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Hashemi A, Khabazkhoob M, Hashemi H. High prevalence of refractive errors in an elderly population; a public health issue. BMC Ophthalmol 2023; 23:38. [PMID: 36707798 PMCID: PMC9881344 DOI: 10.1186/s12886-023-02791-x] [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: 08/02/2022] [Accepted: 01/20/2023] [Indexed: 01/28/2023] Open
Abstract
PURPOSE To determine the prevalence of myopia and hyperopia and their associated demographic and ocular factors in people 60 years of age and above. METHODS The sampling was performed using a multi-stage stratified random cluster sampling method. The complete demographic and case history information were collected through an interview. Then, all participants underwent optometric examinations including measurement of uncorrected and best-corrected visual acuity, objective, and subjective refraction. Myopia and hyperopia were defined as a spherical equivalent (SE) refraction worse than -0.50 diopters (D) and + 0.50 D, respectively. RESULTS Three thousand three hundred ten of 3791 invitees participated, and the data of 3263 individuals were analyzed for this report. The mean age of participants was 68.25 ± 6.53 (60 to 97) years, and 1895 (58.1%) of them were female (number of male/female participants = 1368/1895). The prevalence of myopia and hyperopia was 31.65% (95% CI: 29.68 -33.61) and 45.36% (95% CI: 43.36 -47.37), respectively. The prevalence of severe myopia and hyperopia was 1.14% (95% CI: 0.73 -1.55) and 2.27% (95% CI: 1.57 -2.97), respectively. Based on the results of multiple logistic regression, the prevalence of myopia had a statistically significant direct relationship with age (OR: 1.04; p < 0.001), history of glaucoma surgery (OR:2.75; p < 0.001), pseudophakia (OR: 2.27; p < 0.001), axial length (OR:3.05; p < 0.001), and mean keratometry (OR:1.61; p < 0.001). The education level was significantly inversely related to the myopia prevalence. Moreover, a history of glaucoma surgery (OR:0.44; p < 0.001), pseudophakia (OR = 0.15; p < 0.001), axial length (OR:35; p < 0.001) and mean keratometry (OR:0.62; p < 0.001) were significantly inversely related to the prevalence of hyperopia. 19% and 40.02% of myopic and hyperopic patients had complete visual acuity after correction of refractive error, respectively. CONCLUSION The prevalence of refractive errors was high in the Iranian elderly population. A large percentage of the elderly still did not have complete visual acuity after the correction of refractive errors indicating the necessity for attention to other ocular diseases in this age group. The history of cataract and glaucoma surgery could be associated with a myopic shift of refractive error.
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Affiliation(s)
- Alireza Hashemi
- grid.416362.40000 0004 0456 5893Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- grid.411600.2Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Hashemi
- grid.416362.40000 0004 0456 5893Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
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Ye L, Yang YQ, Zhang GY, Wang WJ, Ren MX, Ge P, Zhang J, Zhang N, Liu XZ, Zhang ML, Tong YJ, Lu LC, Lv MQ, Zhou DX, Pei C. Increasing prevalence of myopia and the impact of education in primary-school students in Xi'an, north-western of China. Front Public Health 2022; 10:1070984. [PMID: 36600934 PMCID: PMC9806175 DOI: 10.3389/fpubh.2022.1070984] [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: 10/15/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
Purpose The present study was performed to detect the prevalence of myopia among primary-school students in Xi'an, north-western of China. Methods The present study was a school-based study with students aged from 6 to 13 years old. All the individuals underwent ophthalmological examination and spherical equivalent (SE) of refractive error were measured with non-cycloplegic refraction. Myopia was defined as a SE of ≤ -0.5 diopters (D), and further divided into three stratified groups based on SE: low myopia (≤ -0.5 to >-3.0 D), moderate myopia (≤ -3.0 to >-6.0 D), and high myopia (≤ -6.0 D). Relative risk factors, including age, sex, grade and ethnicity were investigated using questionnaire. Results A total of 4,680 individuals were eligible for this survey and 4,654 (99.4% participation rate) were finally included (51.2% boys). The mean age of participants was 8.756 ± 1.727 years. The whole city-level prevalence of total myopia was 57.1% (95% CI: 55.7-58.6%). Additionally, the prevalence of low, moderate, and high myopia was 45.0% (95% CI: 43.5-46.4%), 11.1% (95% CI: 10.2-12.0%), and 1.0% (95% CI: 0.7-1.3%), respectively. Moreover, grade (education level) instead of age, sex and ethnicity was the most essential risk factor for prevalence of overall myopia (OR = 1.844, 95% CI: 1.605-2.119), and an increase of prevalence by 84.4% per grade was seen. Furthermore, similar associations of grade were significant with low myopia (OR = 1.613, 95% CI: 1.385-1.877) and moderate myopia (OR = 2.186, 95% CI: 1.693-2.823), meanwhile, prevalence of low myopia and moderate myopia demonstrated an increase of prevalence by 61.3 and 118.6% per grade, respectively. None of the factors included in the present study was significant risk factor for high myopia. Conclusions The present study investigated a non-negligible high prevalence of myopia among primary-school students in Xi'an, north-western of China, and a gradual increasing in proportion with education level.
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Affiliation(s)
- Lu Ye
- Health Science Center, Xi'an Jiaotong University, Xi'an, China,Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China
| | - Yan-qi Yang
- Department of Pathology, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Guo-yun Zhang
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China
| | - Wen-jun Wang
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China
| | - Mei-xia Ren
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China
| | - Pan Ge
- Department of Pathology, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Jian Zhang
- Department of Pathology, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Nan Zhang
- Department of Pathology, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Xing-zhou Liu
- Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Ming-lei Zhang
- Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yu-jiao Tong
- Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Liang-cai Lu
- Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Mo-qi Lv
- Department of Pathology, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, China,*Correspondence: Mo-qi Lv
| | - Dang-xia Zhou
- Department of Pathology, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, China,Dang-xia Zhou
| | - Cheng Pei
- Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China,Cheng Pei
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Xie Z, Long Y, Wang J, Li Q, Zhang Q. Prevalence of myopia and associated risk factors among primary students in Chongqing: multilevel modeling. BMC Ophthalmol 2020; 20:146. [PMID: 32295555 PMCID: PMC7161106 DOI: 10.1186/s12886-020-01410-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 03/30/2020] [Indexed: 02/08/2023] Open
Abstract
Background The prevalence of myopia and associated risk factors among children in Chongqing has not yet been determined. This study investigated the prevalence of myopia and possible relationships between myopia and several related factors among school children in Chongqing. Methods This cross-sectional study assessed a sample of 997 children (7–13 years of age) attending primary school in Chongqing. Data were obtained from visual acuity and refractive error measurements and a structured questionnaire. Myopia was defined as visual acuity < 5.0 and refractive error (spherical equivalent) of < − 0.50 diopters (D) in either eye. Multilevel modeling was applied to investigate potential risk factors. Results The overall prevalence of myopia was 33.9% [95% confidence interval (CI) = 31.0–36.8]; myopia prevalence significantly increased with age. Girls were at a higher risk of myopia than boys [odds ratio (OR) = 1.449, 95% CI = 1.060–1.979]. Children with paternal myopia (OR = 2.130, 95% CI = 1.376–3.297) or maternal myopia (OR = 1.861, 95% CI =1.153–3.002) had a higher risk of myopia than those without myopic parents. Children who spent more than 1 h daily outdoors were less likely to have myopia; meanwhile, children who did homework more than 3 h daily (OR = 2.237, 95% CI = 1.041–4.804), watched television more than 3 h daily (OR = 2.106, 95% CI = 1.200–3.697), or played electronics more than 1 h daily (OR = 2.983, 95% CI = 2.088–4.262) had a higher risk of myopia. Conclusions Myopia in school children is a serious public health problem in Chongqing. Myopia was significantly positively associated with higher age, female sex, parental myopia, and spending a long time indoors; notably, playing with electronics had the greatest influence on the risk of myopia.
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Affiliation(s)
- Zhihao Xie
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, #16, Section 3, Renmin Nan Lu, Chengdu, Sichuan, 610041, People's Republic of China
| | - Yue Long
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Jingxuan Wang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, #16, Section 3, Renmin Nan Lu, Chengdu, Sichuan, 610041, People's Republic of China
| | - Qiaoqiao Li
- School of Education, Soochow University, Suzhou, China
| | - Qiang Zhang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, #16, Section 3, Renmin Nan Lu, Chengdu, Sichuan, 610041, People's Republic of China.
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Hashemi H, Pakzad R, Ali B, Yekta A, Ostadimoghaddam H, Heravian J, Yekta R, Khabazkhoob M. Prevalence of Refractive Errors in Iranian University Students in Kazerun. J Curr Ophthalmol 2020; 32:75-81. [PMID: 32510017 PMCID: PMC7265272 DOI: 10.1016/j.joco.2018.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 05/23/2018] [Accepted: 08/03/2018] [Indexed: 01/30/2023] Open
Abstract
Purpose: To determine the prevalence of refractive errors and visual impairment and the correlation between personal characteristics, including age, sex, weight, and height, with different types of refractive errors in a population of university students in the south of Iran. Methods: In this cross-sectional study, a number of university majors were selected as clusters using multi-stage sampling in all universities located in Kazerun (27 clusters of 133 clusters). Then, proportional to size, a number of students in each major were randomly selected to participate in the study. Uncorrected and corrected visual acuity, non-cycloplegic objective refraction and subjective refraction were measured in all participants. Results: The prevalence and 95% confidence interval (CI) of presenting visual impairment and blindness was 2.19% (1.48–3.23) and 0.27% (0.12–0.62), respectively. Refractive errors comprised 75% of the causes of visual impairment. The prevalence (95% CI) of myopia [spherical equivalent (SE) ≤ –0.5 D], hyperopia (SE ≥ 0.5 D), and astigmatism (cylinder power < –0.5 D) was 42.71% (39.71–45.77), 3.75% (2.85–4.51), and 29.46% (27.50–31.50), respectively. Totally, 49.03% (46.39–51.68) of the participants had at least one type of refractive error. There was a positive association between weight and myopia (1.01; 95% CI: 1.01–1.02), anisometropia (1.03; 95% CI: 1.01–1.06), and refractive errors (1.01; 95% CI: 1.01–1.02). In comparison with the age group 18–19 years, the odds ratio (OR) of astigmatism in the age group 26–27 years was 1.64 (95% CI: 1.03–2.61), and the OR of anisometropia in the age group ≥ 30 years was 0.21 (95% CI: 0.04–0.98). Conclusions: The prevalence of refractive errors, especially myopia, is higher in university students than the general population. Since refractive errors constitute a major part of visual impairment, university students should receive special services for providing corrective lenses and glasses to reduce the burden of these disorders.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Reza Pakzad
- Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Babak Ali
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbasali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Ostadimoghaddam
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Javad Heravian
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reyhaneh Yekta
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Keshavarz K, Angha P, Sayehmiri F, Sayemiri K, Yasemi M. The prevalence of visual disorders in Iranian students: A meta-analysis study and systematic review. Electron Physician 2017; 9:5516-5524. [PMID: 29238492 PMCID: PMC5718856 DOI: 10.19082/5516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 07/12/2017] [Indexed: 11/20/2022] Open
Abstract
Background Visual defects have dramatic effects on health, self-esteem, and educational function of students, and delayed diagnosis will cause complications, like academic failure and psychologic disorders. Objective The present study aimed to investigate the prevalence of ocular disorders in Iranian students in a systematic review. Methods We searched databases, including PubMed, SID, Magiran, Google Scholar, and Iranmedex using the following keywords in Persian and English: disorders, vision, amblyopia, refractive errors, astigmatism, student, and Iran with all the possible combinations, important, chief, and sensitive words. Search resulted in 28 articles, conducted during a period from 1996 to 2014 in Iran and their data was analyzed using meta-analysis and random effects model. Heterogeneity of studies was assessed using I2 index, and data was finally analyzed with R Software and STATA (Version 11.2). Results Total number of subjects in the study was 1,117,274, aged 2 to 18 years. The prevalence of disorders related to amblyopia, refractive error, and strabismus was 8%, 7% and 1%, respectively. The greatest amount of refractive error was related to astigmatism (19%) followed by myopia (17%). Conclusion According to the study results, the prevalence of visual disorders among Iranian students indicated the critical necessity of screening programs for prevention of visual disorders in this age group.
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Affiliation(s)
- Kambiz Keshavarz
- MD, Pediatrician, Assistant Professor of Pediatrics, Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Parvin Angha
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Fatemeh Sayehmiri
- PhD, Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kourosh Sayemiri
- PhD of Biological Statistic, Research Center of Prevention of Psychosocial Disorder, Ilam University of Medical Sciences, Ilam, Iran
| | - Masood Yasemi
- MD, Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Global and regional estimates of prevalence of refractive errors: Systematic review and meta-analysis. J Curr Ophthalmol 2017; 30:3-22. [PMID: 29564404 PMCID: PMC5859285 DOI: 10.1016/j.joco.2017.08.009] [Citation(s) in RCA: 209] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 08/01/2017] [Accepted: 08/24/2017] [Indexed: 11/22/2022] Open
Abstract
Purpose The aim of the study was a systematic review of refractive errors across the world according to the WHO regions. Methods To extract articles on the prevalence of refractive errors for this meta-analysis, international databases were searched from 1990 to 2016. The results of the retrieved studies were merged using a random effect model and reported as estimated pool prevalence (EPP) with 95% confidence interval (CI). Results In children, the EPP of myopia, hyperopia, and astigmatism was 11.7% (95% CI: 10.5–13.0), 4.6% (95% CI: 3.9–5.2), and 14.9% (95% CI: 12.7–17.1), respectively. The EPP of myopia ranged from 4.9% (95% CI: 1.6–8.1) in South–East Asia to 18.2% (95% CI: 10.9–25.5) in the Western Pacific region, the EPP of hyperopia ranged from 2.2% (95% CI: 1.2–3.3) in South-East Asia to 14.3% (95% CI: 13.4–15.2) in the Americas, and the EPP of astigmatism ranged from 9.8% in South-East Asia to 27.2% in the Americas. In adults, the EPP of myopia, hyperopia, and astigmatism was 26.5% (95% CI: 23.4–29.6), 30.9% (95% CI: 26.2–35.6), and 40.4% (95% CI: 34.3–46.6), respectively. The EPP of myopia ranged from 16.2% (95% CI: 15.6–16.8) in the Americas to 32.9% (95% CI: 25.1–40.7) in South-East Asia, the EPP of hyperopia ranged from 23.1% (95% CI: 6.1%–40.2%) in Europe to 38.6% (95% CI: 22.4–54.8) in Africa and 37.2% (95% CI: 25.3–49) in the Americas, and the EPP of astigmatism ranged from 11.4% (95% CI: 2.1–20.7) in Africa to 45.6% (95% CI: 44.1–47.1) in the Americas and 44.8% (95% CI: 36.6–53.1) in South-East Asia. The results of meta-regression showed that the prevalence of myopia increased from 1993 (10.4%) to 2016 (34.2%) (P = 0.097). Conclusion This report showed that astigmatism was the most common refractive errors in children and adults followed by hyperopia and myopia. The highest prevalence of myopia and astigmatism was seen in South-East Asian adults. The highest prevalence of hyperopia in children and adults was seen in the Americas.
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Li Y, Liu J, Qi P. The increasing prevalence of myopia in junior high school students in the Haidian District of Beijing, China: a 10-year population-based survey. BMC Ophthalmol 2017; 17:88. [PMID: 28606071 PMCID: PMC5468969 DOI: 10.1186/s12886-017-0483-6] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 05/31/2017] [Indexed: 11/12/2022] Open
Abstract
Background Myopia is a leading cause of preventable blindness. Although, multiple cross-sectional epidemiological studies have confirmed that there is a high prevalence of myopia in high school-aged students in China. However, few longitudinal studies have been performed to assess junior high school students. In the present study, we investigate changes in the prevalence of myopia in third year junior high school (grade 9) students in the Haidian District of Beijing, China, from 2006 to 2015. Methods A retrospective, longitudinal cohort study was performed over 10 years. A total of 37,424 third-year middle school (grade 9) students from 8 junior high schools in Haidian district, Beijing, were included. Participants underwent a comprehensive ophthalmic examination in which they were evaluated using autorefraction under cycloplegia and submitted to retinoscopy to assess accuracy. According to the spherical equivalent refraction (SER) of the right eye, subjects were separated into the following groups: non-myopia, −0.5 ≤ SER diopters (D); low myopia, −3.0 ≤ SER < −0.5 D; moderate myopia, −6.0 ≤ SER < −3.0 D; and high myopia, SER > −6.0 D. The following characteristics were measured: refractive error; the proportion of subjects with non- myopia, low myopia, moderate myopia and high myopia; and the difference in the prevalence of myopia between male and female subjects. Results From 2006 to 2015, the prevalence of non-myopia (from 44.05% to 34.52%) and low myopia (from 32.27% to 20.73%) decreased, while the prevalence of moderate myopia (from 19.72% to 38.06%) and high myopia (from 3.96% to 6.69%) significantly increased. For refractive error, the worse eye was −2.23 ± 2.42 D (median, −1.75; range − 12.75 to +8.50) in 2006 and −3.13 ± 2.66 D (median, −2.75; range − 12.75 to +8.50) in 2015. When the entire population was considered, the overall prevalence of myopia increased from 55.95% in 2005 to 65.48% in 2015. There was a significant positive relationship between the year and the prevalence of myopia in both girls and boys. Girls were more likely than boys to have myopia (odds ratio, 1.43 [95% CI, 1.14–1.96]), especially moderate myopia, and the prevalence of moderate and high myopia were higher in girls than in boys. Conclusions During the last 10 years, the prevalence of myopia significantly increased on an annual basis among third-year junior high school students in the Haidian District of Beijing, China. The total prevalence of myopia was significantly higher in girl than in boy participants. The refractive status of this age group deserves particular attention. Electronic supplementary material The online version of this article (doi:10.1186/s12886-017-0483-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yan Li
- Department of Ophthalmology, College of Optometry, Peking University Health Science Center; Center of Optometry, Peking University People's Hospital; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, 100044, China
| | - Jia Liu
- Department of Ophthalmology, College of Optometry, Peking University Health Science Center; Center of Optometry, Peking University People's Hospital; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, 100044, China. .,Key Laboratory of Vision Loss and Restoration, Ministry of Education, Department of Ophthalmology, Peking University People's Hospital, Xizhimen South Street 11, Xi Cheng District, Beijing, 100044, China.
| | - Pengcheng Qi
- Department of Ophthalmology, College of Optometry, Peking University Health Science Center; Center of Optometry, Peking University People's Hospital; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, 100044, China
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Hashemi H, Abbastabar H, Yekta A, Heydarian S, Khabazkhoob M. The prevalence of uncorrected refractive errors in underserved rural areas. J Curr Ophthalmol 2017; 29:305-309. [PMID: 29270479 PMCID: PMC5735237 DOI: 10.1016/j.joco.2017.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 02/19/2017] [Accepted: 02/19/2017] [Indexed: 11/29/2022] Open
Abstract
Purpose To determine the prevalence of uncorrected refractive errors, need for spectacles, and the determinants of unmet need in underserved rural areas of Iran. Methods In a cross-sectional study, multistage cluster sampling was done in 2 underserved rural areas of Iran. Then, all subjects underwent vision testing and ophthalmic examinations including the measurement of uncorrected visual acuity (UCVA), best corrected visual acuity, visual acuity with current spectacles, auto-refraction, retinoscopy, and subjective refraction. Need for spectacles was defined as UCVA worse than 20/40 in the better eye that could be corrected to better than 20/40 with suitable spectacles. Results Of the 3851 selected individuals, 3314 participated in the study. Among participants, 18.94% [95% confidence intervals (CI): 13.48–24.39] needed spectacles and 11.23% (95% CI: 7.57–14.89) had an unmet need. The prevalence of need for spectacles was 46.8% and 23.8% in myopic and hyperopic participants, respectively. The prevalence of unmet need was 27% in myopic, 15.8% in hyperopic, and 25.46% in astigmatic participants. Multiple logistic regression showed that education and type of refractive errors were associated with uncorrected refractive errors; the odds of uncorrected refractive errors were highest in illiterate participants, and the odds of unmet need were 12.13, 5.1, and 4.92 times higher in myopic, hyperopic and astigmatic participants as compared with emmetropic individuals. Conclusion The prevalence of uncorrected refractive errors was rather high in our study. Since rural areas have less access to health care facilities, special attention to the correction of refractive errors in these areas, especially with inexpensive methods like spectacles, can prevent a major proportion of visual impairment.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran.,Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | | | - Abbasali Yekta
- Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Samira Heydarian
- Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mohammadpour M, Heidari Z, Mohammad-Rabei H, Jafarzadehpur E, Jabbarvand M, Hashemi H, Khabazkhoob M. Correlation of higher order aberrations and components of astigmatism in myopic refractive surgery candidates. J Curr Ophthalmol 2016; 28:112-6. [PMID: 27579454 PMCID: PMC4992119 DOI: 10.1016/j.joco.2016.04.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 04/29/2016] [Accepted: 04/29/2016] [Indexed: 12/02/2022] Open
Abstract
Purpose To evaluate the correlation between refractive, corneal, and residual astigmatism and higher order aberrations (HOA) in refractive surgery candidates. Methods Three hundred and seventy-five eyes of 188 patients aged 28.2 ± 6.24 years with a predominance of females (62.7%) were enrolled in this study. Refraction, topography (Orbscan IIz, Bausch & Lomb, Rochester, NY, USA), and aberrometry (Zywave, Bausch & Lomb, Rochester, NY, USA) were performed to determine refractive and corneal astigmatism and HOA for all participants. Ocular residual astigmatism was calculated using vector analysis. Results The mean spherical equivalent was −3.59 ± 1.95 D and the mean refractive astigmatism was −1.97 ± 1.3 D. The mean HOA was 0.38 ± 0.15 μm in all cases, which increased with spherical equivalent (p < 0.05). There was a positive significant correlation between both corneal and refractive astigmatism and HOA (p < 0.05), but there was no significant correlation between residual astigmatism and HOA (p = 0.122). Conclusion The results of the study showed significant correlations between corneal and refractive astigmatisms and HOA.
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Affiliation(s)
- Mehrdad Mohammadpour
- Farabi Eye Hospital, Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Heidari
- School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Mohammad-Rabei
- Ophthalmic Research Center, Torfeh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mahmoud Jabbarvand
- Farabi Eye Hospital, Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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10
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Foo VHX, Verkicharla PK, Ikram MK, Chua SYL, Cai S, Tan CS, Chong YS, Kwek K, Gluckman P, Wong TY, Ngo C, Saw SM, On Behalf Of The Gusto Study Group. Axial Length/Corneal Radius of Curvature Ratio and Myopia in 3-Year-Old Children. Transl Vis Sci Technol 2016; 5:5. [PMID: 26929885 PMCID: PMC4757459 DOI: 10.1167/tvst.5.1.5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 12/13/2015] [Indexed: 12/15/2022] Open
Abstract
PURPOSE This study investigated the association of axial length (AL) to corneal radius of curvature (CRC) ratio with spherical equivalent (SE) in a 3-year old Asian cohort. METHODS Three-hundred forty-nine 3-year old Asian children from The Growing Up in Singapore towards Healthy Outcomes (GUSTO) birth cohort study underwent AL and CRC measurements with a noncontact ocular biometer and cycloplegic refraction using an autorefractor. The ratio of AL to CRC (AL/CRC) was calculated for all the participants, and subsequently AL, CRC, and AL/CRC were analyzed in relationship to SE. RESULTS The SE showed better correlation with AL/CRC (Spearman's correlation coefficient, ρ = -0.53; 95% confidence interval [CI]: -0.66; -0.49; P < 0.001) compared to either AL or CRC alone ([ρ = -0.36; 95% CI: -0.51 to 0.51; P = 0.01] and [ρ = 0.05; 95% CI: -0.04 to 0.17; P = 0.34], respectively). Mean AL/CRC was 2.91 ± 0.06 among myopes and decreased to 2.79 ± 0.06 among hyperopes. Axial length to corneal radius of curvature was strongly correlated with SE in myopes (ρ = -0.78; 95% CI: -3.76; -0.79; P = < 0.001), but not in emmetropes and hyperopes ([ρ = -0.39; 95% CI: -10.73; -0.57; P = 0.01] and [ρ = -0.18; 95% CI: -17.28; 12.42; P = 0.38], respectively). Linear regression adjusted for gender and ethnicity showed a 0.74-diopter shift in SE towards myopia with every 0.1 increase in AL/CRC ratio (P < 0.001, r2 = 0.33). CONCLUSION The correlation between SE and AL/CRC is stronger than that between AL or CRC alone. This suggests that in a research setting, when cycloplegic refraction is difficult to perform on 3-year-old children, AL/CRC may be the next best reference for refractive error. TRANSLATIONAL RELEVANCE In the research setting, AL/CRC may be the next best reference for refractive error over AL alone when cycloplegic refraction is unavailable in 3-year old children.
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Affiliation(s)
| | | | - Mohammad Kamran Ikram
- Department of Ophthalmology, National University Hospital, National University Health System, Singapore, Singapore ; Memory Aging & Cognition Center, National University Health System, Singapore, Singapore
| | - Sharon Yu Lin Chua
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Shirong Cai
- Department of Obstetrics and Gynecology, National University Hospital, National University Health System, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Yap-Seng Chong
- Department of Obstetrics and Gynecology, National University Hospital, National University Health System, Singapore, Singapore ; Singapore Institute for Clinical Sciences - ASTAR, Singapore, Singapore
| | - Kenneth Kwek
- KK Women's and Children's Hospital, Singapore, Singapore
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences - ASTAR, Singapore, Singapore ; Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Tien-Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Department of Ophthalmology, National University Hospital, National University Health System, Singapore, Singapore
| | - Cheryl Ngo
- Department of Ophthalmology, National University Hospital, National University Health System, Singapore, Singapore
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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11
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Hashemi H, Rezvan F, Yekta AA, Hashemi M, Norouzirad R, Khabazkhoob M. The prevalence of astigmatism and its determinants in a rural population of Iran: the "Nooravaran Salamat" mobile eye clinic experience. Middle East Afr J Ophthalmol 2014; 21:175-81. [PMID: 24791111 PMCID: PMC4005184 DOI: 10.4103/0974-9233.129772] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Purpose: The prevalence of astigmatism, and the astigmatic axis, and their determinants were evaluated in a rural population of Iran. Materials and Methods: In a cross-sectional study conducted from May to August 2011, 13 villages in the vicinity of the city of Khaf in northeast Iran were investigated in this study. All the examinations including visual acuity, refraction, slit-lamp biomicroscopy and fundoscopy were performed in a Mobile Eye Clinic. Written informed consent was obtained from all participants. Only phakic eye that could be reliably refracted without a previous history of ocular surgery were included. Results: Out of 2635 participants who were screened, 2124 were analysed for this study of whom 52% were female. The prevalence of astigmatism was 32.2% (95% confidence intervals (CI): 30.2-34.2). Astigmatism significantly increased from 14.3% in the under 15-year-old age group to 67.2% in the age group of over 65-years old (P < 0.001). The prevalence of With-The-Rule (WTR), Against-The-Rule (ATR), and oblique astigmatism was 11.7%, 18.1%, and 2.4 %, respectively. ATR significantly increased with age (P < 0.001). The mean corneal astigmatism was 0.73 D which linearly increased with age (P < 0.001). Conclusion: Attention must be paid to astigmatism in rural areas due to the high prevalence. Further studies are suggested to discover the role of the environmental and genetic factors. It seems that environmental and occupational factors in the villages cause a significant increase in the prevalence of astigmatism with age. A high percentage of participants had ATR astigmatism, which was more common at older ages.
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Affiliation(s)
- Hassan Hashemi
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Farhad Rezvan
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Abbas Ali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Hashemi
- Department of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Norouzirad
- Department of Medicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Mehdi Khabazkhoob
- Department of Epidemiology, Faculty of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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