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Christian Wolfram, Alireza Mirshahi, Rene Hoehn, Dagmar Laubert-Reh, Philipp S Wild, Norbert Pfeiffer; The epidemiology of blindness and low vision - Results from the Gutenberg Health Study. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2104.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the prevalence of blindness and low vision in a German adult sample.
The Gutenberg Health Study (GHS) is a population-based, prospective, observational single-center study in the Rhine-Main-Region in Germany with a total of 15010 participants and follow-up after five years. The study sample is recruited from subjects aged between 35 and 74 years at time of the examination. At baseline, participants undergo a standardized protocol with a comprehensive questionnaire, a general cardiovascular and ophthalmic examination, which includes slitlamp biomicroscopy, non-contact tonometry, fundus photography, central corneal thickness measurement and visual field testing. According to WHO-criteria blindness was defined as visual acuity (VA) in the better eye of 0.1 or less, low vision as VA less than 0.3.
14.672 subjects were evaluable. In the overall study population, blindness was prevalent in 0.18% (27 subjects), low vision in 0.43% (63 subjects), within the age group of 65-74 year old persons in 0.33% and 0.86% respectively. The distribution of cases with blindness or low vision was equal between both genders. Causes for blindness were often multifactorial: AMD, high myopia, genetic diseases and corneal pathologies were each found in 18.5%, glaucoma in 14.8%, previous pathologies (i.e. history of injuries, retinal detachments, tumors, vein occlusions) in 29.6%. No case of diabetic-related blindness was found in this study. In cases of low vision the following pathologic conditions were found: amblyopia (30.2%), previous pathologies (25.4%), AMD (20.6%), corneal pathologies (19.1%), cataract (17.5%), high myopia (15.9%), glaucoma (11.1%), genetic diseases (11.1%) and diabetes (3.2%).
In contrast to previous findings from registries, our population-based study reveals more complex and interacting causes for blindness and low vision. Future concepts for the prevention of blindness should address this complexity of underlying causes.
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