Application of big-data for epidemiological studies of refractive error

Purpose To examine whether data sourced from electronic medical records (EMR) and a large industrial spectacle lens manufacturing database can estimate refractive error distribution within large populations as an alternative to typical population surveys of refractive error. Subjects A total of 555,528 patient visits from 28 Irish primary care optometry practices between the years 1980 and 2019 and 141,547,436 spectacle lens sales records from an international European lens manufacturer between the years 1998 and 2016. Methods Anonymized EMR data included demographic, refractive and visual acuity values. Anonymized spectacle lens data included refractive data. Spectacle lens data was separated into lenses containing an addition (ADD) and those without an addition (SV). The proportions of refractive errors from the EMR data and ADD lenses were compared to published results from the European Eye Epidemiology (E3) Consortium and the Gutenberg Health Study (GHS). Results Age and gender matched proportions of refractive error were comparable in the E3 data and the EMR data, with no significant difference in the overall refractive error distribution (χ2 = 527, p = 0.29, DoF = 510). EMR data provided a closer match to the E3 refractive error distribution by age than the ADD lens data. The ADD lens data, however, provided a closer approximation to the E3 data for total myopia prevalence than the GHS data, up to age 64. Conclusions The prevalence of refractive error within a population can be estimated using EMR data in the absence of population surveys. Industry derived sales data can also provide insights on the epidemiology of refractive errors in a population over certain age ranges. EMR and industrial data may therefore provide a fast and cost-effective surrogate measure of refractive error distribution that can be used for future health service planning purposes.

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The effect of initial lens diopter on myopia control by orthokeratology in Teenagers A retrospective Beijing Study

10.21203/rs.2.16212/v1 ◽

2019 ◽

Author(s):

Jifeng Yu ◽

Wei Shi ◽

Xue Liu ◽

Si-Yuan Li ◽

Li Li

Keyword(s):

Refractive Error ◽

Axial Length ◽

Study Data ◽

Refractive Errors ◽

Mixed Effect Model ◽

Mixed Effect ◽

Effect Model ◽

Significant Difference ◽

The Right ◽

Myopia Control

Abstract Background To investigate the effect of initial refractive error on the control of myopia by orthokeratology. Methods Retrospective study. Data were analyzed from 78 patients (156 eyes) who underwent orthokeratology in Beijing Children's Hospital from January 2014 to April 2018. The changes of axial length and diopter after wearing the lenses were measured. Patients were divided into six groups according to refractive error: <-1.00D, -1.00~ -2.00D, -2.00D~ -3.00D, -3.00D~ -4.00D, -4.00D~ -5.00D and -5.00~ -6.00D. A mixed-effect model was used to analyze the relevant data. At the same time, the interaction item between diopter and wearing time was analyzed, and the influence of gender was corrected. Results Patients averaged 12.9±2.161 years old. Two years after wearing orthokeratology lenses, there was a statistically significant difference with the interaction item between refractive error and wearing time in each group. The estimated values were 0.0631 for the right eye and 0.053 for the left eye. Orthokeratology lenses controlled the progression of myopia well, but the reduction depended on the initial diopters. Binocular axial length examination didn’t show statistically significant difference with the interaction item. Axial length increased with time, and the magnitude of increase did not differ among groups. However, the increase in the axial length of the male more than that of the female.Conclusion Initial refractive errors have a significant impact on the control of myopia by orthokeratology. The less severe myopia patient demonstrated a more pronounced benefits after wearing orthokeratology lenses. Key words: refractive error; myopia; orthokeratology

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A Randomized Clinical Trial Using Cyclopentolate and Tropiacmide to Compare Cycloplegic Refractions in Chinese Young Adults

10.21203/rs.3.rs-271275/v1 ◽

2021 ◽

Author(s):

Ruxia Pei ◽

Zhuzhu Liu ◽

Hua Rong ◽

Liqiong Zhao ◽

Bei Du ◽

...

Keyword(s):

Young Adults ◽

Epidemiological Studies ◽

Refractive Errors ◽

Spherical Equivalent ◽

Ocular Biometry ◽

Significant Difference ◽

Before And After ◽

The Mean ◽

Chinese Young Adults ◽

Medical University

Abstract Background: To evaluate the necessity of cycloplegia for epidemiological studies of refraction in Chinese young adults (aged 17-22 years) with dark irises, and to compare the cycloplegic effects of 1% cyclopentolate and 0.5% tropicamide in them. Methods: A total of 300 young adults (108 males and 192 females) aged 17 to 22 years ( mean 19.03±1.01 ) were recruited from Tianjin Medical University from November 2019 to January 2020. Participants were randomly divided into two groups. In the cyclopentolate group, two drops of 1% cyclopentolate eye drop were administrated (one drop every 5 min), followed by autorefraction and subjective refraction 30 to 45 min later. In the tropicamide group, four drops of 1% Mydrin P (Tropicamide 0.5%, phenylephrine HCl 0.5%) eye drop were given (one drop every 5 min), followed by autorefraction and subjective refraction 20 to 30 min later. The participants and the examiners were masked to the medication. Distance visual acuity, intraocular pressure (IOP), non-cycloplegic and cycloplegic autorefraction (Topcon KR-800, Topcon Co. Tokyo, Japan), non-cycloplegic and cycloplegic subjective refraction and ocular biometry (Lenstar LS-900) were performed.Results: The values of spherical equivalent (SE) and sphere component were significantly different before and after cycloplegia in the cyclopentolate group and the tropicamide group (p<0.05). The mean difference between noncycloplegic and cycloplegic autorefraction SE was 0.39 D (±0.66 D) in the cyclopentolate group and 0.39 D (±0.34 D) in the tropicamide group. There was no significant difference in the change of SE and sphere component after cycloplegia between the cyclopentolate group and the tropicamide group (p>0.05). In each group, no significant difference was found between autorefraction and subjective refraction after cycloplegia (p>0.05). We also found that more positive or less negative cycloplegic refraction was associated with the higher difference in SE in each group.Conclusions: Cycloplegic refractions were generally more positive or less negative than non-cycloplegic refractions. It is necessary to perform cycloplegia for Chinese young adults with dark irises to obtain accurate refractive errors. We suggest that cycloplegic autorefraction using tropicamide may be considered as a reliable method for epidemiological studies of refraction in Chinese young adults with dark irises.

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Changing trend in prevalence of refractive errors: a hospital-based study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20200979 ◽

2020 ◽

Vol 7 (3) ◽

pp. 1127

Author(s):

Vimal Krishna Rajput ◽

Naren B. Shetty

Keyword(s):

Refractive Error ◽

Statistical Tests ◽

Tertiary Care ◽

Anterior Segment ◽

Ocular Motility ◽

Refractive Errors ◽

Chi Square ◽

Reverse Pattern ◽

Significant Difference ◽

Changing Trend

Background: Refractive errors are the second most common reason of blindness in India after cataract. It accounts for 33.3% of cases of childhood blindness. The purpose of this study was to estimate the prevalence of refractive error and related visual impairment in children visiting a tertiary care eye center in Southern India.Methods: This was hospital-based descriptive study. Children <15 years of age with significant refractive error were included in the study. They were examined for visual acuity measurements, ocular motility evaluation, retinoscopy and autorefraction under cycloplegia, and examination of the anterior segment and fundus. Significant refractive error was defined as myopia ≥-0.75D, hypermetropia >+2D and astigmatism >0.75D. Descriptive statistics with frequency, mean±Standard deviation were computed for better and the worse eye. Statistical tests were applied between the worse and better eye using Chi square test.Results: A total of 946 children were screened. The mean age was 10.5±6.2 years (3-15 years) with 503 (53.2%) males and 443 (46.8%) females. With respect to vision in the worse eye; 54.01% (n=511) had moderately subnormal vision. One hundred and twenty- two children (23.4%) of <10 years, and 351 (67.4%) of ≥10 years group had myopia, with statistically significant difference (p<0.001). The reverse pattern was seen with respect to hypermetropia and astigmatism. Prevalence of amblyopia was found to be 8.6%.Conclusions: Though myopia is more prevalent among general population, prevalence of astigmatism is higher among children attending an eye hospital and uncorrected astigmatism is the most significant amblyogenic factor in refractive amblyopia.

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Refractive Errors and Strabismus In Patients with Orofacial Clefts

10.21203/rs.3.rs-731190/v1 ◽

2021 ◽

Author(s):

Camille Catarina Artuso ◽

Ana Kelly Fernandes ◽

Luisa Moreira Hopker ◽

Ricardo Mokross Fernandes ◽

Renato da Silva Freitas ◽

...

Keyword(s):

Refractive Error ◽

Medical Records ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Refractive Errors ◽

Orofacial Clefts ◽

Significant Difference ◽

Eye Examination ◽

The Mean ◽

Isolated Cleft Palate

Abstract Purpose: To evaluate the prevalence of refractive errors and strabismus in patients with orofacial clefts. Methods: This retrospective study analyzed the medical records of 54 patients with orofacial clefts between August 2018 and March 2020. A complete eye examination was performed, including visual acuity assessment on a logMAR scale, anterior biomicroscopy, cycloplegic refraction, eye motility examination, and indirect ophthalmoscopy. Results: The mean age of the patients at presentation was 9.47 years. Twentythree (42.59%) patients had isolated cleft palate (CP), 10 (18.52%) had cleft lip (CL), and 21 (38.89%) had cleft lip and palate (CLP). The mean spherical equivalent was 1.30D (±1.56) in CL, 0.32D (±2.24) in CLP, and 0.62D (±3.76) in CP. The prevalence of refractive error, either spherical or cylinder >0.5 was 88%. The most common refractive error was hyperopia (60%), followed by astigmatism (54%) and myopia (16%). Overall, 52.63% of the patients were prescribed glasses. No statistically significant difference was observed between the groups with respect to the need for prescription of glasses (p=0.6753). There were 15 patients with some type of strabismus, and other ophthalmological changes were observed in 13 patients. Conclusion: In this population with orofacial clefts, the prevalence of refractive errors and strabismus was 88% and 22%, respectively.

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Vision problems: A review of prevalence studies on refractive errors in school-age children

African Vision and Eye Health ◽

10.4102/aveh.v78i1.461 ◽

2019 ◽

Vol 78 (1) ◽

Author(s):

Uchenna C. Atowa ◽

Rekha Hansraj ◽

Samuel O. Wajuihian

Keyword(s):

Diagnostic Criteria ◽

Refractive Error ◽

Measurement Techniques ◽

Epidemiological Studies ◽

Health Concern ◽

School Age Children ◽

Refractive Errors ◽

Racial Groups ◽

School Age ◽

Prevalence Studies

Background: Refractive errors are common eye disorders and are leading causes of visual impairment in the general population. Children with uncorrected refractive error may experience reduced visual acuity, transient blurring, headache and persistent ocular discomforts particularly for close work which can impair reading efficiency and school performance.Aim: This article documents the prevalence of refractive errors in school-age children of different ethnic origins. The goal is to identify possible variation in measuring techniques and diagnostic criteria, as well as limitations of studies, to provide a clear direction for future studies.Methods: The review was undertaken through a detailed evaluation of peer-reviewed publications of primary research on this topic. The keywords for the search included ‘refractive error’, ‘hyperopia’, ‘myopia’, ‘astigmatism’ and ‘school children’. Only epidemiological studies with participants between 5 and 18 years of age were included.Results: Although several population and school-based studies have been conducted in various racial groups and populations, their findings were diverse owing to inconsistencies in the methods applied in identifying children in need of refraction, measurement techniques and diagnostic criteria for refractive errors. There are also some limitations associated with the sampling design and characteristics, which may have influenced the outcome measures.Conclusion: Despite the problems inherent in the studies, the review indicates that refractive error in school-age children is a public health concern in those populations and warrants additional research that will provide reliable data for proper planning of intervention strategies.

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AWARENESS ABOUT INDOOR AIR POLLUTION IN GENERAL POPULATION OF RAWALPINDI AND ISLAMABAD

Pakistan Journal of Public Health ◽

10.32413/pjph.v8i2.118 ◽

2018 ◽

Vol 8 (2) ◽

pp. 80-83

Author(s):

Nadia Tariq ◽

Tamkeen Jaffry ◽

Rahma Fiaz ◽

Abdul Majid Rajput ◽

Sadaf Khalid

Keyword(s):

Air Pollution ◽

General Population ◽

Indoor Air ◽

Indoor Air Pollution ◽

Economic Status ◽

Educational Status ◽

Epidemiological Studies ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Significant Difference

Background: Indoor air pollutants are increasingly being associated with respiratory illnesses leading to high degree of morbidity and mortality. There are not sufficient epidemiological studies from Pakistan which assess level of awareness of indoor air pollution resulting in respiratory diseases in population. Methods: This cross sectional survey was carried out on general population of Rawalpindi/Islamabad. Sample size was 223 study subjects selected by non-probability convenient sampling. Knowledge of the study subjects was determined with regard to indoor air pollution, its effects on health and different sources of indoor air pollution with the help of a questionnaire. The influence of age, gender, educational status and socio economic status on the level of awareness was also analyzed. Results: Out of total 223 participants, 115 were males and108 females. Participants aware of indoor air pollution were 91.5% and adequate awareness about its sources was 80.7%. Those who knew indoor air pollution is detrimental to health were 95.1%. Awareness about building construction dust as source of indoor air pollution was maximum (84.8%). There was significant difference in awareness among participants with different monthly incomes and educational status and also between males and females. Conclusion: This study concludes that general population of Rawalpindi/Islamabad has fairly good awareness about sources of indoor air pollution. Use of harmful material causing indoor air pollution should be limited or substituted with better ones where possible.

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Testing telediagnostic thyroid ultrasound in Peru: a new horizon in expanding access to imaging in rural and underserved areas

Journal of Endocrinological Investigation ◽

10.1007/s40618-021-01584-7 ◽

2021 ◽

Author(s):

T. J. Marini ◽

S. L. Weiss ◽

A. Gupta ◽

Y. T. Zhao ◽

T. M. Baran ◽

...

Keyword(s):

Thyroid Nodule ◽

Standard Of Care ◽

The United States ◽

Epidemiological Studies ◽

Thyroid Ultrasound ◽

Target Region ◽

Experienced Radiologist ◽

Significant Difference ◽

Size Evaluation

Abstract Purpose Thyroid ultrasound is a key tool in the evaluation of the thyroid, but billions of people around the world lack access to ultrasound imaging. In this study, we tested an asynchronous telediagnostic ultrasound system operated by individuals without prior ultrasound training which may be used to effectively evaluate the thyroid and improve access to imaging worldwide. Methods The telediagnostic system in this study utilizes volume sweep imaging (VSI), an imaging technique in which the operator scans the target region with simple sweeps of the ultrasound probe based on external body landmarks. Sweeps are recorded and saved as video clips for later interpretation by an expert. Two operators without prior ultrasound experience underwent 8 h of training on the thyroid VSI protocol and the operation of the telemedicine platform. After training, the operators scanned patients at a health center in Lima. Telediagnostic examinations were sent to the United States for remote interpretation. Standard of care thyroid ultrasound was performed by an experienced radiologist at the time of VSI examination to serve as a reference standard. Results Novice operators scanned 121 subjects with the thyroid VSI protocol. Of these exams, 88% were rated of excellent image quality showing complete or near complete thyroid visualization. There was 98.3% agreement on thyroid nodule presence between VSI teleultrasound and standard of care ultrasound (Cohen’s kappa 0.91, P < 0.0001). VSI measured the thyroid size, on average, within 5 mm compared to standard of care. Readers of VSI were also able to effectively characterize thyroid nodules, and there was no significant difference in measurement of thyroid nodule size (P = 0.74) between VSI and standard of care. Conclusion Thyroid VSI telediagnostic ultrasound demonstrated both excellent visualization of the thyroid gland and agreement with standard of care thyroid ultrasound for nodules and thyroid size evaluation. This system could be deployed for evaluation of palpable thyroid abnormalities, nodule follow-up, and epidemiological studies to promote global health and improve the availability of diagnostic imaging in underserved communities.

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Epidemiological Findings of Refractive Errors and Amblyopia among the Schoolchildren in Hatta Region of the United Arab Emirates

Dubai Medical Journal ◽

10.1159/000512521 ◽

2021 ◽

pp. 1-7

Author(s):

Salam Chettian Kandi ◽

Hayat Ahmad Khan

Keyword(s):

Visual Acuity ◽

Visual Field ◽

United Arab Emirates ◽

Refractive Error ◽

Screening Program ◽

Low Vision ◽

Refractive Errors ◽

Vision Screening ◽

Screening Programs ◽

School Based

Introduction: Uncorrected refractive errors and amblyopia pose a major problem affecting schoolchildren. We had previously observed that many schoolchildren in the Hatta region presented to the ophthalmology clinic with uncorrected refractive errors and amblyopia, which led us to undertake this research. As per the WHO, the term “visual impairment” can be “low vision” or “blindness.” Based on the presenting vision, “low vision” is defined for children who have vision of <6/18 to 3/60 or having visual field loss to <20° in the better-seeing eye. Children defined to have “blindness” have presenting vision of <3/60 or corresponding visual field of <10°. Purpose: To estimate the magnitude of uncorrected refractive errors and amblyopia among the schoolchildren aged 6–19 years and to assess the efficacy of school-based refractive error screening programs in the Hatta region of the United Arab Emirates. Methods: An epidemiological, cross-sectional, descriptive study was conducted on the entire student population studying in the government schools of the region. Those who failed the Snellen visual acuity chart test and those who were wearing spectacles were evaluated comprehensively by the researcher in the Department of Ophthalmology of the Hatta Hospital. Data were entered in the Refractive Error Study in School Children (RESC) eye examination form recommended by the WHO, and were later transferred to Excel sheets and analyzed by SPSS. Results: 1,591 students were screened and evaluated from the end of 2016 to mid-2017. About 21.37% (n = 340) had impaired vision with 20.9% (n = 333) refractive errors, of which 58% were uncorrected. Among the refractive error group, 19% (64 subjects) had amblyopia (4% of total students). The incidence of low vision was 9.5% and blindness was 0.38%. Low vision was found to be 9.5% and blindness 0.38%, taking in to account presenting visual acuity rather than best-corrected visual acuity for defining low vision and blindness. Conclusion: A significant number of students were detected to have uncorrected refractive errors among the vision impaired group (59%, n = 197) despite a school-based vision screening program in place. Seventy-eight percent of the amblyopia cases (n = 50) were found to be in the 11–19 years age group. Noncompliance with optical corrections was the reason for the high number of cases. A rigorous vision screening program and refractive services, complimented with awareness among parents and teachers, are recommended.

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The Effect of Alcohol on Telomere Length: A Systematic Review of Epidemiological Evidence and a Pilot Study during Pregnancy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18095038 ◽

2021 ◽

Vol 18 (9) ◽

pp. 5038

Author(s):

Andrea Maugeri ◽

Martina Barchitta ◽

Roberta Magnano San Lio ◽

Maria Clara La Rosa ◽

Claudia La Mastra ◽

...

Keyword(s):

Systematic Review ◽

Pilot Study ◽

Alcohol Consumption ◽

Telomere Length ◽

Molecular Mechanisms ◽

Epidemiological Studies ◽

Potential Association ◽

Significant Difference ◽

Periconceptional Period ◽

Using Data

Several studies—albeit with still inconclusive and limited findings—began to focus on the effect of drinking alcohol on telomere length (TL). Here, we present results from a systematic review of these epidemiological studies to investigate the potential association between alcohol consumption, alcohol-related disorders, and TL. The analysis of fourteen studies—selected from PubMed, Medline, and Web of Science databases—showed that people with alcohol-related disorders exhibited shorter TL, but also that alcohol consumption per se did not appear to affect TL in the absence of alcohol abuse or dependence. Our work also revealed a lack of studies in the periconceptional period, raising the need for evaluating this potential relationship during pregnancy. To fill this gap, we conducted a pilot study using data and samples form the Mamma & Bambino cohort. We compared five non-smoking but drinking women with ten non-smoking and non-drinking women, matched for maternal age, gestational age at recruitment, pregestational body mass index, and fetal sex. Interestingly, we detected a significant difference when analyzing relative TL of leukocyte DNA of cord blood samples from newborns. In particular, newborns from drinking women exhibited shorter relative TL than those born from non-drinking women (p = 0.024). Although these findings appeared promising, further research should be encouraged to test any dose–response relationship, to adjust for the effect of other exposures, and to understand the molecular mechanisms involved.

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Assessment of new-onset depression and anxiety associated with COVID-19

Middle East Current Psychiatry ◽

10.1186/s43045-021-00112-w ◽

2021 ◽

Vol 28 (1) ◽

Author(s):

Eman Hurissi ◽

Ethar Abu-jabir ◽

Amnah Mohammed ◽

Mashael Mahnashi ◽

Sana Alharbi ◽

...

Keyword(s):

Epidemiological Studies ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Online Questionnaire ◽

Final Sample ◽

Significant Difference ◽

Patient Health ◽

Males And Females ◽

Arabian Population ◽

New Onset

Abstract Background Psychological disorders are common among individuals who experienced COVID-19. Previous studies have shown that females report higher depression and anxiety than males. The present study aims to test the differences in depression and anxiety between males and females who have experienced COVID-19. This a descriptive, observational, comparative study, among Saudi Arabian population. A total of 686 participants have been recruited. Participants completed an online questionnaire that contains questions about sociodemographic, COVID-19, Generalized Anxiety Disorder (GAD-7) questionnaire, and Patient Health Questionnaire (PHQ-9) to measure anxiety and depression, respectively. Results Twenty-six percent of the participants were excluded and our final sample consisted of 507 participants (median age 23; 65% females). Of the final sample, 23% (118) have been previously diagnosed with COVID-19. There is no significant difference in GAD-7 and PHQ-9 scores between COVID-19- positive and COVID-19-negative populations. However, females who have experienced COVID-19 reported significantly higher GAD-7 and PHQ-9 scores compared to males. Conclusion The results of our study show that females are significantly at a higher risk for depression and anxiety as a result of COVID-19 infection compared to males. Further epidemiological studies are required for a better understanding of this correlation.

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