Singapore Chinese Eye Study: key findings from baseline examination and the rationale, methodology of the 6-year follow-up series

2019 ◽  
Vol 104 (5) ◽  
pp. 610-615 ◽  
Author(s):  
Shivani Majithia ◽  
Yih Chung Tham ◽  
Miao Li Chee ◽  
Cong Ling Teo ◽  
Miao-Ling Chee ◽  
...  
Keyword(s):  
Low Vision ◽  
Health Impact ◽  
Population Based ◽  
Current Smoker ◽  
Eye Diseases ◽  
Age Related Macular Degeneration ◽  
Care Needs ◽  
Age Related ◽  
Singapore Chinese

Background/aimsIn order to address the eye care needs of the increasing numbers of elderly Chinese globally, there is a need for comprehensive understanding on the longitudinal trends of age-related eye diseases among Chinese. We herein report the key findings from the baseline Singapore Chinese Eye Study (SCES-1), and describe the rationale and methodology of the 6-year follow-up study (SCES-2).Methods3353 Chinese adults who participated in the baseline SCES-1 (2009–2011) were invited for the 6-year follow-up SCES-2 (2015–2017). Examination procedures for SCES-2 included standardised ocular, systemic examinations and questionnaires identical to SCES-1. SCES-2 further included new examinations such as optical coherence tomography angiography, and questionnaires to evaluate health impact and economic burden of eye diseases.ResultsIn SCES-1, the age-adjusted prevalence of best-corrected low vision (VA<6/12, better-seeing eye) and blindness (VA<6/60, better-seeing eye) were 3.4% and 0.2%, respectively. The prevalence rates for glaucoma, age related macular degeneration, and diabetic retinopathy (among diabetics) were 3.2%, 6.8%, 26.2%, respectively. Of the 3033 eligible individuals from SCES-1, 2661 participated in SCES-2 (response rate=87.7%). Comparing with those who did not attend SCES-2, those attended were younger, had higher SES (all p<0.001), but less likely to be a current smoker, to have diabetes, hypertension, hyperlipidaemia (all p≤0.025).ConclusionsBuilding on SCES-1, SCES-2 will be one of the few longitudinal population-based eye studies to report incidence, progression, and risk factors of major age-related eye diseases. Findings from this cohort may offer new insights, and provide useful reference information for other Chinese populations elsewhere.

scholarly journals Plasma Lutein, a Nutritional Biomarker for Development of Advanced Age-Related Macular Degeneration: The Alienor Study

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2047
Author(s):  
Bénédicte M. J. Merle ◽  
Audrey Cougnard-Grégoire ◽  
Jean-François Korobelnik ◽  
Wolfgang Schalch ◽  
Stéphane Etheve ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
High Performance ◽  
Population Based ◽  
Age Related Macular Degeneration ◽  
Cox Proportional Hazard ◽  
Age Related ◽  
Cox Proportional Hazard Models ◽  
Adjusted Model ◽  
Reduced Risk

Lutein and zeaxanthin may lower the risk of age-related macular degeneration (AMD). We evaluated the associations of plasma lutein and zeaxanthin with the incidence of advanced AMD in the Alienor study (Antioxydants Lipides Essentiels Nutrition et Maladies Oculaires). Alienor study is a prospective population-based cohort of 963 residents of Bordeaux, France, who were 73 years or older at baseline (2006–2008). The present study included 609 participants with complete ophthalmologic and plasma carotenoids data. Examinations were performed every two years over an eight-year period (2006 to 2017). Plasma lutein and zeaxanthin were determined at baseline from fasting blood samples using high-performance liquid chromatography. Cox proportional hazard models were used to assess associations between plasma lutein, zeaxanthin, and their (total cholesterol (TC) + triglycerides (TG)) ratios with AMD. Among the 609 included participants, 54 developed advanced incident AMD during a median follow-up time of 7.6 years (range 0.7 to 10.4). Participants with higher plasma lutein had a reduced risk for incident advanced AMD in the fully adjusted model (HR = 0.63 per 1-SD increase (95% CI, 0.41–0.97), p = 0.03). A similar association was observed using the lutein/(TC + TG) ratio (HR = 0.59 (95% CI, 0.39–0.90), p = 0.01). No associations were evidenced for other carotenoids. Higher plasma lutein was associated with a 37% reduced risk of incident advanced AMD.

scholarly journals Five-year cumulative incidence and progression of age-related macular degeneration: results from the German population-based Gutenberg Health Study (GHS)

2021 ◽  
Author(s):  
Christina A. Korb ◽  
Hisham Elbaz ◽  
Alexander K. Schuster ◽  
Stefan Nickels ◽  
Katharina A. Ponto ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Cumulative Incidence ◽  
Population Based ◽  
Age Related Macular Degeneration ◽  
Fundus Photography ◽  
Health Study ◽  
German Population ◽  
Gutenberg Health Study ◽  
Age Related

Abstract Purpose Age-related macular degeneration (AMD) is a major cause of visual impairment and blindness. This study evaluates the incidence and progression of AMD in a large German cohort. Methods The Gutenberg Health Study (GHS) is a population-based, prospective, observational cohort study in Germany that includes 15,010 participants between 35 and 74 years of age. The baseline examination, including fundus photography, was conducted between 2007 and 2012, and the 5-year follow-up examination was performed between 2012 and 2017. AMD grading of fundus photographs was performed according to the Rotterdam Eye Study classification. The 5-year cumulative incidence and progression of AMD were calculated. Poisson regression analysis was conducted to investigate factors associated with the cumulative incidence and progression of AMD. Results Six-thousand-eight-hundred-eighty-eight participants (49.8%, n = 3427 female) were included in the analysis. AMD prevalence was 8.5% [95% CI: 7.9–9.2%] at baseline and 10.3% [95% CI: 9.6–11.1%] at follow-up. The cumulative 5-year-incidence was 2.0% [1.7–2.4%]. AMD progression within 5 years was seen in 18.1% [95% CI: 15.1–21.5%] of the participants. AMD incidence and AMD progression were associated with higher age, for each 10-year increase in age, the risk of AMD doubles (RR = 2.30), and the risk of progression of the disease is increased by 1.6. while AMD incidence also with pseudophakic status. Conclusions In summary, this population-based sample provides substantial epidemiologic data from a large German cohort, including data on progression and cumulative incidence of macular degeneration in younger age groups. AMD progression over 5 years is common in the German population, 18.1% of subjects with AMD showed progression in at least one eye in this time frame and is associated with higher age. Nevertheless, although usually defined to occur over the age of 50, in this cohort AMD occurred in 0.5% and AMD progression occurred in 5.4% of those already affected in the youngest age group before 50 years of age.

scholarly journals Causes of visual impairment and blindness among the middle-aged and elderly in northern Jordan

2002 ◽  
Vol 8 (2-3) ◽  
pp. 404-408
Author(s):  
A. Haddadin ◽  
I. Ereifej ◽  
F. Zawaida ◽  
H. Haddadin
Keyword(s):  
Visual Acuity ◽  
Low Vision ◽  
The Elderly ◽  
Education Programme ◽  
Population Based ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Common Causes ◽  
Northern Jordan ◽  
Population Based Survey

Causes of bilateral low vision [BLLV] and bilateral blindness [BLB] were investigated among 720 outpatients aged > 45 years in Irbid, Jordan, between July 1999 and October 2000. All received full ophthalmic examinations. BLLV was defined as visual acuity < 6/18 but > 3/60 in the better eye; BLB as acuity < 3/60 in the better eye. The leading cause of BLB and BLLV was cataract. Refractive error was the second major cause of BLLV. Other common causes were diabetic retinopathy and glaucoma. Age-related macular degeneration was the single cause of BLB and BLLV for only 1.6% and 2.8% respectively. A population-based survey of BLB and BLLV in the elderly, yearly vision examinations and an ophthalmic education programme are recommended.

scholarly journals Incidence, progression and risk factors of age-related macular degeneration in 35–95-year-old individuals from three jointly designed German cohort studies

2022 ◽  
Vol 7 (1) ◽  
pp. e000912
Author(s):  
Caroline Brandl ◽  
Felix Günther ◽  
Martina E Zimmermann ◽  
Kathrin I Hartmann ◽  
Gregor Eberlein ◽  
...  
Keyword(s):  
Risk Factor ◽  
Macular Degeneration ◽  
Population Based ◽  
Healthcare Management ◽  
Age Related Macular Degeneration ◽  
Severity Scale ◽  
Fundus Imaging ◽  
Age Related ◽  
Age Range

ObjectiveTo estimate age-related macular degeneration (AMD) incidence/progression across a wide age range.Methods and analysisAMD at baseline and follow-up (colour fundus imaging, Three Continent AMD Consortium Severity Scale, 3CACSS, clinical classification, CC) was assessed for 1513 individuals aged 35–95 years at baseline from three jointly designed population-based cohorts in Germany: Kooperative Gesundheitsforschung in der Region Augsburg (KORA-Fit, KORA-FF4) and Altersbezogene Untersuchungen zur Gesundheit der Universität Regensburg (AugUR) with 18-year, 14-year or 3-year follow-up, respectively. Baseline assessment included lifestyle, metabolic and genetic markers. We derived cumulative estimates, rates and risk factor association for: (1) incident early AMD, (2) incident late AMD among no AMD at baseline (definition 1), (3) incident late AMD among no/early AMD at baseline (definition 2), (4) progression from early to late AMD.ResultsIncidence/progression increased by age, except progression in 70+-year old. We observed 35–55-year-old with 3CACSS-based early AMD who progressed to late AMD. Predominant risk factor for incident late AMD definition 2 was early AMD followed by genetics and smoking. When separating incident late AMD definition 1 from progression (instead of combined as incident late AMD definition 2), estimates help judge an individual’s risk based on age and (3CACSS) early AMD status: for example, for a 65-year old, 3-year late AMD risk with no or early AMD is 0.5% or 7%, 3-year early AMD risk is 3%; for an 85-year old, these numbers are 0.5%, 21%, 12%, respectively. For CC-based ‘early/intermediate’ AMD, incidence was higher, but progression was lower.ConclusionWe provide a practical guide for AMD risk for ophthalmology practice and healthcare management and document a late AMD risk for individuals aged <55 years.

scholarly journals Mortality during 6 years of follow-up in relation to visual impairment and eye disease: results from a population-based cohort study of people aged 50 years and above in Nakuru, Kenya

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e029700 ◽  
Author(s):  
Hannah Kuper ◽  
Wanjiku Mathenge ◽  
David Macleod ◽  
Allen Foster ◽  
Michael Gichangi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
Visual Impairment ◽  
Mortality Risk ◽  
Cumulative Incidence ◽  
Population Based ◽  
Age Related Macular Degeneration ◽  
Eye Disease ◽  
Age Related

ObjectiveTo estimate the association between (1) visual impairment (VI) and (2) eye disease and 6-year mortality risk within a cohort of elderly Kenyan people.Design, setting and participantsThe baseline of the Nakuru Posterior Segment Eye Disease Study was formed from a population-based survey of 4318 participants aged ≥50 years, enrolled in 2007–2008. Ophthalmic and anthropometric examinations were undertaken on all participants at baseline, and a questionnaire was administered, including medical and ophthalmic history. Participants were retraced in 2013–2014 for a second examination. Vital status was recorded for all participants through information from community members. Cumulative incidence of mortality, and its relationship with baseline VI and types of eye disease was estimated. Inverse probability weighting was used to adjust for non-participation.Primary outcome measuresCumulative incidence of mortality in relation to VI level at baseline.ResultsOf the baseline sample, 2170 (50%) were re-examined at follow-up and 407 (10%) were known to have died (adjusted risk of 11.9% over 6 years). Compared to those with normal vision (visual acuity (VA) ≥6/12, risk=9.7%), the 6-year mortality risk was higher among people with VI (<6/18 to ≥6/60; risk=28.3%; risk ratio (RR) 1.75, 95% CI 1.28 to 2.40) or severe VI (SVI)/blindness (<6/60; risk=34.9%; RR 1.98, 95% CI 1.04 to 3.80). These associations remained after adjustment for non-communicable disease (NCD) risk factors (mortality: RR 1.56, 95% CI 1.14 to 2.15; SVI/blind: RR 1.46, 95% CI 0.80 to 2.68). Mortality risk was also associated with presence of diabetic retinopathy at baseline (RR 3.18, 95% CI 1.98 to 5.09), cataract (RR 1.26, 95% CI 0.95 to 1.66) and presence of both cataract and VI (RR 1.57, 95% CI 1.24 to 1.98). Mortality risk was higher among people with age-related macular degeneration at baseline (with or without VI), compared with those without (RR 1.42, 95% CI 0.91 to 2.22 and RR 1.34, 95% CI 0.99 to 1.81, respectively).ConclusionsVisual acuity was related to 6-year mortality risk in this cohort of elderly Kenyan people, potentially because both VI and mortality are related to ageing and risk factors for NCD.

scholarly journals Four Years of Observation to Evaluate Autonomy and Quality of Life after Implantation of a High-Add Intraocular Lens in Age-Related Macular Degeneration Patients

2020 ◽  
Vol 11 (2) ◽  
pp. 448-456
Author(s):  
Andreas F. Borkenstein ◽  
Eva-Maria Borkenstein
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Low Vision ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Corrected Distance Visual Acuity ◽  
Near Visual Acuity ◽  
Dry Amd

Visual impairment resulting from advanced dry age-related macular degeneration (AMD) limits the ability to perform activities required for independent living and adversely affects quality of life. We aimed to determine changes in these parameters in patients with AMD-related geographic atrophy who underwent magnifying cataract surgery (MAGS) using a foldable, bifocal high-add intraocular lens (IOL). The high-add IOL (LENTIS® MAX LS-313 MF 80, Oculentis) was implanted in the better seeing or dominant eye of eligible patients with clinically significant cataract, best corrected distance visual acuity 1.3–0.5 logMAR (20/400–20/63), best corrected near visual acuity >0.8 logMAR (20/125), and stable advanced dry AMD. Self-reported feasibility of performing routine activities and change in quality of life were the main outcome measures. Eleven of 15 operated patients had complete follow-up to 48 months. There were no significant intraoperative or postoperative complications. AMD converted from dry to wet in 2 patients. All patients reported functional gains in the first 3–6 months after surgery, and 10/11 patients reported improved quality of life. From baseline to 48 months, functional performance remained improved in all patients, and quality of life remained improved in the 9 patients with stable AMD. Best corrected distance visual acuity and uncorrected near visual acuity improved in all cases after surgery. Conclusion: Implantation of the high-add IOL was safe and resulted in durable functional and quality of life benefits. To our knowledge, our report describes the longest prospective follow-up (4 years) of a series of patients undergoing MAGS for rehabilitation of low vision related to advanced AMD. Data are needed from larger cohorts, but our experience supports giving consideration to MAGS in appropriately selected patients with low vision related to advanced dry AMD. We encourage further industry development of this technology and additional clinical research to collect more outcomes data to determine its potential to help patients maintain highly valued autonomy and quality of life.

scholarly journals Pseudoexfoliation Syndrome Association with Aging and Ocular Changes in Cornea, Lens, Retina

2021 ◽  
Author(s):  
Ugnė Rumelaitienė ◽  
Dalia Žaliūnienė ◽  
Martynas Špečkauskas ◽  
Abdonas Tamošiūnas ◽  
Ričardas Radišauskas ◽  
...  
Keyword(s):  
Corneal Thickness ◽  
Population Based ◽  
Age Related Macular Degeneration ◽  
Pseudoexfoliation Syndrome ◽  
Ophthalmological Examination ◽  
Follow Up Study ◽  
Age Related ◽  
Increased Risk ◽  
Ocular Changes

Abstract Purpose: To examine the 10-year incidence of the pseudoexfoliation syndrome (PEX), possible risk factors of PEX, and its association with aging and ocular changes in cornea, lens, retina within a population-based follow-up study.Methods: The baseline examination was conducted in 2006 on a random sample of 1,033 adult participants from Kaunas city (Lithuania) population. Out of them 631 participants returned to the follow-up study in 2016. Ophthalmological examination included keratometry, central corneal pachymetry, after diagnostic mydriasis lens opacification was evaluated by LOCS III International classification, PEX was diagnosed by the presence of typical grayish-white exfoliation material on the anterior capsule surface of the lens.Results: During the 10 years follow-up, the prevalence of the PEX increased from 9.8% to 34.2%. Nuclear cataract was diagnosed the most both in the PEX-group and those without, however, there was no statistically significantly increased risk of developing cataract in those with PEX when compared to those without PEX (OR 1.2; p=0.61). Central corneal thickness (CCT) was thinner in PEX group (529±34μm) and in the eldest group (525±36μm) (p<0.001). Compared to baseline, corneal curvature (CC) became steeper both in the PEX and the no-PEX groups during the follow-up (p=0.013), but the difference didn’t reach significance between groups. The biggest part of corneal astigmatism was with-the-rule in no-PEX and PEX groups (37 vs 148; p>0.05). The age, sex and PEX had no influence to age related macular degeneration distribution.Conclusion: The prevalence of the PEX increased significantly with age. CCT was thinner in PEX group and in elder people. CC was flatter in PEX group.

Aflibercept in real-life for the treatment of age-related macular degeneration using a treat and extend protocol: The Armada study

2021 ◽  
pp. 112067212110057
Author(s):  
Pierre Gascon ◽  
Prithvi Ramtohul ◽  
Charles Delaporte ◽  
Sébastien Kerever ◽  
Danièle Denis ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Real Life ◽  
Age Related Macular Degeneration ◽  
Cumulative Number ◽  
Treat And Extend ◽  
Treatment Interval ◽  
Age Related ◽  
Treatment Naïve ◽  
The Mean

Purpose: To report the visual and anatomic outcomes in treatment-naïve neovascular age-related macular degeneration (nAMD) patients treated with aflibercept under a standardized Treat and Extend (T&E) protocol for up to 3 years of follow-up in “real-life” practice. Methods: This retrospective, observational, multicenter study included patients with treatment-naïve nAMD and at least 12 months of follow-up. T&E regimen adjustment was initiated after loading phase. At each visit best-corrected visual acuity (BCVA) and optical coherence tomography parameters were performed. Results: One hundred and thirty-six eyes of 115patients had at least 1 year of follow-up with 114 and 82 eyes completing at least 2 and 3 years of follow-up, respectively (mean follow-up duration: 2.7 ± 1.3 years). Mean age was 78.6 ± 8.6 years old and 52% were women. Mean BCVA increased from 60.6 ± 18.7 letters at diagnosis to 66.9 ± 16.2 letters at 1 year (+6.3 letters, p = 0.003) and remained stable throughout the follow-up period (63.1 ± 20.3 letters (+2.5, p = 0.1) and 64.0 ± 20.1 letters (+3.4, p = 0.27) at 2 and 3 years, respectively). The mean central retinal thickness decreased significantly from 358.2 ± 87.9 µm at baseline to 302 ± 71.7 µm at 12 months and maintained stable after 36 months of follow-up (297.1 ± 76 µm, p < 0.0001). Mean number of injections was 6.6 ± 2.2, 4.8 ± 1.9, and 5.6 ± 1.7 at 1, 2, and 3 years, respectively. Mean cumulative number of 16.4 ± 5.6 injections after 3 years. Mean treatment interval was 6.8 ± 2.5 weeks at 1 year. Eight-week and 12-week treatment interval were achieved in 59.5% and 19.1%, 65.8%, and 36.8% and 69.5% and 41.5% at 1, 2, and 3 years, respectively. Conclusions: Our study demonstrated that intravitreal injections of aflibercept initiated under a standardized T&E for patients with treatment-naïve nAMD allow for significant visual improvement at 12 months, which was maintained over a 3-year follow-up period.

scholarly journals Subthreshold laser treatment for reticular pseudodrusen secondary to age-related macular degeneration

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Giuseppe Querques ◽  
Riccardo Sacconi ◽  
Francesco Gelormini ◽  
Enrico Borrelli ◽  
Francesco Prascina ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Laser Treatment ◽  
Age Related Macular Degeneration ◽  
Short Term ◽  
Treated Area ◽  
Reticular Pseudodrusen ◽  
End Point ◽  
Age Related ◽  
Subthreshold Laser

AbstractThere is a lack of treatment aimed at the regression of reticular pseudodrusen (RPD) secondary to age-related macular degeneration (AMD). The aim of this prospective, pilot study is to evaluate the safety and short-term efficacy of subthreshold laser treatment (SLT) in patients affected by RPD secondary to dry AMD (dAMD). Twenty eyes of 20 patients (mean age 78.4 ± 6.8 years) with RPD secondary to dAMD were prospectively enrolled. All patients were treated in an extrafoveal area of 1.27 mm2 using end-point management yellow subthreshold laser and followed for 3 months. Best-corrected visual acuity was 0.140 ± 0.09 LogMAR at the baseline and no changes were observed during the follow-up (p = 0.232). No significant worsening was disclosed before and after the treatment analyzing the macular sensitivity of the treated area (p = 0.152). No topical and/or systemic side effects were disclosed during the 3-month follow-up. The distribution among the RPD stages changed after the treatment (p < 0.001). In detail, in the treated area, we observed a significant increase in the number of Stage 1 RPD during the follow-up (p = 0.002), associated with a significant decrease of Stage 3 RPD (p = 0.020). Outer nuclear layer (ONL) thickness analysis showed a significant increase after the treatment associated with RPD regression (p = 0.001). End-point management SLT appears a safe treatment for RPD secondary to dAMD, showing short-term safety outcomes. Our results suggest that SLT could be effective in inducing a RPD regression in terms of RPD stage and ONL thickening.

Sign in / Sign up

Export Citation Format

Share Document