June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Influence of Pterygium on Refractive Status in Older Adults: The Brazilian Amazon Region Eye Survey (BARES)
Author Affiliations & Notes
  • Solange Rios Salomao
    Departamento de Oftalmologia e Ciencias Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, Sao Paulo, SP, Brazil
  • Arthur Gustavo Fernandes
    Departamento de Oftalmologia e Ciencias Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, Sao Paulo, SP, Brazil
  • Adriana Berezovsky
    Departamento de Oftalmologia e Ciencias Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, Sao Paulo, SP, Brazil
  • Marcia Higashi
    Departamento de Oftalmologia e Ciencias Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, Sao Paulo, SP, Brazil
  • Joao M Furtado
    Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Faculdade de Medicina de Ribeirão Preto USP, Ribeirao Preto, SP, Brazil
    Departamento de Oftalmologia e Ciencias Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, Sao Paulo, SP, Brazil
  • Sung Watanabe
    Departamento de Oftalmologia e Ciencias Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, Sao Paulo, SP, Brazil
  • Galton Carvalho Vasconcelos
    Oftalmologia e Otorrinolaringologia, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
    Departamento de Oftalmologia e Ciencias Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, Sao Paulo, SP, Brazil
  • Marcos Jacob Cohen
    Divisao de Oftalmologia do Departamento de Cirurgia, Faculdade de Medicina da Universidade Federal do Amazonas, Manaus, AM, Brazil
    Departamento de Oftalmologia e Ciencias Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, Sao Paulo, SP, Brazil
  • Jacob Moyses Cohen
    Divisao de Oftalmologia do Departamento de Cirurgia, Faculdade de Medicina da Universidade Federal do Amazonas, Manaus, AM, Brazil
    Instituto de Olhos de Manaus, Manaus, AM, Brazil
  • Marcela Cypel
    Departamento de Oftalmologia e Ciencias Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, Sao Paulo, SP, Brazil
  • Cristina Coimbra Cunha
    Residência Médica em Oftalmologia, Faculdade de Medicina da Universidade Federal do Pará, Belém, PA, Brazil
    Departamento de Oftalmologia e Ciencias Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, Sao Paulo, SP, Brazil
  • Nivea Nunes Cavascan
    Departamento de Oftalmologia e Ciencias Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, Sao Paulo, SP, Brazil
  • Paula Sacai
    Departamento de Oftalmologia e Ciencias Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, Sao Paulo, SP, Brazil
  • Paulo Henrique Morales
    Departamento de Oftalmologia e Ciencias Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, Sao Paulo, SP, Brazil
  • Sergio Munoz
    Salud Publica, Universidad de La Frontera, Temuco, Chile
  • Rubens Belfort
    Departamento de Oftalmologia e Ciencias Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, Sao Paulo, SP, Brazil
  • Footnotes
    Commercial Relationships   Solange Salomao, None; Arthur Fernandes, None; Adriana Berezovsky, None; Marcia Higashi, None; Joao Furtado, None; Sung Watanabe, None; Galton Carvalho Vasconcelos, None; Marcos Jacob Cohen, None; Jacob Moyses Cohen, None; Marcela Cypel, None; Cristina Cunha, None; Nivea Nunes Cavascan, None; Paula Sacai, None; Paulo Henrique Morales, None; Sergio Munoz, None; Rubens Belfort, 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, 4799. doi:
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      Solange Rios Salomao, Arthur Gustavo Fernandes, Adriana Berezovsky, Marcia Higashi, Joao M Furtado, Sung Watanabe, Galton Carvalho Vasconcelos, Marcos Jacob Cohen, Jacob Moyses Cohen, Marcela Cypel, Cristina Coimbra Cunha, Nivea Nunes Cavascan, Paula Sacai, Paulo Henrique Morales, Sergio Munoz, Rubens Belfort; Influence of Pterygium on Refractive Status in Older Adults: The Brazilian Amazon Region Eye Survey (BARES). Invest. Ophthalmol. Vis. Sci. 2017;58(8):4799.

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

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Abstract

Purpose : Pterygium is a proliferative overgrowth of bulbar conjunctiva that can induce refractive changes and cause visual impairment. The purpose of this study is to determine the influence of pterygium on the refractive status in older adults.

Methods : BARES is a population-based cross sectional study conducted using cluster random sampling, to enumerate subjects ≥45 years of age from Parintins city. Eligible subjects were enumerated through a door-to-door household survey and invited for an eye exam including measurement of uncorrected (UCVA), presenting (PVA) and best-corrected (BCVA) visual acuity. Pterygium was assessed in each eye considering its location (nasal, temporal or both), size (> 3mm) and pupillary invasion. The influence of pterygium on spherical and cylinder components from subjective and auto refraction and lines of improvement of visual acuity from UCVA and PVA to BCVA were analyzed. Eyes with previous ocular surgery, other anterior segment abnormalities and fundus changes were excluded.

Results : From a total of 2384 eligible subjects, 2041 (85.6%) were examined, with 2933 eyes included in the study. When compared to eyes without pterygium (N=1511), eyes with any pterygium (N=1422) had significantly higher subjective means of spherical component (1.00D vs 0.85 D, p=0.0026) and cylinder component (-0.79D vs -0.48D, p=0.0001) as well as auto-refraction means of spherical (1.68D vs 1.07D, p=0.0001) and cylinder (-1.49D vs -0.74D, p=0.0001) disregarded the lesion’s location and size. Significantly larger subjective spherical equivalent (0.91 vs 0.56SE; p = 0.0001) was found only for pterygium >3mm. In auto-refraction significantly larger spherical equivalent was found for any pterygium (0.92 vs 0.70 SE; p=0.0002) and for pterygium >3mm (1.67 vs 0.68; p=0.0001). The number of lines of improvement from UCVA to BCVA was significantly higher (2.75 vs 2.25, p=0.0001) only for pterygium > 3mm. Improvement from PVA to BCVA was significantly higher for any pterygium (1.71 vs 1.52, p=0.0052) and for pterygium >3mm (1.98 vs 1.56; p=0.0001).

Conclusions : Pterygium was associated with increase of refractive error with direct effect on visual acuity. Advanced cases showed substantial effect of refractive correction probably due to significant pterygium-induced refractive error. As a treatable condition the access to surgical excision should be improved for this specific population.

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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