Prevalence and Causes of Visual Impairment and Blindness in Adults Aged 45 Years and Older from Parintins: The Brazilian Amazon Region Eye Survey

Furtado, João M.; Berezovsky, Adriana; Ferraz, Nívea Nunes; Muñoz, Sergio; Watanabe, Sung Eun Song; Cunha, Cristina Coimbra; Vasconcelos, Galton Carvalho; Sacai, Paula Yuri; Cypel, Marcela; Mitsuhiro, Márcia H.; Morales, Paulo Henrique; Cohen, Marcos Jacob; Campos, Mauro; Cohen, Jacob; Belfort, Rubens; Salomão, Solange Rios

doi:10.1080/09286586.2019.1624783

Cited by 24 publications

(29 citation statements)

References 26 publications

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“…The association between age and visual impairment and blindness found in the Xingu Indigenous population are in accordance with previous studies, with rates increasing with aging [ 1 , 18 – 20 ]. The magnitude of blindness, however, indicate a worse ocular health in the indigenous population when compared to the overall worldwide population.…”

Section: Discussionsupporting

confidence: 92%

“…In the evaluated indigenous population, the burden of blindness was significantly higher than the worldwide statistics. The most recent national survey in the Brazilian Amazon Region showed a prevalence of blindness in adults 45 years and older of 2.8%, still significantly lower than the results from the current study [ 20 ]. As a result, public health policies designed aiming the decrease of blindness rates in general populations may not be efficient to cover minority populations as the indigenous, once specific data of those populations are often ignored when general estimates are calculated.…”

Section: Discussioncontrasting

confidence: 88%

“…Following the results from national population-based studies and worldwide trends, cataract and uncorrected refractive errors were the main causes of visual impairment and blindness in the population [ 2 , 18 – 20 ]. Main causes of blindness varied according to the age group with uncorrected refractive error showing a higher impact on younger individuals and cataracts on older individuals.…”

Section: Discussionmentioning

confidence: 99%

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Visual impairment and blindness in the Xingu Indigenous Park – Brazil

Alves

Nascimento

Valdrighi

et al. 2021

Int J Equity Health

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Background Most estimates of visual impairment and blindness worldwide do not include data from specific minority groups as indigenous populations. We aimed to evaluate frequencies and causes of visual impairment and blindness in a large population sample from the Xingu Indigenous Park. Methods Cross-sectional study performed at Xingu Indigenous Park, Brazil, from 2016 to 2017. Residents from 16 selected villages were invited to participate and underwent a detailed ocular examination, including uncorrected (UVA) and best-corrected visual acuity (BCVA). The main cause of UVA < 20/32 per eye was determined. Results A total of 2,099 individuals were evaluated. Overall, the frequency of visual impairment and blindness was 10.00% (95% CI: 8.72–11.29%) when considering UVA, decreasing to 7.15% (95% CI: 6.04–8.25%) when considering BCVA. For each increasing year on age, the risk of being in the visually impaired or blind category increased by 9% (p < 0.001). Cataracts (39.1%) and uncorrected refractive errors (29.1%) were the most frequent causes of visual impairment and blindness in this population. The main causes among those aged 45 years and more were cataracts (54.5%) while refractive errors were the main cause in adults aged 18 to 45 years (50.0%) and children up to 18 years old (37.1%). Conclusions A higher frequency of visual impairment and blindness was observed in the indigenous population when compared to worldwide estimates with most of the causes being preventable and/or treatable. Blindness prevention programs should focus on accessibility to eye exam, cataract surgeries and eyeglass distribution.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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Visual impairment and blindness in the Xingu Indigenous Park – Brazil

Alves

Nascimento

Valdrighi

et al. 2021

Int J Equity Health

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“…Systematic evaluation of the anterior segment is not universally performed in teleophthalmology strategies of DR screening [ 15 , 16 ], and the presence of cataracts is usually considered a flaw in such strategies, as lens opacities frequently preclude DR classification [ 21 ]; some screening protocols propose the exclusion of patients with cataracts [ 22 ]. However, by evaluating anterior segment images, the reader is able to judge whether cataracts are the reason for ungradable fundus images, which is a clinically relevant information, as cataracts are a significant public health issue and an important cause of blindness in developing countries [ 23 ]. We believe that grouping cataract and referable DR patients is effective in providing proper health care for those individuals; cataract referral and treatment in patients with diabetes should follow a special protocol because of the increased risk of ocular complications in such patients.…”

Section: Discussionmentioning

confidence: 99%

Diabetic retinopathy screening in urban primary care setting with a handheld smartphone-based retinal camera

Queiroz

Carvalho²,

Bortoto

et al. 2020

Acta Diabetol

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Aims To evaluate diabetic retinopathy (DR) screening with a portable handheld smartphone-based retinal camera and telemedicine in an urban primary healthcare setting and to evaluate the learning curve for image acquisition, performed by healthcare personnel without previous experience in retinal imaging. Methods This was a prospective study that enrolled patients with type 2 diabetes mellitus (T2DM) followed at a primary healthcare unit in São Paulo, Brazil. After a brief training in image acquisition, there was further continuous feedback given by a retina specialist during the remote image reading process. Each patient underwent two fundus and one anterior ocular segment images per eye, after mydriasis. Patients were classified according to the need of referral. Results A total of 627 adult individuals with T2DM underwent retinal evaluation. The population was composed by 63.2% female individuals, age median of 66 years, diabetes duration 10.7 ± 8.2 years and HbA1c 7.7 ± 1.9% (61 + 20.8 mmol/mol). The most prevalent associated comorbidities were arterial hypertension (80.3%) and dyslipidemia (50.2%). Referral decision was possible in 81.2% patients. Most patients had absent or non-referable DR; the main ocular media opacity detected was cataract. After the 7th day of image acquisition, the daily rate of patients whose images allowed clinical decision was maintained above 80%. A higher HbA1c was associated with referable DR. Conclusions A low-cost DR screening strategy with a handheld device and telemedicine is feasible and has the potential to increase coverage of DR screening in underserved areas; the possibility of mobile units is relevant for DR screening in the context of COVID-19 pandemic. This article belongs to the topical collection Eye Complications of Diabetes, managed by Giuseppe Querques.

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“…Em Botucatu, cujo estudo avaliou pessoas de 1 a 91 anos de idade, a frequência de deficiência visual moderada e grave foi de 1,3% e cegueira de 0,4% e as principais causas foram erro refrativo e catarata, respectivamente 10 . Na cidade de Parintins, na região norte do Brasil, Furtado et al 11 encontraram frequência de 6,9% de pessoas com deficiência visual moderada e as principais causas foram erro refrativo, catarata e pterígio.…”

Section: Who-world Health Organizationunclassified

Causas de baixa visão funcional e perfil dos usuários de um serviço de reabilitação visual no Estado de São Paulo

Ferreira¹

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Fortes Furtado, pela preciosa orientação, estímulo e apoio concedidos. Um exemplo como professor, pesquisador e pessoa. À Profa. Dra Rosália Maria Simões Antunes Foschini, por partilhar sua experiência, pelas palavras de otimismo, pela orientação e amizade. Aos Professores EduardoMelani Rocha e Maria de Lourdes Veronese Rodrigues, pelas orientações e sugestões no exame de qualificação.

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Prevalence and Causes of Visual Impairment and Blindness in Adults Aged 45 Years and Older from Parintins: The Brazilian Amazon Region Eye Survey

Cited by 24 publications

References 26 publications

Visual impairment and blindness in the Xingu Indigenous Park – Brazil

Visual impairment and blindness in the Xingu Indigenous Park – Brazil

Diabetic retinopathy screening in urban primary care setting with a handheld smartphone-based retinal camera

Causas de baixa visão funcional e perfil dos usuários de um serviço de reabilitação visual no Estado de São Paulo

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