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H. Y. Cajucom-Uy, S. M. Saw, W. L. Wong, M. Rosman, J. L. Loo, S. C. Loon, S. Y. Shen, D. T. H. Tan, T. Y. Wong; The Prevalence of and Risk Factors for Pterygium in a Malay Population: The Singapore Malay Eye Study (SiMES). Invest. Ophthalmol. Vis. Sci. 2007;48(13):4285.
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To describe the prevalence of pterygium and its risk factors in the urban Malay population of Singapore
A population-based cross-sectional study of 3,280 (78.7% response rate) Malays aged 40-80 years in Singapore. The population was selected based on an age-stratified random sampling procedure of Malay people living in the south-western part of Singapore. Participants had a standardized interview, examination and ocular imaging at a centralized study clinic. Pterygium was diagnosed and graded clinically by slit-lamp examination as Grade 1 (atrophic), Grade 2 ( intermediate) and Grade 3 ( fleshy), and also classified as either unilateral or bilateral pterygia.
Data were available on 3266 participants. There were 508 people with any pterygia, 289 with unilateral and 219 with bilateral pterygia. The overall prevalence was 15.6% (95% confidence intervals, 14.3, 16.8). The prevalence increased with age (7.1%,15.0%, 19.0% and 22.0% among participants aged 40-49, 50-59, 60-69 and 70-79 years, respectively (p for trend <0.001) and was higher in men than women (20.4% vs 11.1%, p<0.001). After adjusting for age and gender, pterygium was more common in subjects with elementary education or lower (odds ratio[OR] 2.24, 95%CI, 1.33, 3.77), among subjects with a history of smoking(OR: 1.52, 95%CI, 1.15, 2.01), hypertension ( OR: 1.56, 95%CI, 1.25, 1.94) and previous myocardial infarction (OR: 1.43, 95%CI, 1.01, 2.03) and among service workers and cleaners (OR: 1.76,95%CI, 1.13, 2.75) and production workers (OR: 2.27, 95%CI,1.41,3.65) as compared to professionals and office workers. Grade 3 (n=92) pterygium was independently associated with male gender but not related to age. Grade 3 pterygium was more common in subjects with lower educational attainment and in those who were unemployed.
The prevalence of pterygium in Singapore is 15.6% among Malays aged 40 years and older. This rate is higher than most other population-based studies. Independent associations with male gender, older age, certain occupations as well as systemic and medical factors suggest a multi-factorial etiology for this condition.
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