Ethnic differences in the incidence of pterygium in a multi-ethnic Asian population: the Singapore Epidemiology of Eye Diseases Study

Abstract

We evaluated the 6-year incidence and risk factors of pterygium in a multi-ethnic Asian population. Participants who attended the baseline visit of the Singapore Epidemiology of Eye Diseases Study (year 2004–2011) and returned six years later, were included in this study. Pterygium was diagnosed based on anterior segment photographs. Incident pterygium was defined as presence of pterygium at 6-year follow-up in either eye, among individuals without pterygium at baseline. Multivariable logistic regression models were used to determine factors associated with incident pterygium, adjusting for baseline age, gender, ethnicity, body mass index, occupation type, educational level, income status, smoking, alcohol consumption, presence of hypertension, diabetes and hyperlipidemia. The overall age-adjusted 6-year incidence of pterygium was 1.2% (95% confidence interval [CI] 1.0–1.6%); with Chinese (1.9%; 95% CI 1.4%-2.5%) having the highest incidence rate followed by Malays (1.4%; 95% CI 0.9%-2.1%) and Indians (0.3%; 95% CI 0.3–0.7%). In multivariable analysis, Chinese (compared with Indians; odds ratio [OR] = 4.21; 95% CI 2.12–9.35) and Malays (OR 3.22; 95% CI 1.52–7.45), male (OR 2.13; 95% CI 1.26–3.63), outdoor occupation (OR 2.33; 95% CI 1.16–4.38), and smoking (OR 0.41; 95% CI 0.16–0.87) were significantly associated with incident pterygium. Findings from this multi-ethnic Asian population provide useful information in identifying at-risk individuals for pterygium.

UV Protection in the Cornea: Failure and Rescue

“…These vascularized, fibrotic degenerations continuously advance across the cornea over time [ 67 ]. It is well documented across several ethnicities, locations, and age-groups that the primary risk factor of pterygia is UV [ 68 , 69 , 70 , 71 , 72 , 73 ]. The incidence is generally higher for men than for women (14.5% vs. 13.6%), and unilateral cases were more prevalent than bilateral cases [ 74 ].…”

Machine learning with validation to detect diabetic microvascular complications using clinical and metabolomics data

“…We derived the study data from Singapore Epidemiology of Eye Diseases study (SEED), a population-based cross-sectional study conducted in Singapore from 2004 to 2011, with methodological details reported elsewhere [11]. In brief, we recruited participants aged 40-80 years in an age-stratified random sampling manner and asked them to take the interviewer-administered questionnaire, ocular examinations, and biochemical laboratory tests.…”

Expression profiling suggests the involvement of hormone-related, metabolic, and Wnt signaling pathways in pterygium progression

“…The incidence of pterygium was 1.4% in the Asian population and 2.1% in the Chinese (3). Ultraviolet (UV) radiation, male gender, older age, ethnicity, outdoor occupation, and air pollution were associated with the occurrence and development of pterygium (3)(4)(5). Pterygium excision with conjunctival autograft and adjuvant therapy is the conventional treatment (6).…”

“…Furthermore, other studies have reported the involvement of various matrix metalloproteinases in the progression of pterygium (MMP1, MMP2, MMP3, MMP9, and MMP13) (24)(25)(26). On the other hand, it has been reported that the Chinese have a higher incidence of the disease than the whole Asian population (3), so the transcriptomic information needs to be more abundant. Moreover, identifying the similarities and differences of transcripts between Asian studies is necessary to reveal the underlying mechanisms of pterygium.…”

“…Pterygium is a benign ocular surface disease that typically appears as a fibrovascular conjunctiva thickening from the nasal side and may progressively extend onto the cornea, causing visual impairment ( 1 , 2 ). The incidence of pterygium was 1.4% in the Asian population and 2.1% in the Chinese ( 3 ). Ultraviolet (UV) radiation, male gender, older age, ethnicity, outdoor occupation, and air pollution were associated with the occurrence and development of pterygium ( 3 – 5 ).…”