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S.L. Hoki, R. Varma, M.Y. Lai, S.P. Azen, R. Klein, The Los Angeles Latino Eye Study (LALES); Prevalence and Associations of Retinal Emboli in Latinos: The Los Angeles Latino Eye Study (LALES) . Invest. Ophthalmol. Vis. Sci. 2006;47(13):920.
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To study the prevalence and associations of asymptomatic retinal emboli in a population–based cohort of Latinos.
LALES is a population–based prevalence study of eye disease in Latinos, aged 40 years and older. Past medical history, estrogen use, smoking and alcohol history were collected using a standardized interview. Blood presssure, glucose and hemoglobin A1C levels were obtained using standard protocols. Persons having diabetes were identified by history of diabetic diagnosis or treatment, or qualifying serum glucose or hemoglobin A1C levels. Participants underwent eye exams including stereoscopic fundus photographs. Retinal emboli were identified by photographic grading performed by masked trained graders. Frequency distributions were used to determine age and gender–specific prevalences. Univariate and multivariate logistic regression models were used to identify independent associations.
5988 participants of the study had fundus photographs allowing evaluation for the presence of asymptomatic retinal emboli. Overall, 55 (0.9%) subjects had retinal emboli in at least one eye. On univariate analysis, men were twice as likely as women to have retinal emboli (1.3% of males and 0.6% of females, P<0.007). Although age was not a significant factor, the prevalence of retinal emboli increased with age in those aged 40–79 years, with the highest prevalence seen in men aged 70–79 years (2.4%). However on multivariate analysis, history of smoking (OR 2.8, 95% CI 1.5–5.2) and diabetes (OR 1.9, 95% CI 1.1–3.4) were the only independent risk factors associated with the presence of retinal emboli. Neither male gender nor older age were independently associated with retinal emboli, as men were more likely to be smokers compared to women, and older Latinos were more likely to be smokers and have diabetes compared to younger Latinos. Alcohol consumption and estrogen use (in women) were not associated with retinal emboli.
We found a small but significant prevalence of asymptomatic retinal emboli in a Latino population. Diabetes and smoking history were independently associated with the presence of retinal emboli. One explanation for this is that retinal emboli stem from cardiac and carotid atherosclerosis, which are associated with diabetes and smoking. Since retinal emboli have the potential to cause significant ocular morbidity, the role of diabetes prevention and smoking cessation programs should be evaluated.
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