Prevalence and causes of visual impairment and blindness in Lao People's Democratic Republic: the Vientiane Eye Study.

AIMS: To determine the prevalence and causes of visual impairment and blindness in Vientiane Province, the Lao People's Democratic Republic (Lao PDR). METHODS: We conducted a population-based, cross-sectional study of 1264 participants aged 40 years and older from urban and rural areas of Vientiane Province. The ophthalmic examination included presenting and pinhole Snellen visual acuity (VA) with an illiterate E chart, slit-lamp examination of the anterior segment and dilated stereoscopic fundus examination. Visual impairment and blindness were defined by both presenting and pinhole VA based on the better eye according to WHO criteria: VA worse than 6/12 to 6/18 for mild impairment, VA worse than 6/18 to 6/60 for moderate impairment, VA worse than 6/60 to 3/60 for severe impairment and VA worse than 3/60 for blindness. RESULTS: Comprehensive ophthalmic examinations were performed on 1264 participants (77.8% participation rate). Population-weighted prevalence of presenting bilateral blindness was 1.4% (95% CI 0.8 to 2.0) and bilateral visual impairment was 22.4% (95% CI 14.7 to 30.1). After pinhole correction, the corresponding prevalence of blindness was 1.3% (95% CI 0.8 to 2.0) and that of visual impairment was 12.6% (95% CI 8.2 to 16.9). Cataract was the leading cause of presenting bilateral blindness (52.9%), whereas uncorrected refractive error was the predominant cause of presenting visual impairment (40.3%). CONCLUSIONS: Visual impairment and blindness remain major public health problems in Lao PDR. There is an ongoing need to fund ophthalmic care resources and community education programmes to improve access to healthcare in this region.

Risk and predictors of sudden death in cardiac sarcoidosis: A systematic review and meta-analysis.

BACKGROUND: To evaluate the risk for ventricular arrhythmia (VA) and sudden cardiac death (SCD) in patients with cardiac sarcoidosis (CS) and determine the prognostic factors. METHODS AND RESULTS: PUBMED, EMBASE and SCOPUS were searched up to 14th April 2020. Studies reporting the incidence of SCD, appropriate ICD therapy in CS patients, or relevant prognostic information in patients having undergone MRI, PET, or programmed electrical stimulation (PES) were included. Nineteen studies consisting of 1247 patients, reported the risk of ICD therapies or SCD over a follow-up period of 1.7-7 years. 22.7% (n = 9; 22.7, 95%CI [16.10-29.36]) of patients in primary and 58.4% (n = 9; 58.42, 95% CI [38.61-78.22]) in secondary prevention cohorts experienced appropriate device therapy or SCD events. 18% (n = 2; 18, 95%CI [14-23]) of patients received ≥5 appropriate therapies. 9 out of 664 patients with confirmed cardiac sarcoidosis but without implanted ICDs died suddenly. 17.9% of patients (n = 4; 17.9, 95%CI [10.80-25.03]) experienced inappropriate device therapy. Positive LGE-MRI and PES were associated with an 8.6-fold (n = 6; RR = 8.60, 95%CI [3.80-19.48]) and 9-fold (n = 5; RR = 9.07, 95%CI [4.65-17.68]) increased risk of VA respectively. Positive LGE-MRI and PET with associated with a 6.8-fold (n = 12; RR = 6.82, 95%CI [4.57-10.18]) and 3.4-fold (n = 7; RR = 3.41, 95%CI [2.03-5.74]) respectively for increased risk of major adverse cardiac events. CONCLUSIONS: The risk of appropriate ICD therapy or sudden cardiac death is high in patients with CS. The presence of LGE-MRI and positive electrophysiology study identify patients at increased risk of ventricular arrhythmias. [CRD42019124220].