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R. Varma, M. Torres, M.Y. Lai, J. Deneen, S.H. Paz, S. Fraser–Bell, R. Klein, S.P. Azen, Los Angeles Latino Eye Study Group; The Burden of Undetected Eye disease in Latinos: The Los Angeles Latino Eye Study . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1121.
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Purpose: To estimate the prevalence of previously undetected eye disease in a population–based cohort of Latinos, aged 40 years and older. Methods: We examined a population–based cohort of Latinos (primarily Mexican–Americans) in Los Angeles, California. A disease–specific history of eye disease was obtained from each participant. Each participant also underwent a complete ophthalmic examination including measurements of visual acuity, IOP, Humphrey visual fields, stereoscopic fundus and disc photography. Standardized examination–based protocols were used to define cataract (LOCS II grading at the slit–lamp and visual acuity worse than 20/40), diabetic retinopathy (DR, fundus photograph grading using the Airlie House classification system), age–related macular degeneration (AMD, the Wisconsin Age Related Maculopathy Grading system) and open–angle glaucoma (OAG, masked evaluation of disc photographs and visual field tests by three glaucoma specialists). The burden of undetected eye disease was calculated as the difference between the examination–based diagnosis and the history of eye disease for each of the diagnosed diseases––DR, AMD, OAG and cataract. Results: 6142 participants that completed both an eye examination and an interview are included in this analysis. 1742 (28%) of these 6142 had one of the four major blinding eye diseases – 304 persons with cataract, 571 persons with DR, 574 persons with AMD and 293 persons with OAG. The disease–specific burden of previously undetected eye disease was 59% (179/304) for cataract, 76% (222/293) for OAG, 81% (463/571) for DR, and 92% for AMD (530/574). Overall, of the 1715 persons with these four major blinding eye diseases, 81% (1394/1742) had previously undetected eye disease. Also, 81% of all participants reported not seeing an eye care provider in the previous 12 months. While the overall rates of eye disease was higher in older persons compared to younger persons, the age–specific rates of undetected eye disease overall (combined rates for cataract, DR, AMD and OAG), decreased from 93% in persons aged 40–49 year to 71% in persons aged 80 years and older. Conclusions: There is a significant burden of undetected eye disease among adult Latinos – the fastest growing segment of the US population. As the burden of undetected eye disease is high in adult Latinos aged 40 years and older, programs for the early detection of eye disease in adult Latinos should be developed.
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