Pub Date : 2024-06-01Epub Date: 2023-08-23DOI: 10.1080/09286586.2023.2249540
Jessica Brinson, Priyanka Kumar, Jiangxia Wang, Varshini Varadaraj, Bonnielin K Swenor, Adrienne W Scott
Purpose: To assess differences in eye care utilization by vision difficulty (VD), diabetes status, and sociodemographic characteristics for American adults.
Methods: The analysis pooled cross-sectional data from the National Health Interview Survey (2010-2018) from US adults ≥ 18 years. The outcome measure was eye care utilization in the past year. The primary independent variable included four groups: no VD or diabetes, only diabetes, only VD, and diabetes and VD. VD was defined as self-reported difficulty seeing even with glasses or contacts. Diabetic status was defined as ever receiving this diagnosis by a health professional. Multivariable logistic regression analyses examined associations between eye care utilization, VD, diabetic status, and sociodemographic characteristics.
Results: Of the 284,599 adults included in this study, the majority were female (55%), White (73%), and non-Hispanic (84%). In regression analysis, as compared to adults without diabetes or VD, adults with both diabetes and VD had the greatest utilization (OR = 2.49, 99% CI = 2.18-2.85). Females had higher utilization than men (OR = 1.45, 99% CI = 1.41-1.50). Higher levels of education was associated with greater utilization (OR = 1.82, 99% CI = 1.72-1.92). White and American Indian adults without diabetes had higher utilization compared to other races (OR = 1.17, 99% CI = 1.12-1.24, 0.98-1.39).
Conclusion: While adults with VD and diabetes are better connected to eye care, significant eye care disparities persist for marginalized groups in the U.S. Identifying and understanding these disparities and eliminating barriers to care is critical to better support all patient populations.
目的:评估美国成年人因视力困难(VD)、糖尿病状况和社会人口特征而在眼科保健利用率方面存在的差异:分析汇集了全国健康访谈调查(2010-2018 年)中的横截面数据,这些数据来自年龄≥ 18 岁的美国成年人。结果测量指标为过去一年的眼科保健使用情况。主要自变量包括四组:无视网膜病变或糖尿病、仅有糖尿病、仅有视网膜病变以及糖尿病和视网膜病变。视力障碍的定义是自述即使戴眼镜或隐形眼镜也看不清东西。糖尿病状态的定义是曾被医疗专业人员诊断为糖尿病。多变量逻辑回归分析研究了眼科护理利用率、视力障碍、糖尿病状况和社会人口特征之间的关联:在 284,599 名参与研究的成年人中,大多数为女性(55%)、白人(73%)和非西班牙裔(84%)。在回归分析中,与没有糖尿病或退行性病变的成年人相比,同时患有糖尿病和退行性病变的成年人的使用率最高(OR = 2.49,99% CI = 2.18-2.85)。女性的使用率高于男性(OR = 1.45,99% CI = 1.41-1.50)。教育程度越高,使用率越高(OR = 1.82,99% CI = 1.72-1.92)。与其他种族相比,没有糖尿病的白人和美国印第安人使用率更高(OR = 1.17, 99% CI = 1.12-1.24, 0.98-1.39):虽然患有退行性视网膜病变和糖尿病的成年人更容易获得眼科护理,但在美国,边缘化群体在眼科护理方面仍存在显著差异。
{"title":"Disparities in Eye Care Utilization by Self-Reported Vision Difficulty and Diabetes Status in the United States.","authors":"Jessica Brinson, Priyanka Kumar, Jiangxia Wang, Varshini Varadaraj, Bonnielin K Swenor, Adrienne W Scott","doi":"10.1080/09286586.2023.2249540","DOIUrl":"10.1080/09286586.2023.2249540","url":null,"abstract":"<p><strong>Purpose: </strong>To assess differences in eye care utilization by vision difficulty (VD), diabetes status, and sociodemographic characteristics for American adults.</p><p><strong>Methods: </strong>The analysis pooled cross-sectional data from the National Health Interview Survey (2010-2018) from US adults ≥ 18 years. The outcome measure was eye care utilization in the past year. The primary independent variable included four groups: no VD or diabetes, only diabetes, only VD, and diabetes and VD. VD was defined as self-reported difficulty seeing even with glasses or contacts. Diabetic status was defined as ever receiving this diagnosis by a health professional. Multivariable logistic regression analyses examined associations between eye care utilization, VD, diabetic status, and sociodemographic characteristics.</p><p><strong>Results: </strong>Of the 284,599 adults included in this study, the majority were female (55%), White (73%), and non-Hispanic (84%). In regression analysis, as compared to adults without diabetes or VD, adults with both diabetes and VD had the greatest utilization (OR = 2.49, 99% CI = 2.18-2.85). Females had higher utilization than men (OR = 1.45, 99% CI = 1.41-1.50). Higher levels of education was associated with greater utilization (OR = 1.82, 99% CI = 1.72-1.92). White and American Indian adults without diabetes had higher utilization compared to other races (OR = 1.17, 99% CI = 1.12-1.24, 0.98-1.39).</p><p><strong>Conclusion: </strong>While adults with VD and diabetes are better connected to eye care, significant eye care disparities persist for marginalized groups in the U.S. Identifying and understanding these disparities and eliminating barriers to care is critical to better support all patient populations.</p>","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":" ","pages":"283-290"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10435084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2023-08-25DOI: 10.1080/09286586.2023.2248628
Elizabeth Kishiki, George Kabona, Grace Mwangi, Harran Mkocha, Fortunate Shija, Paul Courtright, Robert Geneau
Purpose: Despite the importance of trachomatous trichiasis (TT) case-finding activities in national trachoma elimination campaigns, the scientific literature on the determinants of good outcomes - finding and managing all TT cases - is still sparse. In Tanzania, we studied differences in case finding activities and outcomes between male and female case finders.
Methods: This case study was conducted in two districts in Tanzania in 2021-2022. Quantitative data were extracted from case finder forms and outreach registers, and qualitative data were collected through direct observation, interviews, and focus group discussions.
Results: Across both districts, more males were trained as case finders (68%). Productivity differences were minor, not statistically significant, between male and female case finders regarding the number of households visited and the number of adults examined. Whether identified by a male or female case finder, similar proportions of men and women suspected to have TT were subsequently managed. There is evidence that suggests that female case finders were more active in supporting suspected and confirmed TT cases to access follow-up services.
Conclusion: The findings do not suggest that gender balance in the recruitment of TT case finders would have led to better TT campaign outcomes in the study districts. Programmes may benefit from integrating gender considerations in the design and implementation of case finding activities - e.g. in monitoring gender differences among case finders and the relationship with key outcomes. This study also highlights how women with TT face greater barriers to care.
{"title":"Understanding the Role of Gender in Trichiasis Case Finding in Tanzania.","authors":"Elizabeth Kishiki, George Kabona, Grace Mwangi, Harran Mkocha, Fortunate Shija, Paul Courtright, Robert Geneau","doi":"10.1080/09286586.2023.2248628","DOIUrl":"10.1080/09286586.2023.2248628","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the importance of trachomatous trichiasis (TT) case-finding activities in national trachoma elimination campaigns, the scientific literature on the determinants of good outcomes - finding and managing all TT cases - is still sparse. In Tanzania, we studied differences in case finding activities and outcomes between male and female case finders.</p><p><strong>Methods: </strong>This case study was conducted in two districts in Tanzania in 2021-2022. Quantitative data were extracted from case finder forms and outreach registers, and qualitative data were collected through direct observation, interviews, and focus group discussions.</p><p><strong>Results: </strong>Across both districts, more males were trained as case finders (68%). Productivity differences were minor, not statistically significant, between male and female case finders regarding the number of households visited and the number of adults examined. Whether identified by a male or female case finder, similar proportions of men and women suspected to have TT were subsequently managed. There is evidence that suggests that female case finders were more active in supporting suspected and confirmed TT cases to access follow-up services.</p><p><strong>Conclusion: </strong>The findings do not suggest that gender balance in the recruitment of TT case finders would have led to better TT campaign outcomes in the study districts. Programmes may benefit from integrating gender considerations in the design and implementation of case finding activities - e.g. in monitoring gender differences among case finders and the relationship with key outcomes. This study also highlights how women with TT face greater barriers to care.</p>","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":" ","pages":"266-273"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10058567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2023-07-06DOI: 10.1080/09286586.2023.2232460
Amber T Wolf, Janek Klawe, Bian Liu, Sumayya Ahmad
Purpose: To assess the relationship between serum vitamin D levels and myopia in people aged 12-50 years using the National Health and Nutrition Examination Survey (NHANES) database.
Methods: Demographics, vision, and serum vitamin D levels from NHANES (2001-2006) were analyzed. Multivariate analyses were performed to examine the relationship between serum vitamin D levels and myopia while controlling for sex, age, ethnicity, education level, serum vitamin A, and poverty status. The main outcome was presence or absence of myopia, defined as a spherical equivalent of -1 diopters or more.
Results: Of the 11669 participants, 5,310 (45.5%) had myopia. The average serum vitamin D concentration was 61.6 ± 0.9 nmol/L for the myopic group and 63.1 ± 0.8 nmol/L for the non-myopic group (p = .01). After adjusting for all covariates, having higher serum vitamin D was associated with lower odds of having myopia (odds ratio 0.82 [0.74-0.92], p = .0007). In linear regression modeling that excluded hyperopes (spherical equivalent > +1 diopters), there was a positive relationship between spherical equivalent and serum vitamin D levels. Specifically, as serum vitamin D doubled, spherical equivalent increased by 0.17 (p = .02) indicating a positive dose-response relationship between vitamin D and myopia.
Conclusions: Participants with myopia, on average, had lower serum concentrations of vitamin D compared to those without myopia. While further studies are needed to determine the mechanism, this study suggests that higher vitamin D levels are associated with lower incidence of myopia.
目的:利用美国国家健康与营养调查(NHANES)数据库,评估 12-50 岁人群血清维生素 D 水平与近视之间的关系:分析了 NHANES(2001-2006 年)的人口统计学、视力和血清维生素 D 水平。在控制性别、年龄、种族、教育水平、血清维生素 A 和贫困状况的情况下,进行了多变量分析,以研究血清维生素 D 水平与近视之间的关系。主要结果是有无近视,近视的定义是球面等效度数为-1 或以上:在 11669 名参与者中,5310 人(45.5%)患有近视。近视组的平均血清维生素 D 浓度为 61.6 ± 0.9 nmol/L,非近视组的平均血清维生素 D 浓度为 63.1 ± 0.8 nmol/L(p = .01)。在对所有协变量进行调整后,血清维生素 D 含量越高,患近视的几率越低(几率比 0.82 [0.74-0.92],p = 0.0007)。在排除远视眼(球面等效 > +1 斜度)的线性回归模型中,球面等效与血清维生素 D 水平之间存在正相关关系。具体来说,当血清维生素 D 增加一倍时,球面等效度增加 0.17 (p = .02),这表明维生素 D 与近视之间存在正剂量反应关系:结论:与没有近视的人相比,患有近视的参与者血清中维生素 D 的浓度平均较低。虽然还需要进一步研究来确定其机制,但本研究表明,维生素 D 水平越高,近视的发病率越低。
{"title":"Association Between Serum Vitamin D Levels and Myopia in the National Health and Nutrition Examination Survey (2001-2006).","authors":"Amber T Wolf, Janek Klawe, Bian Liu, Sumayya Ahmad","doi":"10.1080/09286586.2023.2232460","DOIUrl":"10.1080/09286586.2023.2232460","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the relationship between serum vitamin D levels and myopia in people aged 12-50 years using the National Health and Nutrition Examination Survey (NHANES) database.</p><p><strong>Methods: </strong>Demographics, vision, and serum vitamin D levels from NHANES (2001-2006) were analyzed. Multivariate analyses were performed to examine the relationship between serum vitamin D levels and myopia while controlling for sex, age, ethnicity, education level, serum vitamin A, and poverty status. The main outcome was presence or absence of myopia, defined as a spherical equivalent of -1 diopters or more.</p><p><strong>Results: </strong>Of the 11669 participants, 5,310 (45.5%) had myopia. The average serum vitamin D concentration was 61.6 ± 0.9 nmol/L for the myopic group and 63.1 ± 0.8 nmol/L for the non-myopic group (<i>p</i> = .01). After adjusting for all covariates, having higher serum vitamin D was associated with lower odds of having myopia (odds ratio 0.82 [0.74-0.92], <i>p</i> = .0007). In linear regression modeling that excluded hyperopes (spherical equivalent > +1 diopters), there was a positive relationship between spherical equivalent and serum vitamin D levels. Specifically, as serum vitamin D doubled, spherical equivalent increased by 0.17 (<i>p</i> = .02) indicating a positive dose-response relationship between vitamin D and myopia.</p><p><strong>Conclusions: </strong>Participants with myopia, on average, had lower serum concentrations of vitamin D compared to those without myopia. While further studies are needed to determine the mechanism, this study suggests that higher vitamin D levels are associated with lower incidence of myopia.</p>","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":" ","pages":"229-239"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10117547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2023-08-17DOI: 10.1080/09286586.2023.2248627
Aida Giloyan, Naira Khachatryan, Ala Paduca, Hans Limburg, Varduhi Petrosyan
Purpose: This study assessed the prevalence of cataract blindness, cataract surgical coverage (CSC), effective CSC, visual outcome after cataract surgery, and barriers to cataract surgery in a population aged 50 years and older in Armenia using Rapid Assessment of Avoidable Blindness (RAAB) methodology.
Methods: The study sample included 2258 individuals aged 50 years and older who were randomly selected from 11 provinces of Armenia in 2019 following the RAAB methodology. The study team randomly selected 50 clusters, 50 people in each. The RAAB survey form was used to collect information on cataract blindness, visual outcome after cataract surgery, and barriers to cataract surgery.
Results: The mean age of the participants was 65.3 (SD = 9.9) ranging from 50 to 99. The majority of participants were women (65.6%). Age- and sex-adjusted prevalence of blindness due to all causes was 1.5%; of which 36.4% was bilaterally blind due to cataract. The CSC and effective CSC at a cataract surgical threshold of <6/12 were 55.1% and 24.4%, respectively. Good outcome was reported in 43.7% of eyes after cataract surgery, borderline in 37.2% of eyes, and poor outcome in 19.1%. The main barriers to cataract surgery included "cost," "need not felt," or "fear."
Conclusion: The prevalence of cataract blindness in our study was higher compared to high-income regions and lower than estimates from South/Southeast Asia. This study suggests the urgent need to update the National Strategic Plan to prevent blindness in Armenia with a focus on improving the quality and coverage of cataract surgery.
{"title":"Cataract Blindness in Armenia: The Results of Nationwide Rapid Assessment of Avoidable Blindness (RAAB).","authors":"Aida Giloyan, Naira Khachatryan, Ala Paduca, Hans Limburg, Varduhi Petrosyan","doi":"10.1080/09286586.2023.2248627","DOIUrl":"10.1080/09286586.2023.2248627","url":null,"abstract":"<p><strong>Purpose: </strong>This study assessed the prevalence of cataract blindness, cataract surgical coverage (CSC), effective CSC, visual outcome after cataract surgery, and barriers to cataract surgery in a population aged 50 years and older in Armenia using Rapid Assessment of Avoidable Blindness (RAAB) methodology.</p><p><strong>Methods: </strong>The study sample included 2258 individuals aged 50 years and older who were randomly selected from 11 provinces of Armenia in 2019 following the RAAB methodology. The study team randomly selected 50 clusters, 50 people in each. The RAAB survey form was used to collect information on cataract blindness, visual outcome after cataract surgery, and barriers to cataract surgery.</p><p><strong>Results: </strong>The mean age of the participants was 65.3 (SD = 9.9) ranging from 50 to 99. The majority of participants were women (65.6%). Age- and sex-adjusted prevalence of blindness due to all causes was 1.5%; of which 36.4% was bilaterally blind due to cataract. The CSC and effective CSC at a cataract surgical threshold of <6/12 were 55.1% and 24.4%, respectively. Good outcome was reported in 43.7% of eyes after cataract surgery, borderline in 37.2% of eyes, and poor outcome in 19.1%. The main barriers to cataract surgery included \"cost,\" \"need not felt,\" or \"fear.\"</p><p><strong>Conclusion: </strong>The prevalence of cataract blindness in our study was higher compared to high-income regions and lower than estimates from South/Southeast Asia. This study suggests the urgent need to update the National Strategic Plan to prevent blindness in Armenia with a focus on improving the quality and coverage of cataract surgery.</p>","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":" ","pages":"258-265"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10012252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2023-08-01DOI: 10.1080/09286586.2023.2232462
Hongbo Zhang, Peihua Yang, Yahong Li, Weixiao Zhang, Shumao Li
Purpose: Atropine eye drops have been shown to slow the progression of myopia, but there has been limited research on the effectiveness of 0.05% atropine in treating myopia. This study aimed to investigate the safety and efficacy of 0.05% atropine eye drops in controlling myopia in children.
Methods: The study included 424 participants aged 6 to 12 years between January 1, 2015, and January 1, 2021. Of these, 213 were randomly assigned to the 0.05% atropine group and 211 to the placebo group. The cycloplegic spherical equivalent (SE), axial length (AL), corneal curvature (K), and anterior chamber depth (ACD) were measured using IOLMaster. The lens power and corneal astigmatism were also determined. The changes in ocular biometric parameters were compared between the two groups, and the contributions of ocular characteristics to SE progression were calculated and compared.
Results: Over a 12-month period, the changes in spherical equivalent were -0.03 ± 0.28 and -0.32 ± 0.14 in the atropine and placebo groups, respectively (P = .01). The changes in axial length were 0.06 ± 0.11 and 0.17 ± 0.12, respectively (P = .01). At 18 and 24 months, there were significant differences in axial length and spherical equivalent between the atropine and placebo groups. Multiple regression models accounting for changes in AL, K, and lens magnification explained 87.23% and 98.32% of SE changes in the atropine and placebo groups, respectively. At 1 year (p = .01) and 2 years (p = .03), there were significant differences in photophobia between the atropine and placebo groups.
Conclusions: This two-year follow-up study demonstrates that 0.05% atropine eye drops are safe and effective in preventing the development of myopia in school-aged children.
{"title":"Effect of Low-Concentration Atropine Eye Drops in Controlling the Progression of Myopia in Children: A One- and Two-Year Follow-Up Study.","authors":"Hongbo Zhang, Peihua Yang, Yahong Li, Weixiao Zhang, Shumao Li","doi":"10.1080/09286586.2023.2232462","DOIUrl":"10.1080/09286586.2023.2232462","url":null,"abstract":"<p><strong>Purpose: </strong>Atropine eye drops have been shown to slow the progression of myopia, but there has been limited research on the effectiveness of 0.05% atropine in treating myopia. This study aimed to investigate the safety and efficacy of 0.05% atropine eye drops in controlling myopia in children.</p><p><strong>Methods: </strong>The study included 424 participants aged 6 to 12 years between January 1, 2015, and January 1, 2021. Of these, 213 were randomly assigned to the 0.05% atropine group and 211 to the placebo group. The cycloplegic spherical equivalent (SE), axial length (AL), corneal curvature (K), and anterior chamber depth (ACD) were measured using IOLMaster. The lens power and corneal astigmatism were also determined. The changes in ocular biometric parameters were compared between the two groups, and the contributions of ocular characteristics to SE progression were calculated and compared.</p><p><strong>Results: </strong>Over a 12-month period, the changes in spherical equivalent were -0.03 ± 0.28 and -0.32 ± 0.14 in the atropine and placebo groups, respectively (<i>P</i> = .01). The changes in axial length were 0.06 ± 0.11 and 0.17 ± 0.12, respectively (<i>P</i> = .01). At 18 and 24 months, there were significant differences in axial length and spherical equivalent between the atropine and placebo groups. Multiple regression models accounting for changes in AL, K, and lens magnification explained 87.23% and 98.32% of SE changes in the atropine and placebo groups, respectively. At 1 year (<i>p</i> = .01) and 2 years (<i>p</i> = .03), there were significant differences in photophobia between the atropine and placebo groups.</p><p><strong>Conclusions: </strong>This two-year follow-up study demonstrates that 0.05% atropine eye drops are safe and effective in preventing the development of myopia in school-aged children.</p>","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":" ","pages":"240-248"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10040089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2023-07-05DOI: 10.1080/09286586.2023.2232038
Saloni Sapru, Simani M Price, Lisa A Hark, Lindsay A Rhodes, Paula Anne Newman-Casey
Purpose: We compared recruitment of participants at high risk for glaucoma and other eye diseases in three community-based studies designed to improve access to eye care in underserved populations in New York City, Alabama, and Michigan.
Methods: We used (1) participant data collected at enrollment (e.g. demographic, medical conditions, healthcare access, and method of hearing about study) and (2) interviews with study staff to assess effective recruitment strategies in enrolling people at high risk for eye disease. We analyzed participant data using descriptive statistics and interview data using content analysis to categorize responses to questions.
Results: In these community-based studies, all sites recruited greater proportions of populations with increased risk of eye disease compared to their estimates in the US population. High-risk characteristics varied based on the setting (i.e. Federally Qualified Health Centers or affordable housing buildings). Older adults represented 35% to 57%; 43% to 56% identified as Black; 1% to 40% as Hispanic/Latino; 20% to 42% reported a family history of glaucoma; 32% to 61% reported diabetes; and 50% to 67% reported high blood pressure. Social risk factors for under-utilization of eye care due to poverty included that 43% to 70% of participants had high school or lower education; 16% to 40% were employed; and 7% and 31% had no health insurance. From a qualitative perspective, active, personalized, culturally sensitive methods were most effective in recruiting participants.
Conclusion: Implementing eye disease detection interventions in community-based settings facilitated recruiting individuals at high risk for glaucoma and other eye diseases.
{"title":"Recruiting Populations at Higher Risk for Glaucoma and Other Eye Diseases Experiencing Eye Health Disparities.","authors":"Saloni Sapru, Simani M Price, Lisa A Hark, Lindsay A Rhodes, Paula Anne Newman-Casey","doi":"10.1080/09286586.2023.2232038","DOIUrl":"10.1080/09286586.2023.2232038","url":null,"abstract":"<p><strong>Purpose: </strong>We compared recruitment of participants at high risk for glaucoma and other eye diseases in three community-based studies designed to improve access to eye care in underserved populations in New York City, Alabama, and Michigan.</p><p><strong>Methods: </strong>We used (1) participant data collected at enrollment (e.g. demographic, medical conditions, healthcare access, and method of hearing about study) and (2) interviews with study staff to assess effective recruitment strategies in enrolling people at high risk for eye disease. We analyzed participant data using descriptive statistics and interview data using content analysis to categorize responses to questions.</p><p><strong>Results: </strong>In these community-based studies, all sites recruited greater proportions of populations with increased risk of eye disease compared to their estimates in the US population. High-risk characteristics varied based on the setting (i.e. Federally Qualified Health Centers or affordable housing buildings). Older adults represented 35% to 57%; 43% to 56% identified as Black; 1% to 40% as Hispanic/Latino; 20% to 42% reported a family history of glaucoma; 32% to 61% reported diabetes; and 50% to 67% reported high blood pressure. Social risk factors for under-utilization of eye care due to poverty included that 43% to 70% of participants had high school or lower education; 16% to 40% were employed; and 7% and 31% had no health insurance. From a qualitative perspective, active, personalized, culturally sensitive methods were most effective in recruiting participants.</p><p><strong>Conclusion: </strong>Implementing eye disease detection interventions in community-based settings facilitated recruiting individuals at high risk for glaucoma and other eye diseases.</p>","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":" ","pages":"220-228"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9812068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2023-05-15DOI: 10.1080/09286586.2023.2213324
Xiaole Li, Manav Nayeni, Monali S Malvankar-Mehta
Purpose: Herpes stromal keratitis (HSK) is an immune-mediated corneal inflammation that occurs after a herpes simplex virus infection. This paper aims to systematically identify and compare interventions for treating HSK and their patient outcomes.
Methods: This systematic review followed the PRISMA methodology. Online databases were searched to obtain all relevant papers. Two independent reviewers screened through 168 records. Seven papers were included and used for data extraction. A qualitative analysis was conducted.
Results: HSK patients receiving prednisolone phosphate and acyclovir showed a higher treatment success rate and significantly longer time to failure compared to patients receiving only acyclovir (P < .001). No difference in resolution time was found between oral and topical acyclovir. Between groups receiving dexamethasone and flurbiprofen, resolution occurred in 93% and 67% of patients, and BCVA (LogMAR) improved from 1.0 to 0.30 and 0.48, respectively. BCVA improved in both cyclosporine-A (P < .001) and its control (prednisolone) groups (P = .002). A tacrolimus treatment group showed greater improvement in BCVA compared to its control (prednisolone) group (P < .001).
Conclusion: Corticosteroids and antivirals managed HSK most effectively only when used concurrently. Oral acyclovir showed similar effectiveness to its ointment counterpart, a preferable alternative for easier administration. Corticosteroid use could induce greater therapeutic benefits when tapered in concentration and frequency and administrated for at least 10 weeks. Anti-inflammatory drugs including flurbiprofen, cyclosporine-A, and tacrolimus could be safe and effective for treating HSK. Future long-term follow-up and RCTs could provide insights on the therapeutic benefits of these potential alternatives.
{"title":"Antiviral and Anti-Inflammatory Therapeutic Interventions for Treating Herpes Stromal Keratitis: A Systematic Review.","authors":"Xiaole Li, Manav Nayeni, Monali S Malvankar-Mehta","doi":"10.1080/09286586.2023.2213324","DOIUrl":"10.1080/09286586.2023.2213324","url":null,"abstract":"<p><strong>Purpose: </strong>Herpes stromal keratitis (HSK) is an immune-mediated corneal inflammation that occurs after a herpes simplex virus infection. This paper aims to systematically identify and compare interventions for treating HSK and their patient outcomes.</p><p><strong>Methods: </strong>This systematic review followed the PRISMA methodology. Online databases were searched to obtain all relevant papers. Two independent reviewers screened through 168 records. Seven papers were included and used for data extraction. A qualitative analysis was conducted.</p><p><strong>Results: </strong>HSK patients receiving prednisolone phosphate and acyclovir showed a higher treatment success rate and significantly longer time to failure compared to patients receiving only acyclovir (<i>P</i> < .001). No difference in resolution time was found between oral and topical acyclovir. Between groups receiving dexamethasone and flurbiprofen, resolution occurred in 93% and 67% of patients, and BCVA (LogMAR) improved from 1.0 to 0.30 and 0.48, respectively. BCVA improved in both cyclosporine-A (<i>P</i> < .001) and its control (prednisolone) groups (<i>P</i> = .002). A tacrolimus treatment group showed greater improvement in BCVA compared to its control (prednisolone) group (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>Corticosteroids and antivirals managed HSK most effectively only when used concurrently. Oral acyclovir showed similar effectiveness to its ointment counterpart, a preferable alternative for easier administration. Corticosteroid use could induce greater therapeutic benefits when tapered in concentration and frequency and administrated for at least 10 weeks. Anti-inflammatory drugs including flurbiprofen, cyclosporine-A, and tacrolimus could be safe and effective for treating HSK. Future long-term follow-up and RCTs could provide insights on the therapeutic benefits of these potential alternatives.</p>","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":" ","pages":"191-209"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9464177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2023-08-17DOI: 10.1080/09286586.2023.2248629
Andrew Tawfik, Maxwell Pistilli, Maureen G Maguire, Yineng Chen, Yinxi Yu, Jack V Greiner, Penny A Asbell, Gui-Shuang Ying
Purpose: To determine the correlations among symptoms and signs of dry eye disease (DED) in the Dry Eye Assessment and Management (DREAM) study.
Methods: A total of 535 patients with moderate-to-severe DED were assessed for symptoms using the Ocular Surface Disease Index (OSDI) and four DED signs in both eyes (conjunctival lissamine green staining, corneal fluorescein staining, Schirmer's testing, and tear break-up time (TBUT)) following standardized protocols at baseline and follow-up visits (months 3, 6, and 12). Spearman correlation coefficients (rho) were calculated for correlations among symptoms and signs of DED at baseline and among changes in symptoms and signs from baseline at 12 months. The confidence intervals and p-values for correlation coefficients were calculated using a cluster bootstrapping to account for inter-eye correlation.
Results: At baseline, OSDI total score was not correlated with signs; however, OSDI subscale score of ocular symptoms was weakly correlated with corneal staining score (rho = 0.14, p = .002) and Schirmer test score (rho = 0.11, p = .01). There were statistically significant correlations among the four signs (p < .001), with absolute correlation coefficient ranging from 0.14 (conjunctival staining score vs. TBUT) to 0.33 (conjunctival staining score vs. cornea staining score). The correlations among changes in symptoms and signs were weaker, with the highest correlation between change in conjunctival staining and corneal staining (rho = 0.21, p < .001).
Conclusions: Consistent with previous studies, among DREAM participants with moderate-to-severe DED at baseline, correlations of DED symptoms with signs were low and correlations among four objective signs were low to moderate. The correlations among changes in symptoms and signs were even weaker.
{"title":"Association of Dry Eye Symptoms and Signs in Patients with Dry Eye Disease.","authors":"Andrew Tawfik, Maxwell Pistilli, Maureen G Maguire, Yineng Chen, Yinxi Yu, Jack V Greiner, Penny A Asbell, Gui-Shuang Ying","doi":"10.1080/09286586.2023.2248629","DOIUrl":"10.1080/09286586.2023.2248629","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the correlations among symptoms and signs of dry eye disease (DED) in the Dry Eye Assessment and Management (DREAM) study.</p><p><strong>Methods: </strong>A total of 535 patients with moderate-to-severe DED were assessed for symptoms using the Ocular Surface Disease Index (OSDI) and four DED signs in both eyes (conjunctival lissamine green staining, corneal fluorescein staining, Schirmer's testing, and tear break-up time (TBUT)) following standardized protocols at baseline and follow-up visits (months 3, 6, and 12). Spearman correlation coefficients (rho) were calculated for correlations among symptoms and signs of DED at baseline and among changes in symptoms and signs from baseline at 12 months. The confidence intervals and p-values for correlation coefficients were calculated using a cluster bootstrapping to account for inter-eye correlation.</p><p><strong>Results: </strong>At baseline, OSDI total score was not correlated with signs; however, OSDI subscale score of ocular symptoms was weakly correlated with corneal staining score (rho = 0.14, p = .002) and Schirmer test score (rho = 0.11, p = .01). There were statistically significant correlations among the four signs (p < .001), with absolute correlation coefficient ranging from 0.14 (conjunctival staining score vs. TBUT) to 0.33 (conjunctival staining score vs. cornea staining score). The correlations among changes in symptoms and signs were weaker, with the highest correlation between change in conjunctival staining and corneal staining (rho = 0.21, p < .001).</p><p><strong>Conclusions: </strong>Consistent with previous studies, among DREAM participants with moderate-to-severe DED at baseline, correlations of DED symptoms with signs were low and correlations among four objective signs were low to moderate. The correlations among changes in symptoms and signs were even weaker.</p>","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":" ","pages":"274-282"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10873469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10021291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2023-08-27DOI: 10.1080/09286586.2023.2251153
Jingyun Wang, Gui-Shuang Ying, Yinxi Yu, Lauren Tomlinson, Gil Binenbaum
{"title":"Racial Differences in Retinopathy of Prematurity-Reply to Letter to the Editor.","authors":"Jingyun Wang, Gui-Shuang Ying, Yinxi Yu, Lauren Tomlinson, Gil Binenbaum","doi":"10.1080/09286586.2023.2251153","DOIUrl":"10.1080/09286586.2023.2251153","url":null,"abstract":"","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":" ","pages":"299-300"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10897058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10459221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2023-06-18DOI: 10.1080/09286586.2023.2225590
Saleha Z Munir, Wuqaas M Munir
Purpose: To examine the association between area-level socioeconomic deprivation and orbital trauma among emergency ophthalmology consults.
Methods: We conducted a cross-sectional study using 5-year Epic data for all hospital-based ophthalmology consults at the University of Maryland Medical System, and the Distressed Communities Index (DCI) data for area-level socioeconomic deprivation. We ran multivariable logistic regression models adjusting for age to compute odds ratios (OR) and 95% confidence intervals (CI) for the association between the DCI quintile 5 distressed score and orbital trauma.
Results: A total of 3,811 cases of acute emergency consults were identified, of whom 750 (19.7%) had orbital trauma and 2,386 (62.6%) had other traumatic ocular emergencies. The odds of orbital trauma among people living in a distressed community were 0.59 (95% CI 0.46-0.76) times the odds for those living in a prosperous community. Among White subjects, the odds of orbital trauma for people living in a distressed community were 1.71 (95% CI 1.12-2.62) times the odds for those living in a prosperous community; among Black subjects, the OR was 0.47 (95% CI 0.30-0.75; p-interaction = 0.0001). Among women, the OR for orbital trauma among those living in a distressed community was 0.46 (95% CI 0.29-0.71); among men, the OR was 0.70 (95% CI 0.52-0.97; p-interaction = 0.03).
Conclusion: Overall, we found an inverse association between higher area-level socioeconomic deprivation and orbital trauma among both men and women. The association varied by race, such that there was an inverse association with higher deprivation among Black subjects in contrast to a positive association among White subjects.
目的:研究眼科急诊中地区级社会经济贫困与眼眶外伤之间的关系:我们使用马里兰大学医疗系统所有医院眼科会诊的 5 年 Epic 数据和贫困社区指数 (DCI) 数据进行了一项横断面研究,以了解地区级社会经济贫困程度。我们运行了多变量逻辑回归模型,对年龄进行了调整,以计算DCI五分位数5困苦得分与眼眶外伤之间关系的几率比(OR)和95%置信区间(CI):共发现 3,811 例急诊病例,其中 750 例(19.7%)有眼眶外伤,2,386 例(62.6%)有其他眼外伤急症。生活在贫困社区的人发生眼眶外伤的几率是生活在富裕社区的人的 0.59 倍(95% CI 0.46-0.76)。在白人受试者中,生活在贫困社区的人发生眼眶外伤的几率是生活在富裕社区的人的 1.71 倍(95% CI 1.12-2.62);在黑人受试者中,发生眼眶外伤的几率是 0.47 倍(95% CI 0.30-0.75;p-交互作用 = 0.0001)。在女性受试者中,生活在贫困社区的受试者发生眼眶外伤的概率为 0.46(95% CI 0.29-0.71);在男性受试者中,发生眼眶外伤的概率为 0.70(95% CI 0.52-0.97;P-交互作用 = 0.03):总体而言,我们发现在男性和女性中,较高的地区社会经济贫困程度与眼眶创伤之间存在反向关联。这种关系因种族而异,在黑人受试者中,较高的贫困程度与眼眶创伤呈反向关系,而在白人受试者中则呈正向关系。
{"title":"Association Between Socioeconomic Deprivation and Orbital Trauma in a Hospital-Based Population.","authors":"Saleha Z Munir, Wuqaas M Munir","doi":"10.1080/09286586.2023.2225590","DOIUrl":"10.1080/09286586.2023.2225590","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the association between area-level socioeconomic deprivation and orbital trauma among emergency ophthalmology consults.</p><p><strong>Methods: </strong>We conducted a cross-sectional study using 5-year Epic data for all hospital-based ophthalmology consults at the University of Maryland Medical System, and the Distressed Communities Index (DCI) data for area-level socioeconomic deprivation. We ran multivariable logistic regression models adjusting for age to compute odds ratios (OR) and 95% confidence intervals (CI) for the association between the DCI quintile 5 distressed score and orbital trauma.</p><p><strong>Results: </strong>A total of 3,811 cases of acute emergency consults were identified, of whom 750 (19.7%) had orbital trauma and 2,386 (62.6%) had other traumatic ocular emergencies. The odds of orbital trauma among people living in a distressed community were 0.59 (95% CI 0.46-0.76) times the odds for those living in a prosperous community. Among White subjects, the odds of orbital trauma for people living in a distressed community were 1.71 (95% CI 1.12-2.62) times the odds for those living in a prosperous community; among Black subjects, the OR was 0.47 (95% CI 0.30-0.75; p-interaction = 0.0001). Among women, the OR for orbital trauma among those living in a distressed community was 0.46 (95% CI 0.29-0.71); among men, the OR was 0.70 (95% CI 0.52-0.97; p-interaction = 0.03).</p><p><strong>Conclusion: </strong>Overall, we found an inverse association between higher area-level socioeconomic deprivation and orbital trauma among both men and women. The association varied by race, such that there was an inverse association with higher deprivation among Black subjects in contrast to a positive association among White subjects.</p>","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":" ","pages":"210-219"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9649217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}