Abstract:
Importance:Mobility limitations arising from vision impairment (VI) can result in loss of independence and reduced quality of life. However, few data are available on the association between VI and mobility limitations at a population-based level, particularly in Asian populations. Objective:To assess the association of VI and major eye diseases with mobility and independence (M&I) in a Chinese population. Design, Setting, and Participants:The Singapore Chinese Eye Study (February 9, 2009, to December 19, 2011) was a population-based, cross-sectional study of 3353 persons aged 40 to 80 years of Chinese ethnicity. Patients underwent visual acuity testing, and sociodemographic and medical data were collected from standardized questionnaires. Data analysis for this study was performed October 2015 to April 2016. Exposures:Presenting bilateral visual acuity (categorized as none, moderate, or severe VI) and major eye diseases (cataract, uncorrected refractive error, glaucoma, age-related macular degeneration, and diabetic retinopathy). Main Outcomes and Measures:Patients answered questions on the M&I scale of the Impact of Vision Impairment questionnaire, validated using Rasch analysis. The composite M&I score (score range, -4.47 to 7.48 logits; higher scores indicate better M&I) and 11 individual item scores were the main outcomes. The association between bilateral VI and eye conditions and the composite and individual M&I item scores was assessed using linear regression models. Results:Of the 3353 patients, the mean (SD) age was 59.7 (9.9) years, and 1662 (49.6%) were male. The mean (SD) presenting visual acuity values in the better and worse eyes were 0.20 (0.21) and 0.39 (0.42) logMAR, respectively. A total of 1432 patients (42.7%) and 114 patients (3.4%) had moderate and severe bilateral VI, respectively. Mobility and independence systematically worsened as the severity of bilateral VI increased. There was a clinically meaningful reduction in M&I (20%; β, -1.44; 95% CI, -1.75 to -1.13) and all 11 M&I tasks in patients with severe bilateral VI compared with no VI. Glaucoma (13%; β, -0.94; 95% CI, -1.82 to -0.06) and cataract (6%; β, -0.43; 95% CI, -0.65 to -0.22) were independently associated with worse M&I, with patients with glaucoma particularly concerned about avoiding falling or tripping. Conclusions and Relevance:Bilateral VI in this population was associated with substantial decrements in M&I, with glaucoma and cataract independently associated with worse M&I. Although these associations do not prove that preventing bilateral VI will improve M&I in this population, the results suggest that such interventions could be of tremendous value from this perspective.
journal_name
JAMA Ophthalmoljournal_title
JAMA ophthalmologyauthors
Fenwick EK,Ong PG,Man RE,Cheng CY,Sabanayagam C,Wong TY,Lamoureux ELdoi
10.1001/jamaophthalmol.2016.2394subject
Has Abstractpub_date
2016-10-01 00:00:00pages
1087-1093issue
10eissn
2168-6165issn
2168-6173pii
2535225journal_volume
134pub_type
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abstract:Importance:Glaucoma-related adverse events constitute serious complications of cataract removal in infancy, yet long-term data on incidence and visual outcome remain lacking. Objective:To identify and characterize incident cases of glaucoma and glaucoma-related adverse events (glaucoma + glaucoma suspect) among childr...
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abstract::IMPORTANCE Advanced glycation end products have been implicated in the pathogenesis of age-related macular degeneration (AMD). OBJECTIVE To investigate the relationship between serum carboxymethyllysine (CML), a major circulating advanced glycation end product, and AMD in older adults. DESIGN, SETTING, AND PARTICIPANT...
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pub_type: 杂志文章,多中心研究,随机对照试验
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