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5.
Br J Ophthalmol ; 103(7): 894-899, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30097432

RESUMO

AIM: To evaluate racial differences, and ocular and systemic determinants of macular thickness (MT), measured by spectral-domain optical coherence tomography (SD-OCT) in a normal multiethnic Asian population. METHOD: MT was measured from a 6×6 mm2 central macular area using the Cirrus high-definition OCT (HD-OCT) (Carl Zeiss Meditec, Dublin, CA). The associations between ocular and systemic factors with MT were evaluated using linear regression analyses with generalised estimating equation models to account for intereye correlation. RESULTS: 7447 healthy eyes (2577 Chinese, 2072 Malays and 2798 Indians) of 4510 subjects were included. Multivariable analysis showed that older age (per decade, ß=-4.39), female gender (ß=-5.74), diabetes (ß=-1.10), chronic kidney disease (CKD) (ß=-3.21), longer axial length (per mm, ß=-2.34), flatter corneal curvature (per mm, ß=-1.79) and presence of cataract (ß=-0.94) were associated with thinner overall average MT (OMT) (all p≤0.026); higher total cholesterol (ß=0.44; p=0.010) was associated with thicker OMT. All these factors were also associated with thinner central subfield MT (CSMT) (all p≤0.001), except for cataract, total cholesterol and CKD. Meanwhile, longer axial length (ß=2.51; p<0.001) was associated with thicker CSMT. OMT (mean±SD) was thickest in Chinese (279.9±12.5 µm), followed by Malays (276.5±13.7 µm) and Indians (272.4±13.1 µm), with p≤0.003 for all interethnic comparisons. Similar trend was observed for CSMT. CONCLUSION: There are interethnic differences in MT profile among Asians, particularly between Chinese and Indians. Ocular and systemic factors affect MT measurements as well. This Asian-specific information may be incorporated into existing clinical interpretation of macular OCT scans to aid in improving the diagnostic and monitoring accuracy of macular diseases among Asians.


Assuntos
Grupos de Populações Continentais , Grupos Étnicos , Oftalmopatias/etnologia , Macula Lutea/patologia , Vigilância da População , Tomografia de Coerência Óptica/métodos , Oftalmopatias/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Singapura/epidemiologia
6.
J Pediatr Ophthalmol Strabismus ; 56(1): 28-34, 2019 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-30371918

RESUMO

PURPOSE: To determine the prevalence of reduced visual acuity and ocular disease in the children of migrant farmworkers in Georgia. METHODS: A retrospective chart review of data acquired by a vision screening was performed on 156 Haitian and Hispanic children of migrant farmworkers attending a summer school in Georgia. Reduced visual acuity at presentation was analyzed and stratified by ethnicity, type of ocular disease, and immediate resolution with refractive correction. RESULTS: The authors found that 20% of migrant farmworker children have a high prevalence of reduced visual acuity in the worse eye. Of those with worse-eye reduced visual acuity, 83% had uncorrected refractive error. The prevalence of uncorrected refractive error from astigmatism and high astigmatism was significantly higher among Hispanics than Haitians. The prevalence of amblyopia suspects among migrant farmworker children was 3%. Of the amblyopia suspects, 80% were anisometropic. CONCLUSIONS: Children of migrant farmworkers in Georgia have a higher rate of reduced visual acuity, largely from uncorrected refractive error, when compared to other Hispanic and African American children in the United States with a prevalence more aligned to children in Asian and Latin American countries than school children in the United States. This illustrates the need for improved access to screening and care in this vulnerable population. [J Pediatr Ophthalmol Strabismus. 2019;56(1):28-34.].


Assuntos
Oftalmopatias/etnologia , Fazendeiros , Migrantes , Transtornos da Visão/etnologia , Seleção Visual/métodos , Acuidade Visual , Adolescente , Criança , Pré-Escolar , Oftalmopatias/fisiopatologia , Feminino , Haiti/etnologia , Humanos , Incidência , Masculino , México/etnologia , Estudos Retrospectivos , Estados Unidos/epidemiologia , Transtornos da Visão/fisiopatologia
7.
Acta Ophthalmol ; 97(5): 532-538, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30537339

RESUMO

PURPOSE: To study the normal relationship between retinal vessel diameter (RVD) with retinal nerve fibre layer (RNFL) thickness and optic nerve head (ONH) parameters in a cohort of middle-aged Caucasians. METHODS: We investigated 3070 individuals (6140 eyes). Central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were measured in the right eye using a semi-automated computer-assisted program. Retinal nerve fibre layer (RNFL) thickness and ONH parameters were assessed with Heidelberg retinal tomography (HRT). RESULTS: Data from 2217 persons were analysed including RNFL, CRAE, CRVE, sex, body mass index, mean arterial pressure, diabetes status, smoking status, optic disc area, rim area, spherical refraction and intraocular pressure. A larger RVD was associated with a thicker mean global RNFL thickness especially in global and inferior segments of the retina and with larger optic discs. Each 10 µm increase in the retinal arteriolar calibre was associated with a 5.58 µm increase in mean global RNFL thickness; the corresponding value for a 10 µm increase in venular calibre was 3.79 µm (p < 0.001 for both). Retinal venular calibre displayed consistent associations with RNFL thickness in both genders (p < 0.001 for all), whereas the association of arteriolar calibre and RNFL was more prominent in men (p < 0.001). CONCLUSION: We found strong associations between larger RVD and thicker RNFL in all subjects. This study helps to clarify the association between RVD, RNFL thickness and ONH parameters and provides normal values for middle-aged Caucasians that will help in future studies investigating the role of vascular aetiology in systemic and eye diseases.


Assuntos
Grupo com Ancestrais do Continente Europeu , Oftalmopatias/diagnóstico , Disco Óptico/patologia , Células Ganglionares da Retina/patologia , Vasos Retinianos/patologia , Tomografia de Coerência Óptica/métodos , Oftalmopatias/etnologia , Feminino , Finlândia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Fibras Nervosas/patologia , Prognóstico , Estudos Prospectivos , Fatores de Tempo , Acuidade Visual
8.
Br J Ophthalmol ; 102(9): 1308-1314, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29907633

RESUMO

BACKGROUND: An Immunochip study recently identified the association of a number of new genetic loci with Behcet's disease (BD). OBJECTIVE: To confirm the association between new genetic loci reported in an Immunochip study and BD in a Han Chinese population. METHODS: A two-stage association study was carried out in 1238 patients with BD and 1458 healthy controls. Twenty-two candidate single nucleotide polymorphisms (SNPs) were selected for genotyping by iPLEXGold genotyping or TaqMan SNP assays and a meta-analysis was performed for significantly associated markers. RESULTS: The results showed that four SNPs (LACC1/rs9316059, CEBPB-PTPN1/rs913678, ADO-EGR2/rs224127 and RIPK2/rs10094579) were associated with BD in an allelic association test (rs9316059 T allele: pc=4.95×10-8, OR=0.687; rs913678 C allele: pc=3.01×10-4, OR=1.297; rs224127 A allele: pc=3.77×10-4, OR=1.274; rs10094579 A allele: pc=6.93×10-4, OR=1.302). For four SNPs tested by meta-analysis, the association with BD was strengthened and all exceeded genome-wide significance (rs9316059: p=2.96×10-16; rs913678: p=2.09×10-16; rs224127: p=5.28×10-13; rs10094579: p=9.21×10-11). CONCLUSIONS: Our findings confirmed the association of four loci (LACC1, CEBPB-PTPN1, ADO-EGR2 and RIPK2) in Chinese Han patients with BD.


Assuntos
Síndrome de Behçet/complicações , Proteína beta Intensificadora de Ligação a CCAAT/genética , Carotenoides/genética , Oftalmopatias/etiologia , Oxigenases/genética , Proteína Tirosina Fosfatase não Receptora Tipo 1/genética , Proteínas/genética , Proteína Serina-Treonina Quinase 2 de Interação com Receptor/genética , Adulto , Alelos , Síndrome de Behçet/etnologia , Síndrome de Behçet/metabolismo , Proteína beta Intensificadora de Ligação a CCAAT/metabolismo , Carotenoides/metabolismo , China/epidemiologia , Grupos Étnicos , Oftalmopatias/etnologia , Oftalmopatias/genética , Feminino , Frequência do Gene , Estudos de Associação Genética , Predisposição Genética para Doença , Genótipo , Humanos , Incidência , Peptídeos e Proteínas de Sinalização Intracelular , Masculino , Oxigenases/metabolismo , Polimorfismo de Nucleotídeo Único , Proteína Tirosina Fosfatase não Receptora Tipo 1/metabolismo , Proteínas/metabolismo , Proteína Serina-Treonina Quinase 2 de Interação com Receptor/metabolismo , Estudos Retrospectivos
9.
Ophthalmic Epidemiol ; 25(4): 306-314, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29580111

RESUMO

PURPOSE: To describe the study design, operational and recruitment strategies, procedures, and baseline characteristics of the African American Eye Disease Study (AFEDS), a population-based assement of the prevalence of visual impairment, ocular disease, visual function, and health-related quality of life in African Americans. METHODS: This population-based, cross-sectional study included over 6000 African Americans 40 years and older residing in and around Inglewood, California. A detailed interview and eye examination was performed on each eligible participant. The interview included an assessment of demographic, behavioral, and ocular risk factors and health-related and vision-related quality of life. The eye examination included measurements of visual acuity, intraocular pressure, visual fields; fundus and optic disc photography; a detailed anterior and posterior segment examination; and measurements of blood pressure, glycosylated hemoglobin levels, and blood glucose levels. RESULTS: The AFEDS cohort includes more than 6000 participants that have completed a home questionnaire and a comprehensive eye examination. The majority of participants were female (63%), the average (± standard deviation) overall age was 60.9 (±11.3). Participants are mostly working (40%) or retired (41%), non-smoking (57%), partial drinking (54%), and with at least some college education (38%). A trust-development recruitment strategy was refined in order to overcome challenges in study participation. CONCLUSION: The AFEDS is the largest epidemiologic eye study among African Americans to date. The AFEDS cohort will provide information about the prevalence and risk factors of ocular disease in the largest ophthalmologic study population of African Americans in the United States.


Assuntos
Afro-Americanos , Oftalmopatias/etnologia , Qualidade de Vida , Projetos de Pesquisa , Medição de Risco/métodos , Acuidade Visual , Adulto , Idoso , Idoso de 80 Anos ou mais , California/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Inquéritos e Questionários
10.
Ann Acad Med Singap ; 47(1): 13-28, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29493707

RESUMO

INTRODUCTION: Singapore's ageing population is likely to see an increase in chronic eye conditions in the future. This study aimed to estimate the burden of eye diseases among resident Singaporeans stratified for age and ethnicity by 2040. MATERIALS AND METHODS: Prevalence data on myopia, epiretinal membrane (ERM), retinal vein occlusion (RVO), age macular degeneration (AMD), diabetic retinopathy (DR), cataract, glaucoma and refractive error (RE) by age cohorts and educational attainment from the Singapore Epidemiology of Eye Diseases (SEED) study were applied to population estimates from the Singapore population model. RESULTS: All eye conditions are projected to increase by 2040. Myopia and RE will remain the most prevalent condition, at 2.393 million (2.32 to 2.41 million) cases, representing a 58% increase from 2015. It is followed by cataract and ERM, with 1.33 million (1.31 to 1.35 million), representing an 81% increase, and 0.54 million (0.53 to 0.549 million) cases representing a 97% increase, respectively. Eye conditions that will see the greatest increase from 2015 to 2040 in the Chinese are: DR (112%), glaucoma (100%) and ERM (91.4%). For Malays, DR (154%), ERM (136%), and cataract (122%) cases are expected to increase the most while for Indians, ERM (112%), AMD (101%), and cataract (87%) are estimated to increase the most in the same period. CONCLUSION: Results indicate that the burden for all eye diseases is expected to increase significantly into the future, but at different rates. These projections can facilitate the planning efforts of both policymakers and healthcare providers in the development and provision of infrastructure and resources to adequately meet the eye care needs of the population. By stratifying for age and ethnicity, high risk groups may be identified and targeted interventions may be implemented.


Assuntos
Efeitos Psicossociais da Doença , Oftalmopatias , Alocação de Recursos para a Atenção à Saúde , Planejamento em Saúde/organização & administração , Adulto , Fatores Etários , Idoso , Doença Crônica , Grupos Étnicos , Oftalmopatias/diagnóstico , Oftalmopatias/economia , Oftalmopatias/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Prevalência , Fatores de Risco , Singapura/epidemiologia
11.
J Immigr Minor Health ; 20(6): 1324-1331, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29362946

RESUMO

Gas station workers (GSWs) are at elevated risk of morbidities associated with exposure to petrochemical substances. This cross-sectional study assessed the prevalence and examined demographics and occupation-related risk factors associated with self-rated ill-health among GSWs in Kuwait. Structured questionnaire was used to record self-rated ill-health from 460 selected GSWs of South-Asian origin. Prevalence of self-rated ill-health conditions was computed. Random-intercept multivariable logistic regression model was used to identify the demographics and/or work-place related potential risk factors associated with one or more morbidities. Prevalent morbidities were eye(s) complaint (45.2%), asthma/shortness of breath (7.6%), frequent sneezing and allergic rhinitis (44.3%), recurrent headache (48.3%), dizziness (9.8%), tremors (42%), and eczema/skin complaint (44.1%). Furthermore, GSWs were significantly more likely to report one or more ill-health conditions (vs. none), if they were overweight/obese (aOR 1.8; 95% CI 1.1-2.9), married (aOR 2.6; 95% CI 1.5-4.5) or on current job for more than one year (aOR 6.4; 95% CI 2.9-15.4). In conclusion, GSWs suffer from ailments of multiple organ systems and need education and facilitation for self-protection.


Assuntos
Óleos Combustíveis , Nível de Saúde , Doenças Profissionais/etnologia , Migrantes/estatística & dados numéricos , Adulto , Ásia Ocidental/etnologia , Estudos Transversais , Oftalmopatias/etnologia , Comportamentos Relacionados com a Saúde , Humanos , Kuweit/epidemiologia , Modelos Logísticos , Masculino , Doenças do Sistema Nervoso/etnologia , Saúde do Trabalhador , Sobrepeso/etnologia , Prevalência , Doenças Respiratórias/etnologia , Fatores de Risco , Autorrelato , Dermatopatias/etnologia , Fumar/etnologia , Fatores Socioeconômicos
12.
JAMA ; 318(22): 2211-2223, 2017 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-29234807

RESUMO

Importance: A deep learning system (DLS) is a machine learning technology with potential for screening diabetic retinopathy and related eye diseases. Objective: To evaluate the performance of a DLS in detecting referable diabetic retinopathy, vision-threatening diabetic retinopathy, possible glaucoma, and age-related macular degeneration (AMD) in community and clinic-based multiethnic populations with diabetes. Design, Setting, and Participants: Diagnostic performance of a DLS for diabetic retinopathy and related eye diseases was evaluated using 494 661 retinal images. A DLS was trained for detecting diabetic retinopathy (using 76 370 images), possible glaucoma (125 189 images), and AMD (72 610 images), and performance of DLS was evaluated for detecting diabetic retinopathy (using 112 648 images), possible glaucoma (71 896 images), and AMD (35 948 images). Training of the DLS was completed in May 2016, and validation of the DLS was completed in May 2017 for detection of referable diabetic retinopathy (moderate nonproliferative diabetic retinopathy or worse) and vision-threatening diabetic retinopathy (severe nonproliferative diabetic retinopathy or worse) using a primary validation data set in the Singapore National Diabetic Retinopathy Screening Program and 10 multiethnic cohorts with diabetes. Exposures: Use of a deep learning system. Main Outcomes and Measures: Area under the receiver operating characteristic curve (AUC) and sensitivity and specificity of the DLS with professional graders (retinal specialists, general ophthalmologists, trained graders, or optometrists) as the reference standard. Results: In the primary validation dataset (n = 14 880 patients; 71 896 images; mean [SD] age, 60.2 [2.2] years; 54.6% men), the prevalence of referable diabetic retinopathy was 3.0%; vision-threatening diabetic retinopathy, 0.6%; possible glaucoma, 0.1%; and AMD, 2.5%. The AUC of the DLS for referable diabetic retinopathy was 0.936 (95% CI, 0.925-0.943), sensitivity was 90.5% (95% CI, 87.3%-93.0%), and specificity was 91.6% (95% CI, 91.0%-92.2%). For vision-threatening diabetic retinopathy, AUC was 0.958 (95% CI, 0.956-0.961), sensitivity was 100% (95% CI, 94.1%-100.0%), and specificity was 91.1% (95% CI, 90.7%-91.4%). For possible glaucoma, AUC was 0.942 (95% CI, 0.929-0.954), sensitivity was 96.4% (95% CI, 81.7%-99.9%), and specificity was 87.2% (95% CI, 86.8%-87.5%). For AMD, AUC was 0.931 (95% CI, 0.928-0.935), sensitivity was 93.2% (95% CI, 91.1%-99.8%), and specificity was 88.7% (95% CI, 88.3%-89.0%). For referable diabetic retinopathy in the 10 additional datasets, AUC range was 0.889 to 0.983 (n = 40 752 images). Conclusions and Relevance: In this evaluation of retinal images from multiethnic cohorts of patients with diabetes, the DLS had high sensitivity and specificity for identifying diabetic retinopathy and related eye diseases. Further research is necessary to evaluate the applicability of the DLS in health care settings and the utility of the DLS to improve vision outcomes.


Assuntos
Retinopatia Diabética/diagnóstico , Oftalmopatias/diagnóstico , Aprendizado de Máquina , Retina/patologia , Área Sob a Curva , Conjuntos de Dados como Assunto , Diabetes Mellitus/etnologia , Retinopatia Diabética/etnologia , Oftalmopatias/etnologia , Feminino , Glaucoma/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Retina/diagnóstico por imagem , Sensibilidade e Especificidade
13.
Clin Exp Ophthalmol ; 45(8): 779-789, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28472538

RESUMO

IMPORTANCE: Asian Indians are the fastest growing migration groups in the world. Studies evaluating the impact of migration on disease outcomes in this population are rare. BACKGROUND: We describe the methodology of the Singapore Indian Eye Study-2 (SINDI-2) aimed to evaluate the impact of migration status on diabetic retinopathy and other major age-related eye diseases in Asian Indians living in an urban environment. DESIGN: Population-based cohort study. PARTICIPANTS: A total of 2200 adults had participated in baseline SINDI (2007-2009, mean age [range] = 57.8 [42.7-84.1] years) and SINDI-2 (2013-2015, 56.5 [48.4-90.2] years). METHODS: Participants were classified as 'first generation' if they were Indian residents born outside of Singapore and as 'second-generation' immigrants (59.7% in SINDI vs. 63.6% in SINDI-2) if they were born in Singapore. MAIN OUTCOME MEASURES: Response rate, participant characteristics and prevalence of systemic diseases were stratified by migration status. RESULTS: Of the 2914 eligible SINDI participants invited to participate, 2200 participated in SINDI-2 (response rate of 75.2%). In both SINDI and SINDI-2, compared with first-generation immigrants, second-generation immigrants were younger, less likely to have income <1000 SGD, had lower levels of pulse pressure, higher levels of high-density lipoprotein cholesterol, had lower prevalence of hypertension and chronic kidney disease and had higher prevalence of current smoking and obesity (all P < 0.05). CONCLUSIONS AND RELEVANCE: In both SINDI and SINDI-2, second-generation immigrants had lower prevalence of cardiovascular risk factors except smoking and obesity compared with first-generation immigrants. The final report will confirm if these differences between generations are evident with regard to eye diseases.


Assuntos
Doenças Cardiovasculares/etnologia , Emigrantes e Imigrantes , Oftalmopatias/etnologia , População Urbana , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Estudos Transversais , Feminino , Humanos , Índia/etnologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Fatores de Risco , Singapura/epidemiologia , Fatores de Tempo
14.
J Stroke Cerebrovasc Dis ; 26(7): 1433-1439, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28411039

RESUMO

BACKGROUND AND PURPOSE: The study aimed to determine the prevalence of and risk factors for self-reported stroke in Indigenous and non-Indigenous Australians. RESEARCH DESIGN AND METHODS: In this national eye study, 1738 Indigenous Australians (41.1% male) aged 40-92 years and 3098 non-Indigenous Australians (46.4% male) aged 50-98 years from 30 randomly selected sites, stratified by remoteness, were recruited and examined. Sociodemographic information and a history of stroke, diabetes, and ocular health were obtained using an interviewer-administered questionnaire. RESULTS: The crude prevalence of self-reported stroke was 5.04% (156 of 3098, 95% confidence interval: 4.29%-5.87%) for non-Indigenous Australians and 8.75% (152 of 1738, 95% confidence interval: 7.46%-10.17%) for Indigenous Australians (P < .0001). The age-adjusted prevalence of self-reported stroke for non-Indigenous and Indigenous Australians was 4.23% and 12.72%, respectively. The prevalence of stroke increased significantly with age for both Indigenous (odds ratio = 1.06 per year, P ≤ .001) and non-Indigenous Australians (odds ratio = 1.04 per year, P ≤ .001), with the Indigenous prevalence being higher than that of the non-Indigenous group at every age. CONCLUSIONS: The prevalence of self-reported stroke was 3 times higher in Indigenous Australians than in non-Indigenous Australians. This disparity is consistent with previous reports, highlighting the need for intensified prevention and support services to reduce the burden of stroke on Indigenous Australians.


Assuntos
Oftalmopatias/etnologia , Autorrelato , Acidente Vascular Cerebral/etnologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Estudos Transversais , Oftalmopatias/diagnóstico , Feminino , Nível de Saúde , Disparidades nos Níveis de Saúde , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Grupo com Ancestrais Oceânicos , Razão de Chances , Prevalência , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Seleção Visual
15.
Am J Ophthalmol ; 176: 183-193, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28161048

RESUMO

PURPOSE: To identify the prevalence and determinants of self-reported eye care use among Chinese Americans. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: A total of 4582 Chinese Americans 50 years and older residing in Monterey Park, California. METHODS: Multivariable logistic regression analyses based on Andersen's Behavioral Model of Health Services Use were conducted to identify predisposing, enabling, and need variables associated with self-reported eye care use. MAIN OUTCOME MEASURES: Prevalence of self-reported use assessed as eye care visit in the past 12 months, dilated eye examination in the past 12 months, and ever having had a dilated examination, and odds ratios for factors associated with these measures. RESULTS: Overall, 36% of participants reported an eye care visit and 21% reported a dilated examination in the past 12 months. Forty-eight percent reported ever having had a dilated eye examination. Older age, female sex, preference for English, more education, health and vision insurance, a usual place for health care, currently driving, a greater number of comorbidities, and lower vision-specific quality-of-life (NEI VFQ-25) scores were associated with higher odds of reporting use of eye care. CONCLUSIONS: Use of eye care among Chinese Americans was found to be as low as what is reported for African Americans and Hispanics, and lower than what is reported for whites. Multiple modifiable factors are associated with use of eye care among the rapidly growing Chinese American population. Culturally sensitive interventions targeting these factors should be a priority. Further research is needed to investigate how findings from this group of Chinese Americans reflect other Asian Americans that are different in language and ethnicity.


Assuntos
Americanos Asiáticos , Oftalmopatias/etnologia , Acesso aos Serviços de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Vigilância da População/métodos , Autorrelato , Idoso , California/epidemiologia , Estudos Transversais , Oftalmopatias/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Estudos Retrospectivos
16.
Ocul Immunol Inflamm ; 25(1): 37-40, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26954704

RESUMO

PURPOSE: Behçet disease (BD) is predominantly found between East Asia and the Mediterranean basin along the historic Silk Road. HLA-B51 is known to be strongly associated with BD. We investigated the association between HLA-B51 and the ocular manifestations of BD among various ethnic groups. METHODS: A literature survey was conducted, and 18 articles written in English were reviewed. RESULTS: A strong correlation was found between HLA-B51 and ocular lesions in the entire cohort discussed in the reviewed articles (OR = 1.76, p = 0.000057). HLA-B51 was shown to have a strong association with ocular manifestations of BD patients in East-Eurasian (OR = 2.40, p = 0.0030) and Middle-Eurasian (OR = 1.87, p = 0.0045), but not in West-Eurasian (OR = 1.28, p = 0.35) areas. This correlation seemed to become stronger towards the east. CONCLUSIONS: A meta-analysis showed that the correlation became stronger towards the east along the Silk Road. The study results may facilitate understanding of the etiology and characteristics of BD.


Assuntos
Síndrome de Behçet/diagnóstico , Oftalmopatias/diagnóstico , Antígeno HLA-B51/genética , Ásia/epidemiologia , Síndrome de Behçet/etnologia , Síndrome de Behçet/genética , Grupos Étnicos , Europa (Continente)/epidemiologia , Oftalmopatias/etnologia , Oftalmopatias/genética , Interação Gene-Ambiente , Predisposição Genética para Doença , Heterozigoto , Humanos
17.
Telemed J E Health ; 23(2): 113-118, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27328169

RESUMO

BACKGROUND: Telemedicine with nonmydriatic cameras can detect not only diabetic retinopathy but also other eye disease. OBJECTIVE: To determine the prevalence of eye diseases detected by telemedicine in a population with a high prevalence of minority and American Indian/Alaskan Native (AI/AN) ethnicities. SUBJECTS AND METHODS: We recruited diabetic patients 18 years and older and used telemedicine with nonmydriatic cameras to detect eye disease. Two trained readers graded the images for diabetic retinopathy, age-related macular degeneration (ARMD), glaucomatous features, macular edema, and other eye disease using a standard protocol. We included both eyes for analysis and excluded images that were too poor to grade. RESULTS: We included 820 eyes from 424 patients with 72.3% nonwhite ethnicity and 50.3% AI/AN heritage. While 283/424 (66.7%) patients had normal eye images, 120/424 (28.3%) had one disease identified; 15/424 (3.5%) had two diseases; and 6/424 (1.4%) had three diseases in one or both eyes. After diabetic retinopathy (104/424, 24.5%), the most common eye diseases were glaucomatous features (44/424, 10.4%) and dry ARMD (24/424, 5.7%). Seventeen percent (72/424, 17.0%) showed eye disease other than diabetic retinopathy. CONCLUSIONS: Telemedicine with nonmydriatic cameras detected diabetic retinopathy, as well as other visually significant eye disease. This suggests that a diabetic retinopathy screening program needs to detect and report other eye disease, including glaucoma and macular disease.


Assuntos
Diabetes Mellitus/etnologia , Oftalmopatias/diagnóstico , Oftalmopatias/etnologia , Oftalmologia/métodos , Telemedicina/métodos , Adulto , Idoso , Retinopatia Diabética/diagnóstico , Feminino , Hispano-Americanos , Humanos , Índios Norte-Americanos , Masculino , Pessoa de Meia-Idade , Processamento de Sinais Assistido por Computador , Telemedicina/organização & administração
18.
Am J Ophthalmol ; 173: 70-75, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27702620

RESUMO

PURPOSE: To assess trends in prevalence of diagnosed ocular disease and use of eye care services in the Veterans Affairs (VA) health care system. DESIGN: Prevalence study. METHODS: We performed a retrospective study of all eligible veterans in the VA Capitol Health Care Network from 2007 to 2011. The VA database was used to abstract demographic and socioeconomic variables, including age, race, sex, marital status, service connection, prescription copay, homelessness, and VA facility. Primary outcome measures were the prevalence of diagnosed ocular disease and use of eye care. Ocular diagnoses were determined by International Classification of Diseases, 9th revision codes and use by prescription medication fills, visits to eye care clinics, and cataract surgery frequency. RESULTS: The average age of veterans ranged from 59.8-60.9, most veterans were male (88.1-89.8%), and there was a high proportion of African Americans (29.5-30%). The prevalence of all ocular diagnoses increased from 20.5% in 2007 to 23.3% in 2011 (P < .01), a 13.7% increase. Similarly, the prevalence of diagnosed cataract increased by 35.7% (P = .02) from 7.1% in 2007 to 9.6% in 2011. Diagnosed glaucoma prevalence increased by 9.4% (P = .03) from 6.7 to 7.4%. The percent of patients seen in eye clinics increased 11.6%% in the 5-year study period to 24.0% in fiscal year 2011 (P = .05). The use of ophthalmic medications increased 20% (P < .01). The rate of cataract surgery did not change significantly during the study period. CONCLUSIONS: The prevalence of diagnosed eye conditions among American Veterans is increasing, as is the use of eye care services. Cataract surgery rates did not increase, which may indicate a need to increase availability of these services.


Assuntos
Grupos Étnicos , Oftalmopatias/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , United States Department of Veterans Affairs/estatística & dados numéricos , Veteranos , Estudos Transversais , Oftalmopatias/diagnóstico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estados Unidos
19.
JAMA Ophthalmol ; 134(10): 1111-1118, 2016 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-27490785

RESUMO

Importance: Understanding the importance of eye health to the US population across ethnic and racial groups helps guide strategies to preserve vision in Americans and inform policy makers regarding priority of eye research to Americans. Objective: To understand the importance and awareness of eye health in the US population across ethnic and racial groups. Design, Setting, and Participants: Online nationwide poll created by experienced policy makers in August 2014 designed to understand the importance of eye health in the US population, although the poll was not subjected previously to formal construct-validity testing. The population survey comprised 2044 US adults including non-Hispanic white individuals and minority groups with minority oversampling to provide predicted margins of error no greater than 5%. Main Outcomes and Measures: Respondent attitudes on the importance of eye health, concerns about losing vision, support for eye health research, and awareness of eye diseases and risk factors. Results: Of the 2044 survey respondents, the weighten mean age was 46.2 years, 48% were male, and 11% were uninsured. Sixty three percent reported wearing glasses. Most individuals surveyed (87.5%; 95% CI, 84.5%-90%) believed that good vision is vital to overall health while 47.4% (95% CI, 43.7%-51.1%) rated losing vision as the worst possible health outcome. Respondents ranked losing vision as equal to or worse than losing hearing, memory, speech, or a limb. When asked about various possible consequences of vision loss, quality of life ranked as the top concern followed by loss of independence. Nearly two-thirds of respondents were aware of cataracts (65.8%) or glaucoma (63.4%); only half were aware of macular degeneration; 37.3% were aware of diabetic retinopathy; and 25% were not aware of any eye conditions. Approximately 75.8% and 58.3%, respectively, identified sunlight and family heritage as risk factors for losing vision; only half were aware of smoking risks on vision loss. Conclusions and Relevance: In this well-characterized survey across all US ethnic and racial groups, vision health was a priority with high support for ongoing research for vision and eye health. Many Americans were unaware of important eye diseases and their behavioral or familial risk factors. The consistency of these findings among the varying ethnic/racial groups underscores the importance of educating the public on eye health and mobilizing public support for vision research.


Assuntos
Atitude , Grupos Étnicos , Oftalmopatias/psicologia , Disparidades nos Níveis de Saúde , Opinião Pública , Qualidade de Vida , Inquéritos e Questionários , Adulto , Oftalmopatias/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários , Morbidade/tendências , Estudos Retrospectivos , Estados Unidos/epidemiologia
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