 15 years included 7.5% one-step and 1.75% two-step progressions, while regression was limited to 1.75% one-step regression. Multiple logistic regression analyses revealed that baseline duration of diabetes, systolic blood pressure, HbA1c levels, and the presence of anemia influenced the incidence of any DR, DME, and STDR. Smoking and higher HbA1c were identified as risk factors for one-step progression of DR.<b><i>Conclusion</i>:</b> This study provides crucial insights into the long-term incidence, progression, and regression of DR among individuals with Type 2 diabetes in India.</p>","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decomposition of Economic Inequality in Age-Related Macular Degeneration by Using Oaxaca-Blinder Decomposition: Tehran Geriatric Eye Study.","authors":"Hassan Hashemi, Reza Pakzad, Mohamadreza Aghamirsalim, Alireza Hashemi, Mehdi Khabazkhoob","doi":"10.1080/09286586.2024.2415047","DOIUrl":"https://doi.org/10.1080/09286586.2024.2415047","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate economic inequality in age-related macular degeneration (AMD) and decompose it into its determinants using Oaxaca-Blinder decomposition (OBD).</p><p><strong>Methods: </strong>The Tehran Geriatric Eye Study was a cross-sectional study conducted on individuals aged 60 years and older, utilizing stratified random cluster sampling. Each participant received a comprehensive optometric, and slit-lamp examination. Diagnosis and classification of AMD were conducted utilizing fundus camera images.</p><p><strong>Results: </strong>The data of the 3268 participants were analyzed. According to OBD, a significant difference was found in AMD between the rich and poor groups (8.36%) disfavoring the poor (<i>p</i> < 0.001). The explained and unexplained portions comprised 93.37% and 6.63% of the difference (<i>p</i> < 0.001 and <i>p</i> = 0.405, respectively). Among study variables, age (coefficient = 4.70; <i>p</i> < 0.001), economic status (coefficient = 3.58; <i>p</i> = 0.004), and myopia (coefficient = 0.73; <i>p</i> = 0.001) were significant determinants of inequality in the explained portion.</p><p><strong>Conclusion: </strong>A significant disparity in the prevalence of AMD was observed between individuals of different socioeconomic statuses, primarily attributed to the explained factors. Factors such as age, economic status, and myopia were found to have the most substantial impact in exacerbating the inequality that disadvantaged the poor group (contributing percentages: 52.17%, 39.73%, and 8.10%, respectively). The findings of this research can be valuable for health policymakers in prioritizing and addressing the determinants of inequality within the population.</p>","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}