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Cypel MC, Berezovsky A, Fernandes AG, Watanabe SS, Kimie Higashi Mitsuhiro MR, Ferraz NN, Sacai PY, Furtado JM, Morales PH, Muñoz S, Cohen JM, Belfort R, Salomão SR. Regional Disparities in Prevalence and Causes of Visual Impairment and Blindness, Cataract Surgical Coverage and Ocular Findings in Adults 50 Years and Older in Brazil: A Comparative Analysis between Two Population-Based Cross-Sectional Surveys Performed Within a 10-Year Interval. Semin Ophthalmol 2023; 38:656-664. [PMID: 37154578 DOI: 10.1080/08820538.2023.2209164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/09/2023] [Accepted: 02/17/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE To investigate disparities in the prevalence and causes of visual impairment and blindness, cataract surgical coverage, and ocular findings in older adults from two Brazilian geo-socio-demographic areas, São Paulo and Parintins cities. METHODS Data from two population-based studies including participants 50 years and older from the cities of São Paulo (São Paulo Eye Study - SPES, 2004) and Parintins (Brazilian Amazon Region Eye Survey - BARES, 2014) were aggregated. RESULTS A total of 5318 participants (3677 from SPES;1641 from BARES) were included. The prevalence of severe visual impairment (SVI) and blindness were, respectively, 0.74% (0.46-1.02) and 0.77% (0.48-1.05) in SPES and 1.72% (1.09-2.35) and 3.44% (2.55-4.33) in BARES. SVI and blindness were associated with BARES study [OR = 2.27 (1.30-3.95); p = .004 - SVI] [OR:4.07 (2.51-6.60); p < .001- blindness]; and older age [OR = 10.93 (4.20-28.45); p < .001 - SPES; OR = 17.96 (8.75-36.83); p < .001 - BARES] while higher education level was a protective factor [OR = 0.21 (0.05-0.95) - SPES; p = .042; OR = 0.21 (0.05-0.91); p = .037 - BARES]. Cataract was the main cause of bilateral severe visual impairment (25.93% in SPES and 64.29% in BARES) and bilateral blindness (21.43% in SPES and 35.71% in BARES). Cataract surgical coverage was significantly lower in BARES (36.32%) compared to SPES (57.75%). CONCLUSION The prevalence of SVI and blindness was three times higher in older adults from the Brazilian Amazon compared to those living in São Paulo city, despite a 10-year interval between the two studies. These disparities should be mitigated by initiatives to promote access to eye care services targeting underprivileged and remote Brazilian areas.
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Affiliation(s)
- Marcela Colussi Cypel
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Adriana Berezovsky
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Arthur Gustavo Fernandes
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Sung Song Watanabe
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Marcia Regina Kimie Higashi Mitsuhiro
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Nivea Nunes Ferraz
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Paula Yuri Sacai
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - João Marcello Furtado
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
- Departamento de Oftalmologia, Otorrinolaringologia, Cirurgia de Cabeça e Pescoço, Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, Brazil
| | - Paulo Henrique Morales
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Sergio Muñoz
- Department of Public Health-CIGES, Universidad de La Frontera, Temuco, Chile
| | - Jacob Moysés Cohen
- Divisão de Oftalmologia, Departamento de Cirurgia, Faculdade de Medicina da Universidade Federal do Amazonas (UFAM), Manaus, Brazil
| | - Rubens Belfort
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
- Instituto da Visão, Instituto Paulista de Estudos e Pesquisas em Oftalmologia (IPEPO), São Paulo, Brazil
| | - Solange Rios Salomão
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
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Prevalence of ocular findings regardless of visual acuity status in older adults from the Brazilian Amazon Region. Sci Rep 2021; 11:23710. [PMID: 34887482 PMCID: PMC8660780 DOI: 10.1038/s41598-021-03172-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/22/2021] [Indexed: 01/19/2023] Open
Abstract
Recently, it has been recommended that population-based studies report not only frequencies of vision impairment and blindness but also any ocular abnormalities that might lead an individual to seek for eyecare services. The current study aimed to determine prevalence of ocular findings regardless of visual acuity (VA) status in older adults from the Brazilian Amazon Region. Disturbances were grouped into: Eyelids; Anterior Segment; Posterior Segment; Increased intraocular pressure; and Overall Globe. The presence of an ocular finding was considered positive when any abnormality was noted, regardless of VA. Refractive errors were not considered. A total 2384 eligible persons were enumerated and 2041 (85.6%) examined. The prevalence of ocular disturbances in either eye was 87.0% and was associated with male gender, older age, lower education, and rural residence. Overall, main findings were pterygium, cataract, and pinguecula, occurring in 58.8%, 45.4% and 17.4%, respectively. Among individuals with 20/20 VA in both eyes, the most frequent findings were pterygium, pinguecula, and glaucoma cupping, occurring in 47.4%, 31.2% and 6.5%, respectively. The high prevalence of ocular findings observed in this population reinforces that different conditions might not immediately decrease VA but can indicate risk and/or discomfort symptoms and should be considered when planning public health ophthalmic services.
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Watanabe SES, Berezovsky A, Furtado JM, Kimie Higashi Mitsuhiro MR, Cypel M, Cohen MJ, Cohen JM, Cunha CC, Sacai PY, Ferraz NN, Vasconcelos GC, Morales PH, Campos M, Fernandes AG, Muñoz S, Belfort R, Salomão SR. Population-Based Cataract Surgery Complications and Their Impact on Visual Status in the Brazilian Amazon Region. Am J Ophthalmol 2019; 208:295-304. [PMID: 31377288 DOI: 10.1016/j.ajo.2019.07.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 07/25/2019] [Accepted: 07/29/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To investigate cataract surgery prevalence, complications, visual outcomes, and coverage in a population of older adults from the Brazilian Amazon region. DESIGN Population-based cross-sectional study. METHODS Individuals ≥45 years of age from urban and rural areas of Parintins City, Brazil, were identified by cluster random sampling. Participants underwent ophthalmic examination, including uncorrected visual acuity, acuity with presenting correction (APC), and best-corrected visual acuity (BCVA) from each eye. In those with previous cataract surgery, surgical technique and complications including its contribution to vision impairment were noted. The association of surgical complications and surgical coverage with sociodemographic variables was assessed by multiple logistic regression. RESULTS A total of 2,384 persons were determined to be eligible, and 2,041 (85.6%) were examined. Overall, prevalence of cataract surgery was 8.6%, with 11.3% urban and 5.0% rural. Surgical complications were associated with males, older age, and urban residency and were found in 60.4%, with posterior capsule opacification in 29.6% and posterior capsule rupture in 16.3%. Among the 270 eyes having cataract surgery, APC ≥20/32 was found in 44.4%, APC 20/40 to 20/63 in 20.8%, APC <20/63 to 20/200 in 14.4%, APC <20/200 to 20/400 in 2.6%, and APC <20/400 in 17.8%. Low surgical coverage was found with 57.9% of those with visual impairment due to cataract not being treated surgically. CONCLUSIONS Although a reasonable prevalence of cataract surgery was found, a high complication rate, poor visual outcomes, and low cataract surgery coverage indicated that actions to improve quality and appropriate postsurgical management should be planned and implemented by public health authorities.
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Fernandes AG, Salomão SR, Ferraz NN, Mitsuhiro MH, Furtado JM, Muñoz S, Cypel MC, Cunha CC, Vasconcelos GC, Sacai PY, Morales PH, Cohen MJ, Cohen JM, Watanabe SS, Campos M, Belfort Junior R, Berezovsky A. Pterygium in adults from the Brazilian Amazon Region: prevalence, visual status and refractive errors. Br J Ophthalmol 2019; 104:757-763. [PMID: 31533928 DOI: 10.1136/bjophthalmol-2019-314131] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 06/19/2019] [Accepted: 08/29/2019] [Indexed: 11/04/2022]
Abstract
AIMS To determine prevalence of pterygium, its role as main cause of unilateral and bilateral visual impairment and blindness and its impact on refractive errors from adults living in a high ultraviolet exposure area in the Brazilian Amazon Region. METHODS Cluster sampling was used in randomly selecting subjects ≥45 years of age from urban and rural areas of Parintins city. Eligible subjects were enumerated through a door-to-door household survey and invited for an eye exam including refraction. Pterygium was assessed considering location (nasal, temporal or both) and size (<3 mm or ≥3 mm reaching or not pupillary margin). RESULTS A total of 2384 persons were enumerated and 2041 (85.6%) were examined. Prevalence of pterygium was 58.8% (95% CI 53.8% to 63.7%) and associated with male gender (OR=1.63; 95% CI 1.37 to 1.94; p=0.001), while higher education was a protective factor (OR=0.63; 95% CI 0.44 to 0.92; p=0.018). Older age and rural residence were associated with pterygium ≥3 mm reaching or not pupillary margin, while higher education was a protective factor for pterygium ≥3 mm reaching pupillary margin. Prevalence of pterygium as cause of visual impairment and blindness was 14.3% and 3.9%, respectively. Significantly higher hyperopic refractive errors were found in eyes with pterygium ≥3 mm reaching or not pupillary margin. CONCLUSIONS Pterygium was highly prevalent and the second cause of visual impairment and blindness after provision of refractive correction. Risk factors for pterygium were male gender, advanced age, lower education and rural residency. Strategies to provide pterygium early detection and proper management should be considered by healthcare authorities in this population.
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Affiliation(s)
- Arthur G Fernandes
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Solange R Salomão
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Nívea N Ferraz
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Márcia H Mitsuhiro
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Joao M Furtado
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil.,Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Sergio Muñoz
- Departamento de Salud Publica, Universidad de La Frontera, Temuco, Chile
| | - Marcela C Cypel
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Cristina C Cunha
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Galton C Vasconcelos
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil.,Departamento de Oftalmologia e Otorrinolaringologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Paula Y Sacai
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Paulo H Morales
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Marcos J Cohen
- Divisão de Oftalmologia, Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Amazonas, Manaus, AM, Brazil
| | - Jacob M Cohen
- Divisão de Oftalmologia, Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Amazonas, Manaus, AM, Brazil
| | - Sung S Watanabe
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Mauro Campos
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Rubens Belfort Junior
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Adriana Berezovsky
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
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Furtado JM, Berezovsky A, Ferraz NN, Muñoz S, Fernandes AG, Watanabe SS, Cunha CC, Vasconcelos GC, Sacai PY, Cypel M, Mitsuhiro MH, Morales PH, Cohen MJ, Campos M, Cohen JM, Belfort R, Salomão SR. Prevalence and Causes of Visual Impairment and Blindness in Adults Aged 45 Years and Older from Parintins: The Brazilian Amazon Region Eye Survey. Ophthalmic Epidemiol 2019; 26:345-354. [DOI: 10.1080/09286586.2019.1624783] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- João M. Furtado
- Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, São Paulo, SP, Brazil
- Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Adriana Berezovsky
- Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Nívea N. Ferraz
- Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Sergio Muñoz
- Departamento de Salud Publica, Universidad de La Frontera, Temuco, Chile
| | - Arthur G. Fernandes
- Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Sung S. Watanabe
- Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Cristina C. Cunha
- Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, São Paulo, SP, Brazil
- Faculdade de Medicina, Universidade Federal do Pará (UFPA), Belém, PA, Brazil
| | - Galton C. Vasconcelos
- Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, São Paulo, SP, Brazil
- Faculdade de Medicina, Departamento de Oftalmologia e Otorrinolaringologia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Paula Y. Sacai
- Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Marcela Cypel
- Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Márcia H. Mitsuhiro
- Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Paulo H. Morales
- Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Marcos J. Cohen
- Faculdade de Medicina, Departamento de Cirurgia, Divisão de Oftalmologia, Universidade Federal do Amazonas (UFAM), Manaus, AM, Brazil
| | - Mauro Campos
- Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Jacob M. Cohen
- Faculdade de Medicina, Departamento de Cirurgia, Divisão de Oftalmologia, Universidade Federal do Amazonas (UFAM), Manaus, AM, Brazil
| | - Rubens Belfort
- Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Solange R. Salomão
- Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, São Paulo, SP, Brazil
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6
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Cunha CC, Berezovsky A, Furtado JM, Ferraz NN, Fernandes AG, Muñoz S, Watanabe SS, Sacai PY, Cypel M, Mitsuhiro MH, Morales PH, Vasconcelos GC, Cohen MJ, Campos M, Cohen JM, Belfort R, Salomão SR. Presbyopia and Ocular Conditions Causing Near Vision Impairment in Older Adults From the Brazilian Amazon Region. Am J Ophthalmol 2018; 196:72-81. [PMID: 30118685 DOI: 10.1016/j.ajo.2018.08.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/25/2018] [Accepted: 08/07/2018] [Indexed: 11/17/2022]
Abstract
PURPOSE To investigate the prevalence and causes of near vision impairment (NVI) in a population of older adults from the Brazilian Amazon Region. DESIGN Population-based cross-sectional study. METHODS Cluster sampling was used in randomly selecting subjects 45 years of age and older from urban and rural areas of Parintins city, Brazil. Participants underwent ophthalmic examination, including uncorrected (UCNVA), presenting (PNVA), and best-corrected near visual acuity (BCNVA) from each eye; biomicroscopy; funduscopy; and subjective refraction, including testing with additional lenses for near vision optical correction. A principal cause for NVI was assigned by the ophthalmologist and presbyopia was defined as UCNVA ≤ 20/40 changing to > 20/40 with BCNVA. Free-of-charge glasses were provided for those in need. RESULTS A total of 2384 subjects were enumerated and 2025 had reliable NVA measurements from both eyes. The prevalence of NVI in the better-seeing eye was 96.5% with UCNVA, decreasing to 81.1% with PNVA and to 20.5% with BCNVA. Presbyopia was the principal cause of NVI in 71.8%, followed by cataract (16.5%) and pterygium (2.5%), and was associated with younger age and high schooling. Glasses for near vision were prescribed and provided to 1414 (69.8%) participants. CONCLUSIONS A high prevalence of NVI was detected even in those wearing glasses for near. Prescription and provision of low-cost reading glasses should be considered by Brazilian health authorities to address this easily and promptly correctable form of vision impairment.
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Affiliation(s)
- Cristina Coimbra Cunha
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Oftalmologia e Ciências Visuais, São Paulo, Brazil
| | - Adriana Berezovsky
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Oftalmologia e Ciências Visuais, São Paulo, Brazil
| | - João Marcello Furtado
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Oftalmologia e Ciências Visuais, São Paulo, Brazil
| | - Nívea Nunes Ferraz
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Oftalmologia e Ciências Visuais, São Paulo, Brazil
| | - Arthur Gustavo Fernandes
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Oftalmologia e Ciências Visuais, São Paulo, Brazil
| | - Sergio Muñoz
- Universidad de La Frontera, Departamento de Salud Publica, Temuco, Chile
| | - Sung Song Watanabe
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Oftalmologia e Ciências Visuais, São Paulo, Brazil
| | - Paula Yuri Sacai
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Oftalmologia e Ciências Visuais, São Paulo, Brazil
| | - Marcela Cypel
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Oftalmologia e Ciências Visuais, São Paulo, Brazil
| | - Márcia Higashi Mitsuhiro
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Oftalmologia e Ciências Visuais, São Paulo, Brazil
| | - Paulo Henrique Morales
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Oftalmologia e Ciências Visuais, São Paulo, Brazil
| | - Galton Carvalho Vasconcelos
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Oftalmologia e Ciências Visuais, São Paulo, Brazil
| | - Marcos Jacob Cohen
- Universidade Federal do Amazonas (UFAM), Faculdade de Medicina, Departamento de Cirurgia, Divisão de Oftalmologia, Manaus, Brazil
| | - Mauro Campos
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Oftalmologia e Ciências Visuais, São Paulo, Brazil
| | - Jacob Moysés Cohen
- Universidade Federal do Amazonas (UFAM), Faculdade de Medicina, Departamento de Cirurgia, Divisão de Oftalmologia, Manaus, Brazil
| | - Rubens Belfort
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Oftalmologia e Ciências Visuais, São Paulo, Brazil
| | - Solange Rios Salomão
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Oftalmologia e Ciências Visuais, São Paulo, Brazil.
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7
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Salomão SR, Berezovsky A, Furtado JM, Fernandes AG, Muñoz S, Cavascan NN, Cypel MC, Cunha CC, Vasconcelos GC, Mitsuhiro MRKH, Sacai PY, Campos M, Morales PHA, Cohen MJ, Cohen JM, Watanabe SES, Belfort R. Vision Status in Older Adults: The Brazilian Amazon Region Eye Survey. Sci Rep 2018; 8:886. [PMID: 29343840 PMCID: PMC5772376 DOI: 10.1038/s41598-018-19338-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 12/11/2017] [Indexed: 12/05/2022] Open
Abstract
Older adults living in remote areas with limited access to health services are at higher risk to develop visual impairment and blindness. We conducted a population-based survey to determine the vision status in subjects 45 years of age and older from urban and rural areas of Parintins city, Brazilian Amazon Region. Participants underwent ophthalmic examination, including uncorrected (UCVA), presenting (PVA) and best-corrected visual acuity (BCVA). Vision status was described as lines of visual acuity (VA) impairment and lines of VA improvement from UCVA to BCVA and from PVA to BCVA in the better-seeing eye. A total of 2384 subjects were enumerated, 2041 (85.6%) were examined, with reliable VA measurements obtained from 2025 participants. Vision status in lines of VA impairment was (mean ± standard deviation): 3.44 ± 3.53 for UCVA, 2.85 ± 3.52 for PVA and 1.50 ± 3.51 for BCVA. Female gender, older age and lower education were associated with ≥6 lines of UCVA impairment. Lines of improvement ≥3 was found in 626 (30.9%) participants and associated with female gender and rural residency. In conclusion, a third of participants could have at least three lines of VA improvement with proper refraction. Strategies to improve access to eye care and affordable glasses are needed.
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Affiliation(s)
- Solange R Salomão
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil.
| | - Adriana Berezovsky
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - João M Furtado
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
- Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Arthur G Fernandes
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Sergio Muñoz
- Departamento de Salud Publica, Universidad de La Frontera, Temuco, Chile
| | - Nívea N Cavascan
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Marcela C Cypel
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Cristina C Cunha
- Faculdade de Medicina da Universidade Federal do Pará - UFPA, Belém, PA, Brazil
| | - Galton C Vasconcelos
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
- Departamento de Oftalmologia e Otorrinolaringologia, Faculdade de Medicina da Universidade Federal de Minas Gerais - UFMG, Belo Horizonte, MG, Brazil
| | - Márcia R K H Mitsuhiro
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Paula Y Sacai
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Mauro Campos
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Paulo H A Morales
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Marcos J Cohen
- Divisão de Oftalmologia, Departamento de Cirurgia, Faculdade de Medicina da Universidade Federal do Amazonas - UFAM, Manaus, AM, Brazil
| | - Jacob M Cohen
- Divisão de Oftalmologia, Departamento de Cirurgia, Faculdade de Medicina da Universidade Federal do Amazonas - UFAM, Manaus, AM, Brazil
| | - Sung E S Watanabe
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Rubens Belfort
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
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