Prevalence of visual impairment, blindness, ocular disorders and cataract surgery outcomes in low-income elderly from a metropolitan region of São Paulo - Brazil

Filho, Arnaud Araújo; Salomão, Solange Rios; Berezovsky, Adriana; Cinoto, R.; Morales, Paulo Henrique; Santos, Francisco Roberto Gonçalves; Belfort, Rubens

doi:10.1590/s0004-27492008000200021

Cited by 26 publications

(8 citation statements)

References 25 publications

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“…It is estimated that about one third of individuals aged 75 and older suffer from some form of AMD (Zarbin, 2004). While the disease is particularly prevalent in developed countries, especially in individuals with Caucasian ethnicities, it is becoming a global health concern (Ambati et al, 2003) due to increases in life expectancies worldwide, with the number of people becoming blind or losing substantial eyesight because of AMD predicted to increase steeply (Araujo Filho et al, 2008). Additionally, more attention is now being focused on AMD as expectations for a high quality of life, including functions such as driving and reading, increase in communities around the world.…”

Section: Introductionmentioning

confidence: 99%

Stem cell based therapies for age-related macular degeneration: The promises and the challenges

Nazari

Zhang

Zhu

et al. 2015

Progress in Retinal and Eye Research

167

128

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Age-related macular degeneration (AMD) is the leading cause of blindness among the elderly in developed countries. AMD is classified as either neovascular (NV-AMD) or non-neovascular (NNV-AMD). Cumulative damage to the retinal pigment epithelium, Bruch's membrane, and choriocapillaris leads to dysfunction and loss of RPE cells. This causes degeneration of the overlying photoreceptors and consequential vision loss in advanced NNV-AMD (Geographic Atrophy). In NV-AMD, abnormal growth of capillaries under the retina and RPE, which leads to hemorrhage and fluid leakage, is the main cause of photoreceptor damage. Although a number of drugs (e.g., anti-VEGF) are in use for NV-AMD, there is currently no treatment for advanced NNV-AMD. However, replacing dead or dysfunctional RPE with healthy RPE has been shown to rescue dying photoreceptors and improve vision in animal models of retinal degeneration and possibly in AMD patients. Differentiation of RPE from human embryonic stem cells (hESC-RPE) and from induced pluripotent stem cells (iPSC-RPE) has created a potentially unlimited source for replacing dead or dying RPE. Such cells have been shown to incorporate into the degenerating retina and result in anatomic and functional improvement. However, major ethical, regulatory, safety, and technical challenges have yet to be overcome before stem cell-based therapies can be used in standard treatments. This review outlines the current knowledge surrounding the application of hESC-RPE and iPSC-RPE in AMD. Following an introduction on the pathogenesis and available treatments of AMD, methods to generate stem cell-derived RPE, immune reaction against such cells, and approaches to deliver desired cells into the eye will be explored along with broader issues of efficacy and safety. Lastly, strategies to improve these stem cell-based treatments will be discussed.

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Section: Introductionmentioning

confidence: 99%

Stem cell based therapies for age-related macular degeneration: The promises and the challenges

Nazari

Zhang

Zhu

et al. 2015

Progress in Retinal and Eye Research

167

128

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“…Furthermore, glaucoma must have been substantially underestimated as a cause of blindness in numerous population studies which have relied solely on VA [2,5-14,16,17,19-21]. Relying on visual acuity alone results in under-estimation of impairment caused by other disease, e.g., in onchocerciasis [26].…”

Section: Discussionmentioning

confidence: 99%

“…In some cases, the prevalence of visual impairment (blindness and low vision) in glaucoma is studied and reported based on VA alone, i.e., not including visual field status [2-21]. It seems obvious that this approach will yield falsely low estimates of the prevalence, because visual impairment will not be recognised in patients who have end-stage glaucomatous visual field loss with preserved central VA.…”

Section: Introductionmentioning

confidence: 99%

The effect of different criteria on the number of patients blind from open-angle glaucoma

2011

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BackgroundThe prevalence of blindness and visual impairment from glaucoma is influenced by the criteria used to define these entities, which differ between countries and regions, as well as among published reports. The objective of the present study was to ascertain the extent to which different criteria of blindness and visual impairment influence estimates of the number of patients classified as blind or visually impaired by glaucoma in a clinic-based population.MethodsWe conducted a retrospective chart review of 914 patients with open-angle glaucoma to compare numbers of patients identified as visually impaired with and without considering visual field status. We also compared proportions classified using World Health Organisation (WHO) and United States (US) blindness criteria, and applying a new US Social Security Administration (SSA) disability criterion: perimetric mean deviation (MD) ≤ -22 dB.ResultsForty patients (4.4%) were bilaterally blind from glaucoma by the WHO criteria. Fifty-two (5.7%) were blind by the the US criterion. Assessing only visual acuity, 14 (1.5%) patients were blind by the WHO criteria and 24 (2.6%) by the US definition. Eighty-five (9.3%) met the US SSA disability criterion. Among those, 52 were impaired also by the WHO definition. No patients impaired according to the WHO criteria had MD values better than -22 dB.ConclusionsExcluding visual field status will seriously underestimate the prevalence of glaucoma blindness. In our patient population, 30% more patients were classified as blind by the US than by the WHO definition. Also, 60% more were identified as visually impaired by the US SSA criterion than by the WHO criteria. Visual field assessment is vital to determine visual impairment caused by glaucoma.

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“…The Sao Paulo Eye Study showed a prevalence of visual impairment at about 4.74% and of bilateral blindness at 1.51%. 12 In another study made in Campinas, Sao Paulo, Brazil, blindness was found in 1.98% of inhabitants. 13 This represents not only a significant burden to those who are affected, but it also represents a large social and economic cost to the State.…”

mentioning

confidence: 94%

Evaluation of efficacy, efficiency and effectiveness of community projects of visual health in the population of the amazon riversides

Loduca¹,

Rehder²,

Neto³

et al. 2016

Medical Express

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OBJECTIVE:To estimate the prevalence of eye diseases in the Amazon region and evaluate the efficacy, efficiency and effectiveness of community projects of visual health in underserved communities. METHODS: Retrospective, observational and ecological study, which covers the underserved communities of the Brazilian Amazon by the Amazon Project Vision 2000. The data were retrieved from a total sample of 1,276 patients. A questionnaire was applied to patients with 22 questions divided into general and health data. All patients were submitted to a complete eye examination. All project data were stored in a database for later evaluation. RESULTS: Of the 1,276 patients evaluated, 65% were female, 51.9% said they had never had an eye examination and 91% believed to have some visual problem. Emmetropia was detected in 3.8% and 47.2% had presbyopia. Cataract (16.2%) and pterygium (23.6%) were the prevalent diseases. During the project, cataract surgeries were performed in 27.6% and pterygium in 6.9% of patients. When asked why they had not operated before, 24.1% said they had no financial conditions and 55.2% because there was no specialized doctor nearby. CONCLUSION: Refractive errors, pterygium and cataract were the most common ocular findings in the population evaluated. The Amazon Project Vision 2000 provided the equipment and resources for the activities proposed, reaching the pre-defined goal. KEYWORDS:

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Prevalence of visual impairment, blindness, ocular disorders and cataract surgery outcomes in low-income elderly from a metropolitan region of São Paulo - Brazil

Cited by 26 publications

References 25 publications

Stem cell based therapies for age-related macular degeneration: The promises and the challenges

Stem cell based therapies for age-related macular degeneration: The promises and the challenges

The effect of different criteria on the number of patients blind from open-angle glaucoma

Evaluation of efficacy, efficiency and effectiveness of community projects of visual health in the population of the amazon riversides

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