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Roberta McKean-Cowdin, Rohit Varma, Mina Torres, Charlotte E Joslin, Chunyi Hsu, Xuejuan Jiang; Risk Indicators and Prevalence of Undetected Eye Disease in Chinese Americans: The Chinese American Eye Study (CHES). Invest. Ophthalmol. Vis. Sci. 2016;57(12):5560.
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© ARVO (1962-2015); The Authors (2016-present)
To characterize the level of undetected eye disease (UED) in Chinese Americans 50 years of age and older, and the proportion of UED attributable to uncorrected refractive error (URE) and specific types of eye disease.
A population-based study of adults participating in the Chinese American Eye Study was completed. Data were obtained by clinical examination and participants were defined as having eye disease if diagnosed at the clinic with macular degeneration, glaucoma, diabetic retinopathy, cataract, or refractive error. Participants diagnosed with incident eye disease at the clinic visit and not reporting a past history were considered undetected. URE was defined as an improvement of 2+ lines in visual acuity in the better seeing eye after refraction. Odds ratios and 95% confidence intervals (95%CI) were calculated to evaluate potential associations between demographics, clinical characteristics, or lifestyle factors and UDE.
Of the 2,284 cases of eye disease in CHES, 1,077 (47.2%) were undetected prior to completing the CHES clinical examination. Of these, 668 (29.3% of 2,284) had URE, and 331 (14.5% of 2,284) had URE alone (without any known ocular diseases). Of the 1,077 with UDE, 197 (18.3% of 1077) were visually impaired based on presenting visual acuity (VA), while only 57 (5.3% of 1077) were visually impaired based on best corrected VA. The major types of undetected eye disease included 281 (12.3% of 2,284) of macular degeneration, 255 (11.2%) glaucoma/ocular hypertension, 193 (8.5%) diabetic retinopathy, and 67 (2.9%) cataract. The major predictors of UDE included male sex, older age, a history of diabetes, not speaking English, never having a regular physical exams, not having a regular place of medical care, low income, not having other comorbidities, and never having a complete eye exam.
While Chinese Americans are typically not recognized as a racial group in the United States negatively impacted by health disparities or experiencing limited access to health care, we found that a high proportion of Chinese Americans in our population-based sample had UED. Outreach and education to the Chinese American community on the value of regular eye exams is needed. Proper refraction and early detection of disease and treatment can improve vision of older, Chinese Americans.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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