Prevalence and the risk factors for visual impairment in age-related macular degeneration

Abstract

PurposeTo characterize the type, and the causes of visual impairment (VI) in various stages of early and late age-related macular degeneration (AMD) and the factors associated with visual impairment in subjects with AMDMethods6617 subjects ≥60 years were enumerated; 5495 (83.04%) participated in eye examination. Of which, 4791 subjects had gradable fundus images. AMD was graded per International ARM Epidemiological Study Group. Subjects underwent detailed ophthalmic exam. VI was defined per the WHO classification. Mild VI was defined as VA less than 6/12 to 6/18, moderate VI-VA less than 6/18 but up to 6/60, severe VI-VA less than 6/60 but up to 3/60 and legal blindness-VA worse than 3/60. Factors associated with VI in AMD was analyzed with univariate and logistic regression analysis.ResultsNine hundred and eighty-eight subjects were identified as having AMD (893 with early AMD and 95 with late AMD); 85% of the subjects (95% CI: 82.7-87.1) had no VI, 13.1% had mild VI (95% CI: 11.1-15.3), 0.8% had severe VI (95% CI: 0.4-1.6), 1.1% had legal blindness (95% CI: 0.6-1.9). Prevalence of any VI was 13.7% in early AMD and 27.4% in late AMD, P=0.0004; age group 65-70 years (OR=1.89, 95% CI: 1.16-3.08, P=0.011), and those ≥75 years (OR=3.67, 95% CI: 1.95-6.91, P=0.0001) had greater odds of VI compared with age group 60-64 years. Male gender was a protective factor for VI (OR=0.57, CI: 0.36-0.90, P=0.016). Cataract (31.8%) and refractive error (28.4%) accounted for a majority of the VI.ConclusionsCataract and refractive error account for a significant proportion of VI in the south Indian population with AMD. Early AMD is the third leading cause of VI. Greater age and female gender are associated with VI in subjects with AMD.

Gender variation in central serous chorioretinopathy

“…Indeed, epidemiological studies have suggested that AMD appears more prevalent in female individuals in many studies, although similar studies in Asia have found a higher prevalence in male patients [2,18,19]. Male gender has been suggested, however, as a possible protective factor in AMD [20]. Structural variations do not necessarily reflect these visual acuity trends; it has been suggested that features of early AMD appear more consistently in patients with male patients [21].…”

Prevalence of severe visual impairment and barriers to access eye care services in the Udupi district

“…The service-related barriers were lack of affordability and accessibility. 17 Our analysis also clearly shows that the majority of the rural population under study with less than 10 years of schooling did not seek eye care mainly due to lack of knowledge about availing health care facility, as well as the economic and social burden of accessing ophthalmic care. Less than 10 years of schooling had a statistically significant association with the prevalence of SVI.…”

“…15 Our study found that, in spite of being close to a tertiary care hospital, availability of primary and secondary level of care nearby, and many awareness programs being conducted in this area, 17.7% of subjects were found to have SVI, i.e., visual acuity less than 6/60 or inability to count fingers at 6 meters in one or both eyes. Other studies in comparable populations, such as by Zhang et al 16 and Srinivisan et al 17 found much lower prevalence of SVI at 0.9% and 0.8%, respectively.…”

Yaşa bağlı makular dejenerasyonu olan hastaların beslenme durumlarının değerlendirilmesi

“…Bu nedenle bütün bu risk faktörleri ve hastalığın seyri için pozitif etkileri olduğu bilinen antioksidan vitamin ve minerallerin, ve diğer makro ve mikrobesin ögelerinin tek başına değerlendirilmesi doğru değildir (35)(36)(37). Hastalığın oluşumunda temel risk faktörü ileri yaş olarak belirtilirken, retinanın oksijenlenmesinin azalması ve buna katkıda bulunan çevresel faktörlerin birlikte değerlendirilmesi, hastalığın seyri hakkında daha doğru bilgi vermektedir (38)(39). Bu nedenle YBMD hastaları üzerinde yapılan çalışmalar birden fazla risk faktörünü birlikte değerlendirmektedir (18, [40][41].…”