June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Prevalence and contribution of pterygium in visual impairment and blindness in older adults: the Brazilian Amazon Region Eye Survey (BARES)
Author Affiliations & Notes
  • Arthur Gustavo Fernandes
    Oftalmologia e Ciencias Visuais, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  • Adriana Berezovsky
    Oftalmologia e Ciencias Visuais, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  • Marcia Higashi
    Oftalmologia e Ciencias Visuais, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  • Joao M Furtado
    Oftalmologia e Ciencias Visuais, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
    Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeca e Pescoco, Faculdade de Medicina de Ribeirao Preto USP, Ribeirao Preto, Brazil
  • Sung Watanabe
    Oftalmologia e Ciencias Visuais, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  • Paulo Henrique Morales
    Oftalmologia e Ciencias Visuais, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  • Marcos Jacob Cohen
    Divisao de Oftalmologia, Depto. de Cirurgia, Universidade Federal do Amazonas, Manaus, Brazil
    Instituto de Olhos de Manaus, Manaus, Brazil
  • Jacob Moyses Cohen
    Divisao de Oftalmologia, Depto. de Cirurgia, Universidade Federal do Amazonas, Manaus, Brazil
    Instituto de Olhos de Manaus, Manaus, Brazil
  • Marcela Cypel
    Oftalmologia e Ciencias Visuais, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  • Cristina Coimbra Cunha
    Oftalmologia e Ciencias Visuais, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
    Hospital Bettina Ferro de Souza, Universidade Federal do Para, Belem , Brazil
  • Nivea Nunes Cavascan
    Oftalmologia e Ciencias Visuais, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  • Paula Sacai
    Oftalmologia e Ciencias Visuais, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  • Galton Carvalho Vasconcelos
    Oftalmologia e Ciencias Visuais, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
    Oftalmologia e Otorrinolaringologia, Universidade Federal de Minas Gerais UFMG, Belo Horizonte, Brazil
  • Sergio Munoz
    Salud Publica, Universidad de La Frontera, Temuco, Chile
  • Rubens Belfort
    Oftalmologia e Ciencias Visuais, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  • Solange Rios Salomao
    Oftalmologia e Ciencias Visuais, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  • Footnotes
    Commercial Relationships   Arthur Fernandes, None; Adriana Berezovsky, None; Marcia Higashi, None; Joao Furtado, None; Sung Watanabe , None; Paulo Henrique Morales, None; Marcos Jacob Cohen, None; Jacob Moyses Cohen , None; Marcela Cypel, None; Cristina Cunha, None; Nivea Nunes Cavascan, None; Paula Sacai, None; Galton Carvalho Vasconcelos, None; Sergio Munoz , None; Rubens Belfort, None; Solange Salomao, None
  • Footnotes
    Support  Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPq, Brasília, Brasil, Programa Ciência sem Fronteiras (Grant # 402120/2012-4 to SRS, SM and JMF; Research Scholarships to SRS and RBJ); Fundação de Amparo à Pesquisa do Estado de São Paulo, FAPESP, São Paulo, Brasil (Grant # 2013/16397-7 to SRS); Sight First Program – Lions Club International Foundation (Grant # 1758 to SRS).
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2199. doi:
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      Arthur Gustavo Fernandes, Adriana Berezovsky, Marcia Higashi, Joao M Furtado, Sung Watanabe, Paulo Henrique Morales, Marcos Jacob Cohen, Jacob Moyses Cohen, Marcela Cypel, Cristina Coimbra Cunha, Nivea Nunes Cavascan, Paula Sacai, Galton Carvalho Vasconcelos, Sergio Munoz, Rubens Belfort, Solange Rios Salomao; Prevalence and contribution of pterygium in visual impairment and blindness in older adults: the Brazilian Amazon Region Eye Survey (BARES). Invest. Ophthalmol. Vis. Sci. 2017;58(8):2199.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Pterygium is an ophthalmic disease strongly related to ocular sun exposure. Our purpose was to determine the prevalence of pterygium and its contribution to visual impairment and blindness in older adults living in a high ultra-violet (UV) exposure area, the city of Parintins in the Brazilian Amazon Region.

Methods : BARES is a population-based cross sectional study conducted using cluster random sampling, to enumerate subjects 45 years of age and older. Eligible subjects were enumerated through a door-to-door household survey and invited for an eye exam. Pterygium was assessed in each eye by ophthalmologists through slit-lamp examination considering its location (nasal, temporal or both), size (> 3mm) and pupillary invasion. Visual impairment was considered as best-corrected visual acuity (BCVA) <20/63 and blindness BCVA <20/200. Associations of pterygium with gender, age, education and local of residence (urban or rural) were investigated.

Results : A total of 2384 eligible persons were enumerated and 2041 (85.6%) were examined. The prevalence of any type of pterygium in either eye was 58.7% [95% Confidence Interval (CI): 56.6% – 60.9%] and for bilateral pterygium was 39.2% [95%CI: 37.1% – 41.4%]. Previous pterygium excision was present in 122 (3.0%) eyes with recurrence in 72 (59.0%) eyes. The prevalence of pterygium as cause of visual impairment and blindness was 14.3% and 3.9%, respectively. Male gender [OR=1.69; 95%CI: 1.35-1.94; p=0.001] was associated to the presence of pterygium in either eye. Older age [OR=2.01; 95%CI: 1.40-2.89; p=0.001] and rural area [OR=1.64; 95%CI: 1.16-2.30; p=0.008] were associated to pterygium >3mm in either eye. Older age [OR=3.66; 95%CI: 1.91-7.04; p=0.001] was associated with pterygium invading the pupil. Male gender [OR=1.59; 95%CI: 1.20-2.10; p=0.003] and rural area [OR=1.61; 95%CI: 1.03-2.51; p=0.006] were associated to the presence of pterygium in both nasal and temporal sides simultaneously.

Conclusions : Pterygium was highly prevalent in older adults and might cause visual impairment and blindness even when the best refractive correction is provided. These findings reinforce the need of strategic actions to prevent and to provide services for early diagnosis and treatment of this disease with emphasis in older males living in rural areas of the Brazilian Amazon Region.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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