Prevalence and risk factors for refractive errors and ocular biometry parameters in an elderly Asian population: the Singapore Longitudinal Aging Study (SLAS)

Abstract

Purpose To determine the prevalence rates of refractive errors and pattern of ocular biometry in a multi-ethnic elderly Asian population. Methods A population-based study of 1835 residents aged 55-85 years, evaluating the refractive error and ocular biometry parameters, including axial length (AL) and anterior chamber depth. Results The age-standardized prevalence of myopia, hyperopia, astigmatism, and anisometropia were 30.0% (95% confidence interval (CI): 29.6, 30.4), 41.5% (95% CI: 41.1, 41.9), 43.5% (95% CI: 43.1, 44.0), and 22.1% (95% CI: 21.7, 22.4), respectively. Male gender (P ¼ 0.02), age Z75 years (P ¼ 0.033), and higher educational level (Po0.001) were significantly associated with higher rates of myopia in multivariate analyses. The prevalence of astigmatism was higher in persons with diabetes (odds ratio (OR) 1.4, 95% CI: 1.03, 1.90, P ¼ 0.031). AL was longer in Chinese than other ethnic groups (23.7 vs 23.4 mm, P ¼ 0.018), and in men compared with women (24.2 vs 23.4 mm, Po0.001). AL was associated with increasing height (AL increased by 0.3 mm for every 10 cm increase in height, Po0.001). Conclusion There is a high prevalence of myopia in elderly Singaporeans, consistent with trends seen in younger populations in Asia. Male gender and higher education were independent risk factors for myopia. These data suggest that higher rates of myopia in East Asians compared with Caucasians may not be a recent phenomenon.

Myopia and Cognitive Dysfunction: The Singapore Malay Eye Study

“…7 Amyloid deposition in the lens can increase lens thickness and curvature, as well as promote lens crystalline aggregation, all of which can increase the refractive index. 8,9 Another possible mechanism is that acetylcholine deficiency, which occurs early in the course of cognitive dysfunction, 28 may reduce parasympathetic input to the ciliary muscle, decreasing the amplitude of accommodation. 29 Suboptimal accommodation during near work leads to hyperopic defocus on the retina, which has been shown to accelerate axial growth.…”

“…7,8 In contrast, myopia is strongly correlated with higher education and reading ability, which in turn could potentially reduce the risk of cognitive dysfunction. 9,10 We are unaware of studies that have directly examined a possible relationship between refractive errors and cognitive function. Thus, the purpose of our study was to examine the relationship between refractive errors and cognitive dysfunction in a population-based sample of adults aged 60 to 79 years.…”

Retinal Detachment - An Update of the Disease and Its Epidemiology - A Discussion Based on Research and Clinical Experience at the Prince Charles Eye Unit, Windsor, England

“…[17][18][19] Axial length is related to height and men tend to be taller than women. 20 Anatomical differences in the vitreoretinal base (with males having larger eyes hence longer vitreous chambers as described in 1912 by Salzmann's Anatomy and Histology of the Human Eyeball) can be in the form of greater migration of the posterior vitreous base towards the retina in males as reported by Wang et al, in their study of donor eyes. 21 This may predispose males to retinal breaks after PVD, either from greater dynamic vitreoretinal traction and/or an increase in vitreoretinal irregularities of the posterior border.…”

Prevalence and Risk Factors for Myopia in a Rural Korean Population

“…In the present study, subjects with a university education had two times higher risk than those with low grade education; whereas in a Singapore study, people with a university education had 5.4 times higher risk than those without education. 39 This finding suggests that even the people with low grade education may be substantially myopic in Korea.…”