1
|
Khachatryan N, Giloyan A, Paduca A, Limburg H, Petrosyan V. Nationwide Rapid Assessment of Avoidable Blindness (RAAB) in Armenia. Ophthalmic Epidemiol 2024; 31:62-69. [PMID: 36872562 DOI: 10.1080/09286586.2023.2187068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 02/28/2023] [Indexed: 03/07/2023]
Abstract
PURPOSE This study aimed to estimate the prevalence and main causes of blindness and visual impairment in population aged 50 years and older in Armenia using Rapid Assessment of Avoidable Blindness (RAAB) methodology. METHODS The study team randomly selected 50 clusters (each consisting of 50 people) from all 11 regions of Armenia. Data on participants' demographics, presenting visual acuity, pinhole visual acuity, principal cause of presenting visual acuity, spectacle coverage, uncorrected refractive error (URE), and presbyopia were collected using the RAAB survey form. Four teams of trained eye care professionals completed data collection in 2019. RESULTS Overall, 2,258 people of 50 years and older participated in the study. The age- and gender- adjusted prevalence of bilateral blindness, severe and moderate visual impairment were 1.5% (95% CI: 1.0-2.1), 1.6% (95% CI: 1.0-2.2) and 6.6% (95% CI: 5.5-7.7), respectively.The main causes of blindness were cataract (43.9%) and glaucoma (17.1%). About 54.6% and 35.3% of participants had URE and uncorrected presbyopia, respectively. The prevalence of bilateral blindness and functional low vision increased with age and was the highest in participants 80 years and older. CONCLUSION The rate of bilateral blindness was comparable with findings from countries that share similar background and confirmed that untreated cataract was the main cause of blindness. Given that cataract blindness is avoidable, strategies should be developed aiming to further increase the volume and quality of cataract care in Armenia.
Collapse
Affiliation(s)
- Naira Khachatryan
- Garo Meghrigian Institute for Preventive Ophthalmology, Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Aida Giloyan
- Garo Meghrigian Institute for Preventive Ophthalmology, Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Ala Paduca
- Faculty of Medicine, State University of Medicine and Pharmacy "Nicolae Testemiteanu", Chişinău, Republic of Moldova
| | - Hans Limburg
- Health Information Services, Grootebroek, The Netherlands
| | - Varduhi Petrosyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| |
Collapse
|
2
|
Barraza-Bernal MJ, Ohlendorf A, Sanz Diez P, Feng X, Yang LH, Lu MX, Wahl S, Kratzer T. Prediction of refractive error and its progression: a machine learning-based algorithm. BMJ Open Ophthalmol 2023; 8:e001298. [PMID: 37793703 PMCID: PMC10551949 DOI: 10.1136/bmjophth-2023-001298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/07/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE Myopia is the refractive error that shows the highest prevalence for younger ages in Southeast Asia and its projection over the next decades indicates that this situation will worsen. Nowadays, several management solutions are being applied to help fight its onset and development, nonetheless, the applications of these techniques depend on a clear and reliable assessment of risk to develop myopia. METHODS AND ANALYSIS In this study, population-based data of Chinese children were used to develop a machine learning-based algorithm that enables the risk assessment of myopia's onset and development. Cross-sectional data of 12 780 kids together with longitudinal data of 226 kids containing age, gender, biometry and refractive parameters were used for the development of the models. RESULTS A combination of support vector regression and Gaussian process regression resulted in the best performing algorithm. The Pearson correlation coefficient between prediction and measured data was 0.77, whereas the bias was -0.05 D and the limits of agreement was 0.85 D (95% CI: -0.91 to 0.80D). DISCUSSION The developed algorithm uses accessible inputs to provide an estimate of refractive development and may serve as guide for the eye care professional to help determine the individual best strategy for management of myopia.
Collapse
Affiliation(s)
| | - Arne Ohlendorf
- Technology and Innovation, Carl Zeiss Vision International GmbH, Aalen, Germany
| | | | - Xiancai Feng
- Myopia Prevention and Management, Carl Zeiss Shanghai Co Ltd, Shanghai, China
| | - Li-Hua Yang
- Wuhan Center for Adolescent Poor Vision Prevention and Control, Wuhan, China
| | - Mei-Xia Lu
- Wuhan Commission of Experts for the Prevention and Control of Adolescent Poor Vision, Wuhan, China
| | | | - Timo Kratzer
- Technology and Innovation, Carl Zeiss Vision GmbH, Aalen, Germany
| |
Collapse
|
3
|
Xu B, Liu Z, Zhao J, Yu Z. Selenium intake help prevent age-related cataract formation: Evidence from NHANES 2001-2008. Front Nutr 2023; 10:1042893. [PMID: 36776608 PMCID: PMC9912772 DOI: 10.3389/fnut.2023.1042893] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 01/09/2023] [Indexed: 01/28/2023] Open
Abstract
Introduction Cataract is one of the leading causes of blindness and visual impairment, about 16 million people around the world. Trace elements play an important role in a variety of the processes in human body. This study aimed to investigate the association between daily dietary intake of trace elements and age-related cataract incidence based on data from the National Health and Nutrition Examination Survey (NHANES) 2001-2008. Methods Iron, zinc, copper, and selenium were conducted in this study among subjects aged 50 years and older for African Americans and 55 and older in US adults. Multivariate logistic regression analysis was used in different models to investigate the association of trace elements intake and cataract. Results After screening, 7,525 subjects were ultimately included in this study. A significant negative association was found between selenium intake and cataract incidence in adjusted models using multivariate logistic regression analysis (model 1: OR = 0.998, 95% CI = 0.997-1.000; model 2: OR = 0.997, 95% CI = 0.995-1.000; and model 3: OR = 0.998, 95% CI = 0.995-1.000). After dividing selenium intake into quintiles, significant negative associations between selenium intake and cataract were observed in the first quintile of model 3, the fourth and fifth quintiles of all models. In subgroup analyses adjusted for age and sex, a significant negative association was observed only in women aged 65-74 years. Discussion Our study points out that maintaining daily dietary selenium intake at higher levels is helpful for cataract prevention, and that increasing daily dietary selenium intake in American women aged 65-74 years may contribute to the prevention of age-related cataract. The intakes of iron, zinc, copper may not be associated with age-related cataract.
Collapse
Affiliation(s)
- Baiwei Xu
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China,Department of Ophthalmology, Eye Hospital of China Medical University, Shenyang, China,Key Lens Research Laboratory of Liaoning Province, Shenyang, China
| | - Zhongwei Liu
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China,Department of Ophthalmology, Eye Hospital of China Medical University, Shenyang, China,Key Lens Research Laboratory of Liaoning Province, Shenyang, China
| | - Jiangyue Zhao
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China,Department of Ophthalmology, Eye Hospital of China Medical University, Shenyang, China,Key Lens Research Laboratory of Liaoning Province, Shenyang, China,*Correspondence: Jiangyue Zhao,
| | - Ziyan Yu
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China,Department of Ophthalmology, Eye Hospital of China Medical University, Shenyang, China,Key Lens Research Laboratory of Liaoning Province, Shenyang, China,Ziyan Yu,
| |
Collapse
|
4
|
The Relationship between Nutrient Intake and Cataracts in the Older Adult Population of Korea. Nutrients 2022; 14:nu14234962. [PMID: 36500992 PMCID: PMC9739297 DOI: 10.3390/nu14234962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 11/24/2022] Open
Abstract
Cataracts are a prevalent ophthalmic disease worldwide, and research on the risk factors for cataracts occurrence is actively being conducted. This study aimed to investigate the relationship between nutrient intake and cataracts in the older adult population in Korea. We analyzed data from Korean adults over the age of 60 years (cataract: 2137, non-cataract: 3497) using the Korean National Health and Nutrition Examination Survey. We performed univariate simple and multiple logistic regressions, adjusting for socio-demographic, medical history, and lifestyle, to identify the associations between nutrient intake and cataracts. A higher intake of vitamin B1 in the male group was associated with a lower incidence of cataracts. A lower intake of polyunsaturated fatty acids and vitamin A, and a higher intake of vitamin B2 in the female group were associated with a higher incidence of cataracts. Our study demonstrated that polyunsaturated fatty acids, vitamin A, and vitamin B2 could affect the incidence of cataracts according to sex. The findings could be used to control nutrient intake for cataract prevention.
Collapse
|
5
|
Vision-related quality of life amongst patients with low vision and blindness in a resource-limited country. Int Ophthalmol 2022; 43:1291-1302. [PMID: 36175783 DOI: 10.1007/s10792-022-02527-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 09/11/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE To evaluate the significance of sociodemographic and clinical variables on the quality of life of low-vision patients in a tertiary hospital in Enugu, Nigeria, and also determine the causative ocular pathologies and their vision-related quality of life. METHODS A cross-sectional study of adults 18 years and above with low vision/blindness. They were consecutively enrolled and clinically evaluated. The WHO-NEI-VFQ-25 questionnaire for quality of life was administered. Descriptive statistics were used to summarize variables. Kruskal-Wallis test, analysis of variance, and post hoc tests were done where appropriate. RESULTS Of the 400 participants, 81% were above 40 years. Mean age was 57.27 ± 16.34 years. Males (52.0%) and females (48.0%). 225 (56.25%) had Moderately Severe Visual Impairment. Low vision/blindness negatively affected the different domains of quality of life significantly, except ocular pain and dependency. Glaucoma and Cataract were the major disease conditions that affected most of the domains significantly. These conditions when poorly managed, due to poor and limited health resources, progress to low vision/blindness. Of all the socio-demographic factors and clinical variables studied, only age and severity of low vision were significant predictors of quality of life. CONCLUSION There is the need for prompt and proper treatment of low-vision patients and advocacy for the establishment of adequate and functional rehabilitation services. Quality of life which measures the overall impact of a disease on an individual was low in people with low vision and blindness. Low-vision services, which include rehabilitation, will provide comprehensive eye-care services and thus improve their quality of life.
Collapse
|
6
|
Ramos PL, Santana R, Marques AP, Sousa I, Rocha-Sousa A, Macedo AF. Cross-sectional study investigating the prevalence and causes of vision impairment in Northwest Portugal using capture-recapture. BMJ Open 2022; 12:e056995. [PMID: 36691224 PMCID: PMC9462125 DOI: 10.1136/bmjopen-2021-056995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 07/06/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES The aim of this study was to estimate the prevalence and causes of vision impairment (VI) in Portugal. SETTING Information about people with VI was obtained from primary care centres, blind association (ACAPO) and from hospitals (the PCVIP study) in the Northwest of Portugal during a period spanning years 2014-2015. Causes of VI were obtained from hospitals. PARTICIPANTS Administrative and medical records of people with visual acuity in the better seeing eye of 0.5 decimal (0.30logMAR) or worse and/or visual field less than 20° were investigated. Capture-recapture with log-linear models was applied to estimate the number of individuals missing from lists of cases obtained from available sources. PRIMARY AND SECONDARY OUTCOME MEASURES Log-linear models were used to estimate the crude prevalence and the category specific prevalence of VI. RESULTS Crude prevalence of VI was 1.97% (95% CI 1.56% to 2.54%), and standardised prevalence was 1% (95% CI 0.78% to 1.27%). The age-specific prevalence was 3.27% (95% CI 2.36% to 4.90%), older than 64 years, 0.64% (95% CI 0.49% to 0.88%), aged 25-64 years, and 0.07% (95% CI 0.045% to 0.13%), aged less than 25 years. The female-to-male ratio was 1.3, that is, higher prevalence among females. The five leading causes of VI were diabetic retinopathy, cataract, age-related macular degeneration, glaucoma and disorders of the globe. CONCLUSIONS The prevalence of VI in Portugal was within the expected range and in line with other European countries. A significant number of cases of VI might be due to preventable cases and, therefore, a reduction of the prevalence of VI in Portugal seems possible. Women and old people were more likely to have VI and, therefore, these groups require extra attention. Future studies are necessary to characterise temporal changes in prevalence of VI in Portugal.
Collapse
Affiliation(s)
- Pedro Lima Ramos
- Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden
- Low Vision and Visual Rehabilitation Lab, Department and Center of Physics - Optometry and Vision Science, University of Minho, Braga, Portugal
| | - Rui Santana
- Escola Nacional Saude Publica, Comprehensive Health Research Centre Universidade Nova de Lisboa, Lisboa, Portugal
| | - Ana Patricia Marques
- Escola Nacional Saude Publica, Comprehensive Health Research Centre Universidade Nova de Lisboa, Lisboa, Portugal
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Ines Sousa
- Department of Mathematics and Applications and Center of Molecular and Environmental Biology, School of Sciences, University of Minho, Braga, Portugal
| | - Amandio Rocha-Sousa
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
- Department of ophthalmology, Centro Hospitalar e Universitário de São João, Porto, Portugal
| | - Antonio Filipe Macedo
- Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden
- Low Vision and Visual Rehabilitation Lab, Department and Center of Physics - Optometry and Vision Science, University of Minho, Braga, Portugal
| |
Collapse
|
7
|
Németh J, Daiki T, Dankovics G, Barna I, Limburg H, Nagy ZZ. Prevalence of refractive errors in Hungary reveals three-fold increase in myopia. Int J Ophthalmol 2022; 15:1174-1179. [PMID: 35919318 PMCID: PMC9318100 DOI: 10.18240/ijo.2022.07.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/21/2022] [Indexed: 11/23/2022] Open
Abstract
AIM To examine the prevalence and composition of refractive errors in Hungary. METHODS Nationwide cross-sectional data collected between 2014 and 2019 were analysed from the Comprehensive Health Screening Program of Hungary, which provided spectacle dioptric power and autorefractometry data for 68 227 people (35 850 women and 32 377 men). Their age distribution, 18-99y, was similar to the national demographic distributions. RESULTS Of the total population, 16.50% of the refractive errors exhibited hyperopia, 40.05% emmetropia, and 43.45% myopia. Myopia was 3 times more frequent (58.7%) in younger ages (18-35y of age) compared to older age groups (19.4% of those 56-70y of age; P<0.001). High myopia showed a low prevalence (0.21%), and an increase parallel with ageing (r=0.716; P=0.009). CONCLUSION Myopia is the most frequent refractive error in Hungary. The prevalence of myopia is especially increased, up to 2-3 times, in the younger age groups. Nationwide actions need to be taken to reduce the onset of myopia and its associated consequences.
Collapse
Affiliation(s)
- János Németh
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary
- Comprehensive Health Test Program of Hungary, Szentendre 2000, Hungary
| | - Tennó Daiki
- Comprehensive Health Test Program of Hungary, Szentendre 2000, Hungary
- Department of Media and Education Informatics, Eötvös Loránd University, Budapest 1053, Hungary
| | - Gergely Dankovics
- Comprehensive Health Test Program of Hungary, Szentendre 2000, Hungary
| | - István Barna
- Comprehensive Health Test Program of Hungary, Szentendre 2000, Hungary
- 1 Department of Internal Medicine, Semmelweis University, Budapest 1083, Hungary
| | - Hans Limburg
- Health Information Services, Grootebroek 1613LC, The Netherlands
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary
| |
Collapse
|
8
|
Wändell P, Li X, Carlsson AC, Sundquist J, Sundquist K. Incident cases of vision impairment and blindness among adult foreign-born and Swedish-born individuals: A national Swedish study. Eur J Ophthalmol 2022; 32:1915-1923. [PMID: 35354335 DOI: 10.1177/11206721221090700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To analyse risk of vision impairment (VI) and blindness in adult foreign-born individuals and Swedish-born individuals. METHODS A nationwide study of individuals 18 years of age and older (N = 6,042,891; 2,902,918 men and 3,139,973 women) in Sweden. VI (in general) and blindness was defined as at least one registered diagnosis in the National Patient Register between January 1, 1998 and December 31, 2015. Cox regression analysis was used to estimate the relative risk (hazard ratios (HR) with 95% confidence intervals (CI)) of incident VI in foreign-born compared to Swedish-born individuals. The Cox regression models were stratified by sex and adjusted for age, co-morbidities, and for sociodemographic status. RESULTS A total of 14,597 cases (6433 men and 8164 women) of VI were registered, with an age-standardized incidence per 100,000 person-years of 10.37 in men and 11.03 in women. VI (in general) was more common in immigrants, fully adjusted HRs (95% CI) were for immigrant men 1.38 (95% CI, 1.29-1.48) and women 1.24 (95% CI, 1.16-1.32), with significantly higher HRs among men and women from Eastern Europe, Africa, Latin America and Asia. Higher risks of blindness were also seen for immigrant men, HR 1.75 (95% CI 1.36-2.25), as well as for the other degrees of VI among immigrant men, HR 1.36 (95% CI 1.26-1.47), and immigrant women, HR 1.26 (95% CI 1.18-1.35). CONCLUSIONS We observed a generally higher risk of VI among foreign-born men and women, especially from some regions.
Collapse
Affiliation(s)
- Per Wändell
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, 27106Karolinska Institutet, Huddinge, Sweden.,Center for Primary Health Care Research, 5193Lund University, Malmö, Sweden
| | - Xinjun Li
- Center for Primary Health Care Research, 5193Lund University, Malmö, Sweden
| | - Axel C Carlsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, 27106Karolinska Institutet, Huddinge, Sweden.,Academic Primary Health Care Centre, Stockholm Region, Stockholm, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, 5193Lund University, Malmö, Sweden.,Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA.,Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan
| | - Kristina Sundquist
- Center for Primary Health Care Research, 5193Lund University, Malmö, Sweden.,Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA.,Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan
| |
Collapse
|
9
|
Reis TF, Paula JS, Furtado JM. Primary glaucomas in adults: Epidemiology and public health-A review. Clin Exp Ophthalmol 2022; 50:128-142. [PMID: 35037725 DOI: 10.1111/ceo.14040] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/26/2021] [Accepted: 12/27/2021] [Indexed: 12/19/2022]
Abstract
Glaucoma is a mixed group of optic neuropathies that lead to irreversible visual field loss and blindness if left untreated. It is estimated that 3.5% of the global population aged 40 to 80 years have any glaucoma, being the primary open-angle and the primary angle-closure glaucoma the most prevalent forms. Although the age-standardised prevalence of blindness caused by glaucoma has decreased substantially over the last decades, population growth and ageing impose many challenges in preventing glaucoma-related morbidities on a global level. In addition, difficulties in diagnoses and treatment, along with its chronic and irreversible nature, urge the development and implementation of innovative approaches in confronting the disease. This manuscript reviews recent literature related to the epidemiology of primary glaucomas in adults, the risk factors attributed to the development of the disease, and discuss challenges and potential solutions from a public health perspective.
Collapse
Affiliation(s)
- Tulio F Reis
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Jayter S Paula
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - João M Furtado
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| |
Collapse
|
10
|
Reis T, Lansingh V, Ramke J, Silva JC, Resnikoff S, Furtado JM. Cataract as a Cause of Blindness and Vision Impairment in Latin America: Progress Made and Challenges Beyond 2020. Am J Ophthalmol 2021; 225:1-10. [PMID: 33412124 DOI: 10.1016/j.ajo.2020.12.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To provide an update of cataract as a cause of vision loss in Latin America and to analyze sex inequalities in cataract surgical coverage (CSC) and effective CSC (eCSC) in the region. DESIGN Population-based systematic review with longitudinal comparisons. METHODS The Latin American and Caribbean Health Sciences Literature (LILACS) and PubMed databased were searched for population-based studies reporting cataract blindness, surgical coverage, and outcomes published between January 2014 and December 2019. Information on the number of surgeries performed from the 2014-2016 period was obtained from ministries of health and was used for calculation of the cataract surgical rate (CSR). Sources such as Rapid Assessment of Avoidable Blindness (RAAB) and Rapid Assessment of Cataract Surgical Services data were reanalyzed to calculate sex inequality in CSC and eCSC by subtracting the rate in women from the rate in men. RESULTS Cataract was the cause of 29.8%-77.6% of cases of blindness in the included studies; the CSR improved in 10 countries. The CSC pinhole visual acuity of 3/60 varied from 24.1% in Peru to 97.1% in Argentina, and the median absolute gender inequality CSC pinhole visual acuity 3/60 was -0.7%. The eCSC pinhole visual acuity 3/60 varied from 14.8% in Guatemala to 92.1% in Argentina, and the median absolute gender inequality eCSC pinhole visual acuity 3/60 was -0.8%. CONCLUSIONS Cataract remains a leading cause of blindness in Latin America. Coverage is suboptimal, and surgical results are also below target levels in many countries. Incentives for a better distribution of human resources, adequate training of ophthalmologists, and the inclusion of vision services in universal health care coverage could reduce the burden of cataract in Latin America.
Collapse
Affiliation(s)
- Tulio Reis
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Van Lansingh
- HelpMeSee, New York City, New York, USA; Instituto Mexicano de Oftalmología, Queretaro, Mexico
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Juan Carlos Silva
- Eye Care Program, Pan-American Health Organization, Bogotá, Colombia
| | - Serge Resnikoff
- Brien Holden Vision Institute and School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - João M Furtado
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| |
Collapse
|
11
|
Pék A, Szabó D, Sándor GL, Tóth G, Papp A, Nagy ZZ, Limburg H, Németh J. Relationship between diabetes mellitus and cataract in Hungary. Int J Ophthalmol 2020; 13:788-793. [PMID: 32420227 DOI: 10.18240/ijo.2020.05.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 12/07/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To examine the coexistence of diabetes mellitus (DM) and cataract in Hungary. The effects of DM on the cataract surgical results were also in the focus of analysis. METHODS Statistical data analysis of the results of the Rapid Assessment of Avoidable Blindness with Diabetic Retinopathy (RAAB+DR) module conducted in Hungary in 2015. This cross-sectional, population-based, national survey included 3523 people aged 50 years and over. Participants of the survey were examined on-site. Visual acuity, main cause for visual impairment (using direct and indirect ophthalmoscopes), in case of best corrected visual acuity (BCVA) ≤0.5 and blood glucose level (random test with glucometer) were examined. RESULTS The prevalence of cataract was 23.4%, and DM was 20.0%. The occurrence of cataract steadily increased with age. Among the examined participants with DM, the prevalence of cataract was significantly (P=0.012) higher (+35%) than that in non-diabetic subjects (29.5% vs 21.8%). Following aging (OR=15.2%, P<0.001), DM proved to be the most independent influencing risk factor (OR=49.9%, P<0.001). The presence of DM was neither an influencing factor for complications of cataract surgery, nor for postoperative visual acuity. CONCLUSION DM appears to be one of the main risk factors for developing cataract. Other risk factors, such as age, sex and environment also play an influencing role. Diabetes does not seem to affect the occurrence of cataract surgical complications.
Collapse
Affiliation(s)
- Anita Pék
- Department of Ophthalmology, Semmelweis University, Mária u. 39., Budapest 1085, Hungary.,Department of Ophthalmology, Petz Aladár Hospital, Vasvári Pál u. 2-4., Győr 9023, Hungary
| | - Dorottya Szabó
- Department of Ophthalmology, Semmelweis University, Mária u. 39., Budapest 1085, Hungary
| | - Gábor László Sándor
- Department of Ophthalmology, Semmelweis University, Mária u. 39., Budapest 1085, Hungary
| | - Gábor Tóth
- Department of Ophthalmology, Semmelweis University, Mária u. 39., Budapest 1085, Hungary
| | - András Papp
- Department of Ophthalmology, Semmelweis University, Mária u. 39., Budapest 1085, Hungary
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Mária u. 39., Budapest 1085, Hungary
| | - Hans Limburg
- Health Information Services, Nijenburg 32, LC1613 Grootebroek, the Netherlands
| | - János Németh
- Department of Ophthalmology, Semmelweis University, Mária u. 39., Budapest 1085, Hungary
| |
Collapse
|
12
|
Sándor GL, Tóth G, Szabó D, Szalai I, Lukács R, Pék A, Tóth GZ, Papp A, Nagy ZZ, Limburg H, Németh J. Cataract blindness in Hungary. Int J Ophthalmol 2020; 13:438-444. [PMID: 32309181 DOI: 10.18240/ijo.2020.03.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 06/21/2019] [Indexed: 01/09/2023] Open
Abstract
AIM To estimate the prevalence of blindness and visual impairment resulting from cataract in the population aged ≥50y in Hungary, and to assess the cataract surgical services. METHODS A rapid assessment of avoidable blindness (RAAB) was conducted. A total of 3523 eligible people were randomly selected and examined. Each participant underwent surgery for cataract was interviewed with regard to the year, place, and costs of the surgery. Participants with obvious cataract were asked why they had not yet undergone surgery (barriers to surgery). RESULTS An estimated 12 514 people were bilaterally blind; the visual acuity (VA) in 19 293 people was <6/60, and the VA in 73 962 people was <6/18 in the better eye due to cataract. An estimated 77 933 eyes are blind; 98 067 eyes had a VA of <6/60, and an estimated 277 493 eyes had a VA of <6/18 due to cataract. Almost all cataract surgeries were conducted in government hospitals. The age- and sex-adjusted cataract surgical coverage with VA<3/60 in eyes was 90.0%. The rate of good visual outcome after surgery was 79.5%. Ocular comorbidity was the main cause of poor outcome (78.1%), followed by late complications (such as posterior capsule opacification) (17.2%), inadequate optical correction (3.1%), and surgical complications (1.6%). The main barrier to surgery in people with bilateral cataract and VA of <6/60 was 'need not felt'. CONCLUSION The prevalence of visual impairment resulting from cataract is slightly higher than expected. The quality of the cataract surgical service seems adequate in Hungary. However, the number of cataract operations per year should continue to increase due to the increasing patient demands and the aging population.
Collapse
Affiliation(s)
- Gábor L Sándor
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary
| | - Gábor Tóth
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary
| | - Dorottya Szabó
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary
| | - Irén Szalai
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary
| | - Regina Lukács
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary.,Department of Ophthalmology, Flór Ferenc Hospital, Kistarcsa 2143, Hungary
| | - Anita Pék
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary.,Department of Ophthalmology, Petz Aladár Hospital, Győr 9024, Hungary
| | - Georgina Z Tóth
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary
| | - András Papp
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary
| | - Zoltán Z Nagy
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary.,Faculty of Health Sciences, Semmelweis University, Budapest 1088, Hungary
| | - Hans Limburg
- Health Information Services, Grootebroek 1613, The Netherlands
| | - János Németh
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary
| |
Collapse
|
13
|
Tóth G, Szabó D, Sándor GL, Szepessy Z, Barsi Á, Nagy ZZ, Limburg H, Németh J. Rural–urban disparities in the prevalence of diabetes and diabetic eye complications in Hungary. SPEKTRUM DER AUGENHEILKUNDE 2019. [DOI: 10.1007/s00717-019-00433-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Summary
Background
To examine the rural–urban differences in the prevalence of diabetes mellitus (DM) and diabetic retinopathy (DR) in the population aged 50 years and older in Hungary.
Methods
105 clusters of 35 people aged 50 years or older were randomly selected. Standardized rapid assessment of avoidable blindness (RAAB) with the diabetic retinopathy module was performed. Participants were classified as diabetic if they had a previous diagnosis of DM or a random blood glucose level ≥200 mg/dl. Each individual with DM who agreed underwent dilated fundus examination and DR grading.
Results
The prevalence of DM was higher in rural (21.8%) than in urban (18.6%) areas (p = 0.016). The prevalence of DR did not differ significantly between rural and urban areas in DM cases. Blindness (0.9% vs. 0.1%; p = 0.048) and blindness due to DM (0.3% vs. 0.0%; p = 0.021) in diabetic participants was significantly more common in rural than in urban areas. Diabetic eye screening coverage was significantly lower in rural than in urban areas (p ≤ 0,007).
Conclusion
Based on our results and the high rate of blindness and blindness due to DR in rural areas, primary eye care should be improved and a telemedical eye screening program should be undertaken, especially concentrating on rural areas.
Collapse
|
14
|
Németh J, Tóth G, Resnikoff S, de Faber JT. Preventing blindness and visual impairment in Europe: What do we have to do? Eur J Ophthalmol 2018; 29:129-132. [PMID: 30572715 DOI: 10.1177/1120672118819397] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Severe visual impairment and blindness are significant public health problems worldwide. Four-fifths of cases of blindness can be prevented or cured. The World Health organisation's 'Universal Eye Health: A Global Action Plan 2014-2019' and the European Society of Ophthalmology's Pilot Committee on Public Eye Health are aiming to decrease the prevalence of blindness in Europe and around the world. Starting discussions addressing possible actions and advocacies to improve current circumstances in public eye health is a common task of ophthalmologists and public health specialists in Europe.
Collapse
Affiliation(s)
- János Németh
- 1 Department of Ophthalmology, Semmelweis University, Budapest, Hungary.,2 The International Agency for the Prevention of Blindness, London, UK
| | - Gábor Tóth
- 1 Department of Ophthalmology, Semmelweis University, Budapest, Hungary.,2 The International Agency for the Prevention of Blindness, London, UK
| | - Serge Resnikoff
- 3 Brien Holden Vision Institute, Sydney, NSW, Australia.,4 SOVS, University of New South Wales, Sydney, NSW, Australia
| | | |
Collapse
|
15
|
Tóth G, Szabó D, Sándor GL, Nagy ZZ, Karadeniz S, Limburg H, Németh J. Diabetes and blindness in people with diabetes in Hungary. Eur J Ophthalmol 2018; 29:141-147. [PMID: 30458640 DOI: 10.1177/1120672118811738] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION: The purpose of the study was to estimate the number of people with diabetes mellitus, the prevalence of diabetes mellitus and the prevalence of blindness and severe visual impairment among people with diabetes mellitus in Hungary based on our recent national representative survey. METHODS: Altogether 105 clusters of 35 people aged 50 years or older were randomly selected. Standardized rapid assessment of avoidable blindness with the diabetic retinopathy module was used. Each individual received a visual acuity assessment, and every person with diabetes mellitus underwent dilated fundus examination. RESULTS: The estimated number of people with diabetes mellitus was 807,885 in the adult (⩾18 years) population in Hungary with 9.9% prevalence. Diabetic retinopathy exhibited an increasing tendency with age. The prevalence rates of blindness and severe visual impairment in people with diabetes mellitus aged ⩾50 years were 1.0% and 0.9%, respectively. Diabetic retinopathy was responsible for 28% of blindness and 50% of severe visual impairment among participants aged ⩾50 years with diabetes mellitus. CONCLUSION: The estimated number of people with diabetes mellitus and prevalence of diabetes mellitus were lower than those recently reported. However, if we extend our estimation, prevalence of undiagnosed diabetes mellitus may be higher and thus prevalence of diabetes mellitus may reach a higher value (between 9.9% and 13.4%). Because of the high number of ophthalmologically uncontrolled diabetic eyes and high rate of blindness due to diabetic retinopathy, primary eye care should be improved, and a nationwide telemedical eye-screening programme should be undertaken.
Collapse
Affiliation(s)
- Gábor Tóth
- 1 Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Dorottya Szabó
- 1 Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Gábor L Sándor
- 1 Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Zoltán Z Nagy
- 1 Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Sehnaz Karadeniz
- 2 Department of Ophthalmology, Istanbul Florence Nightingale Hospital, Istanbul, Turkey
| | - Hans Limburg
- 3 Health Information Services, Grootebroek, The Netherlands
| | - János Németh
- 1 Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| |
Collapse
|
16
|
Baarah BT, Shatnawi RA, Khatatbeh AE. Causes of Permanent Severe Visual Impairment and Blindness among Jordanian Population. Middle East Afr J Ophthalmol 2018; 25:25-29. [PMID: 29899647 PMCID: PMC5974814 DOI: 10.4103/meajo.meajo_202_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To report the causes of permanent severe visual impairment and blindness among Jordanian blind people. MATERIALS AND METHODS This study was conducted on 1422 legally blind or worse vision people of all ages who attended the ophthalmic division of a medical committee for evaluation of disabled persons from July 2013 through November 2014. They were divided into two age groups: adult group (998 cases) and childhood group (<16 years, 424 cases). Patients presented reports from their ophthalmologists detailing their eye examination including best-corrected visual acuity, slit-lamp examinations, and if applicable, intraocular pressure, dilated ophthalmoscopy, and visual field and the primary cause of visual impairment. Blind defined as best-corrected visual acuity < 6/60 (20/200) and/or visual field of 20° or less. RESULTS Retinitis pigmentosa was the most common cause of blindness among adult group (29.7%) followed by diabetic retinopathy (19.9%) and glaucoma (15.8%). Congenital whole-globe malformations were the most common cause of blindness among childhood cases (16.7%) followed by retinopathy of prematurity (ROP) (15.8%) and retinal dystrophies (13.9%). Overall, blindness related to genetic diseases, illnesses, and trauma was present at 56.5% (803), 41.7% (593), and 1.8% (26) of cases, respectively. CONCLUSIONS Genetic diseases such as retinitis pigmentosa, diabetic retinopathy, and glaucoma were the dominant causes of blindness among adults, while whole-globe malformation, ROP, and retinal dystrophies were the dominant causes of childhood blindness. These major causes of blindness should be considered in future public health and nongovernmental organizations strategies for blindness prevention in Jordan.
Collapse
Affiliation(s)
| | - Raed Ali Shatnawi
- Department of General and Special Surgery, Hashemite University, Zarka, Jordan
| | | |
Collapse
|
17
|
Németh J, Szabó D, Tóth G, Sándor G, Lukács R, Pék A, Szalai I, Papp A, Resnikoff S, Limburg H. Feasibility of the rapid assessment of avoidable blindness with diabetic retinopathy module (RAAB+DR) in industrialised countries: challenges and lessons learned in Hungary. Ophthalmic Epidemiol 2018; 25:273-279. [PMID: 29431547 DOI: 10.1080/09286586.2018.1438634] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE To present experiences gained during the planning, implementation, and practical performance of the rapid assessment of avoidable blindness with diabetic retinopathy module (RAAB+DR) in an established market economy. METHODS A total of 3523 people aged 50 years or older were examined at their homes in 105 randomly selected clusters in Hungary. During the 4-month-long field work, five teams visited the clusters. Each team was composed of a senior ophthalmic resident or eye specialist, a nurse, an assistant, a driver, and a local guide. The local guides were found through local mayors of the towns or villages or other local leaders. RESULTS Of all 105 clusters, 41% were completed in 1 day and 59% required a longer stay. The shortest daily examination time was 3.5 hours and the longest was 10 hours. Altogether, 7.6% of the enumeration areas needed revisit, mainly due to insufficient preparatory work and absence of the subjects. The best local guides were the local government workers, health visitors, and general practitioner (GP) nurses. Refusal of pupillary dilatation was relatively high and varied greatly among the study groups (7.7-43.8%). CONCLUSION The performance of a RAAB+DR study in a well-industrialised country is difficult, but may be successful. The most critical factor for success is an excellent local guide who is able to achieve participation of the people. The results of the RAAB are a solid basis for the development of a national programme for universal eye health and to prepare active media campaigns.
Collapse
Affiliation(s)
- János Németh
- a Department of Ophthalmology , Semmelweis University , Budapest , Hungary
| | - Dorottya Szabó
- a Department of Ophthalmology , Semmelweis University , Budapest , Hungary
| | - Gábor Tóth
- a Department of Ophthalmology , Semmelweis University , Budapest , Hungary
| | - Gábor Sándor
- a Department of Ophthalmology , Semmelweis University , Budapest , Hungary
| | - Regina Lukács
- a Department of Ophthalmology , Semmelweis University , Budapest , Hungary.,b Department of Ophthalmology , Flór Ferenc Hospital , Budapest , Hungary
| | - Anita Pék
- a Department of Ophthalmology , Semmelweis University , Budapest , Hungary.,c Department of Ophthalmology , Petz Aladár Hospital , Győr , Hungary
| | - Irén Szalai
- a Department of Ophthalmology , Semmelweis University , Budapest , Hungary
| | - András Papp
- a Department of Ophthalmology , Semmelweis University , Budapest , Hungary
| | - Serge Resnikoff
- d Brien Holden Vision Institute and SOVS , University of New South Wales , Sydney , NSW , Australia
| | - Hans Limburg
- e Health Information Services , Grootebroek , The Netherlands
| |
Collapse
|