Ophthalmic epidemiology最新文献

Purpose: In the wake of the COVID-19 pandemic, vaccines have been pivotal in curbing disease spread and severity. However, concerns over post-vaccination adverse events, including uveitis, an inflammatory ocular condition, have been noted. This systematic review and meta-analysis aimed to evaluate the incidence and association of uveitis following COVID-19 vaccination.

Methods: A literature search was performed across several databases on October 21, 2023. Human studies examining the incidence of uveitis post-COVID-19 vaccination were included. The Newcastle-Ottawa Scale was used for quality appraisal of the included studies. Meta-analysis was performed to assess the overall incidence of uveitis and the relative risk of developing the condition post-vaccination. All statistical analyses were performed using R software version 4.3.

Results: Six studies involving over 2 billion vaccine doses were included. The overall incidence of uveitis was 0.016% (95% CI: 0.010 to 0.026). No significant association was found between vaccination and the onset of uveitis (Relative Risk: 1.45 (95% CI: 0.82 to 2.57, p = 0.12) from four studies. The evidence quality was rated very low due to the limited number of studies and imprecision.

Conclusion: This analysis indicates a low incidence of uveitis following COVID-19 vaccination and no significant association with the vaccine. The findings are constrained by the small number of studies and low certainty of evidence, underscoring the need for further research. Comprehensive and longitudinal studies are necessary to confirm these findings and reinforce public confidence in COVID-19 vaccination programs.

Purpose: To describe the prevalence, incidence, and sociodemographic characterization of moderate to severe vision impairment (MSVI) and blindness in Colombia based on the National Health Registry Integrated Social Protection Information System (SISPRO) Database.

Methods: We performed a nationwide population-based study using SISPRO and the International Classification of Diseases. Total and new cases were identified to calculate the prevalence and incidence per 100,000 inhabitants of MSVI and blindness between 2015 and 2019. Blindness was defined as a best-corrected visual acuity (BCVA) of less than 20/400 in the better-seeing eye. Meanwhile, MSVI is a BCVA from 20/70 to equal or better than 20/400 in the better-seeing eye. An ANOVA test was performed to identify age differences. A conditional autoregressive model was also employed to depict standardized morbidity rate maps.

Results: From the 50 million inhabitants, the average prevalence and incidence of MSVI were 13.94 and 13.34 between 2015 and 2019, respectively, while for blindness, they were 4.03 and 3.53. Females accounted for most reported cases, and there was a notable shift towards individuals over 50 years (p < 0.001). Valle del Cauca was the region with the most cases reported and the greatest disease burden.

Conclusion: This is the first nationwide population-based study describing the prevalence, incidence, and sociodemographic characterization of blindness and MSVI in Colombia. In recent years, there has been an increased number of cases, prevalence, and incidence, with females over 50 particularly affected. This research provides insight into the country's vision impairment epidemiology landscape and contributes to formulating public health policies to improve eye health care.

Purpose: Self-reported visual difficulty is consistently associated with dementia and other neuropsychiatric outcomes, but studies of specific age-related eye diseases have yielded conflicting results.

Methods: We conducted a retrospective cohort study using data from The National Health and Aging Trends Study, an ongoing nationally representative survey of older U.S. adults (n = 10,089). All subjects are screened for self-reported visual difficulty annually. Using linked Medicare claims data, we identified subjects with age-related macular degeneration (AMD), primary open-angle glaucoma (POAG), diabetic retinopathy, and cataract. For each condition, controls with complete Medicare eligibility and at least one eye care encounter were selected. We used semiparametric discrete time proportional hazards models to measure associations with incident dementia, and generalized estimating equations to examine longitudinal associations with depression, anxiety, and hallucinations, adjusting for baseline demographics and time-varying comorbidities.

Results: Self-reported visual difficulty was associated with dementia (HR 1.16, 95% CI: 1.00-1.34), depression (OR 1.14, 95% CI: 1.04-1.26), anxiety (OR 1.17, 95% CI: 1.06-1.29), and hallucinations (OR 1.54, 95% CI: 1.29-1.84). Diabetic retinopathy was associated with depression (OR 1.31, 95% CI: 1.05-1.64), and cataracts were associated with a lower risk of depression (OR 0.84, 95% CI: 0.74-0.95) and anxiety (OR 0.86, 95% CI: 0.75-0.99). There were no other associations between age-related eye disease and neuropsychiatric outcomes.

Conclusion: Self-reported visual difficulty is associated with dementia and other neuropsychiatric outcomes to a greater degree than age-related eye disease. These findings highlight the distinction between self-reported vision and clinically diagnosed eye disease with regard to health outcomes in older adults.

Purpose: This study was aimed to evaluate the agreement between the swept-source optical coherence tomography (SS-OCT)-based biometry, fundus photographs, and their combination, in comparison to the gold standard spectral-domain optical coherence tomography (SD-OCT) for the detection of center-involving diabetic macular edema (CI-DME).

Methods: We conducted a retrospective cross-sectional study involving 55 subjects (78 eyes) diagnosed with diabetic macular edema (DME) detected clinically and on SD-OCT (Carl Zeiss Meditec AG). Post-mydriatic 45-degree color fundus photograph (Crystal-Vue NFC-700), 1 mm macular scan obtained from SS-OCT-based biometry (IOL-Master 700), and macula cube scan obtained from SD-OCT was used to detect and grade DME into CI-DME and NCI-DME.

Results: Our findings revealed that SS-OCT-based biometry was noted to have a high sensitivity of 1 (0.94-1.00) and a specificity of 0.63 (0.31-0.89) in detecting CI-DME compared to the gold standard (SD-OCT). When combined with data from fundus photographs, specificity decreased to 0.32 (0.15-0.53). Fundus photographs alone exhibited a low sensitivity of 0.52 (0.38-0.64) and a specificity of 0.45 (0.16-0.76) in CI-DME detection.

Conclusion: In conclusion, SS-OCT-based biometry can be used as an effective tool for the detection of CI-DME in diabetic patients undergoing cataract surgery and can serve as a screening tool in centers without SD-OCT facilities.

Purpose: To the best of our knowledge, implementation of artificial intelligence (AI)-based vision screening in community health fair settings has not been previously studied. This prospective cohort study explored the incorporation of AI in a community health fair setting to improve access to eyecare.

Methods: Vision screening was implemented during a community health fair event using an AI-based non-mydriatic fundus camera. In addition, a questionnaire was provided to survey the various barriers to eyecare and assess eye health literacy.

Results: A total of 53 individuals were screened at this event. Notably, about 88% of participants had follow-up appointments scheduled accordingly with an approximate 62% attendance rate. The most reported barrier to eyecare was lack of health insurance followed by transportation.

Conclusion: The addition of AI-based vision screening in community health fairs may ultimately help improve access to eye care.

Purpose: To evaluate the prevalence and risk factors of age-related macular degeneration (AMD) in the Korean population.

Methods: In this cross-sectional study based on the Korea National Health and Nutrition Examination Survey (2017-2020) data 13,737 participants aged ≥ 40 years with assessable fundus images were included. The prevalence and risk factors of AMD were evaluated. The prevalence of early AMD, geographic atrophy (GA), and neovascular AMD were also assessed. Logistic regression analyses were used to identify risk factors.

Results: The prevalence (95% confidence interval [CI]) of AMD was 13.94% (13.15-14.72). The prevalence (95% CI) of early AMD, GA, and neovascular AMD was 13.07% (12.29-13.85), 0.26% (0.17-0.35), and 0.61% (0.47-0.75), respectively. The prevalence increased with age; it was 3.61%, 11.33%, 20.31%, 31.37%, and 33.98% in participants in their 40s, 50s, 60s, 70s, and ≥ 80 years, respectively. In multivariate analysis, AMD was positively associated with older age (p < 0.001; odds ratio [OR], 1.08; 95% CI, 1.07-1.09), male sex (p = 0.014; OR, 1.27; 95% CI, 1.05-1.53), and lower degree of education (p < 0.001; OR, 1.36 (for junior high school graduates); 95% CI, 1.12-1.65).

Conclusions: AMD was detected in approximately one-third of individuals aged ≥ 70 years, thus indicating that AMD is a common disease among older Koreans. Regular fundus examinations in populations with risk factors for AMD as well as education on methods to prevent or delay AMD progression, such as the Mediterranean diet, are necessary.

Purpose: The aim of this study was to evaluate the myopia correction and its association with mental health problems among rural primary school students in China.

Methods: Using survey data from 17,950 students in 251 rural primary schools, this study examines the association between corrected myopia and mental health problems, as well as academic performance among rural students in China. Vision exams were offered to sample students, and student mental health status was measured using the Mental Health Test (MHT).

Results: The results show that 21.98% of sample students failed the vision screening for myopia. Over 65% of sample students showed some form of anxiety, with 56.86% experiencing learning anxiety and 18.71% experiencing body anxiety. The MHT score of myopic students was higher than that of students with normal vision, indicating that myopic students had worse mental health overall. Correcting myopia with eyeglasses was associated with better mental health, indicated by a lower MHT score (by 0.62 points) when controlling for covariates. Myopic students with high baseline academic performance who wore eyeglasses benefited especially from myopia correction, as they had a lower total MHT score (by 1.77 points) and lower body anxiety score (by 0.49 points, p < 0.05) than their high-performing peers with uncorrected myopia.

Conclusions: These findings suggest that future mental health prevention programs in rural China should focus on reducing the prevalence of myopia and providing eyeglasses to myopic students as potential interventions.

Purpose: To evaluate the incidence, refractive error (RE) association, and distribution of atraumatic rhegmatogenous retinal detachment (RRD) in U.S. military service members (SMs).

Methods: This study used data from the Military Health System (MHS) M2 database to identify active U.S. military and National Guard SMs diagnosed with RRD from 2017 to 2022. The RE in diopters (D) was manually extracted from available medical charts for 518 eyes. The annual incidence rate of RRD was calculated overall and evaluated in terms of age, gender, and RE. A multivariate Poisson regression model was used to estimate the relative risk (RR) for RRD with RE.

Results: From 2017 to 2022, 1,537 SMs were diagnosed with RRD and 1,243,189 were diagnosed with RE. One thousand two hundred seventy-five SMs had both diagnoses: RRD and RE. The overall incidence rate of RRD over the 6-year study was 16.3 per 100,000 people (16.4 and 15.9 for males and females, respectively). In all study groups, the incidence of RRD increased with age. SMs with RE had an overall 25-fold increased risk for RRD compared to SMs without RE. RE was present in 83.0% of cases of RRD. Myopia accounted for 93.3% of cases for eyes with detailed refractive data.

Conclusion: The incidence of RRD in U.S. SMs is comparable to other studies and is similar among male and female SMs. RE is present in most cases of RRD in SMs, with the most common type being low to moderate amounts of myopia.

Purpose: To determine the incidence rates, risk factors, and economic burden of orbital and preseptal cellulitis in the United States (US).

Methods: This retrospective longitudinal study was completed using data from the US Nationwide Emergency Department Sample dataset. An estimated 732,105 emergency department (ED) visits with a primary or secondary diagnosis of orbital and preseptal cellulitis from 2006 to 2018 were included. Incidence rates, descriptive statistics, and risk factors were calculated using linear and multivariate logistic regression models.

Results: The incidence rates of preseptal cellulitis increased from 6.2 in 2006 to 19.2 per 100,000 US population in 2018. In contrast, orbital cellulitis incidence rates have been decreasing from 6.1 to 2.8 per 100,000 US population from 2006 to 2018, respectively. Young adults (ages 21-44) comprise a majority of patients with either preseptal or orbital cellulitis (31.7%; 95% CI, 30.5-33.0%). Hypertension (11.8%, 12.9%), tobacco use (11.2%, 9.6%), and sinusitis (9.2%, 4.3%) were the most commonly associated diagnoses for orbital and preseptal cellulitis, respectively. Only 27.6% of patients with orbital cellulitis were admitted with 64.7% of patients routinely discharged. The inflation-adjusted ED charges for patients with orbital and preseptal cellulitis from 2006 to 2018 totalled over $997 million.

Conclusion: Orbital and preseptal cellulitis are costly infections in the US with increasing incidence rates for preseptal cellulitis. High rates of routine discharge from the ED for orbital cellulitis may represent a knowledge gap amongst providers and an opportunity to improve care. Identifying individuals at risk for infection is key for diagnosis and appropriate triage of care.

Purpose: To assess the efficacy of the DIGIROP-Birth algorithm in identifying infants at risk for developing retinopathy of prematurity (ROP).

Methods: In a retrospective study, we included preterm infants over 11 years, 2010-2020, meeting the inclusion criteria for the DIGIROP-Birth calculator (24 + 0/7 to 30 + 6/7 weeks of gestational age). We assessed the validity of DIGIROP-Birth using receiver-operating characteristic (ROC) curves and calculated area-under-curve (AUC), sensitivity, specificity, and positive and negative predictive values.

Results: 897 infants were included in the analysis. The median age of the first ophthalmological examination was 40 days (IQR 32-50), the median gestational age was 198 days (IQR 185-209; corresponding to 28 + 2/7 gestational weeks), median birth weight was 1000 g (IQR 790-1300). Of 897 screened children, 458 (51.1%) were diagnosed with ROP, and 34 of 897 (3.8%) required treatment.Analysis of ROP requiring treatment predicted by DIGIROP showed an AUC of 0.860 [95%-CI 0.795-0.925]. An equilibrium of sensitivity and specificity existed at a probability of 4.12%. The positive predictive value was 10.95%, and the negative predictive value was 99.36%. Independent significant peri- and postnatal risk factors were emergency cesarean section and mass blood transfusions.

Conclusions: The DIGIROP-Birth calculator showed good predictive power in our studied population, with an incidence of 3.79% for therapy-requiring ROP. Peri- and postnatal risk factors should be included in ROP screening.