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Bruce Burkemper, Xuejuan Jiang, Mina Torres, Farzana Choudhury, Roberta McKean-Cowdin, Rohit Varma; Risk factors for prevalent Visual Impairment: The Chinese American Eye Study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2210. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To assess associations between prevalent visual impairment (VI) and multiple factors comprising a conceptual model of VI risk in a population of Chinese Americans (CAs), and to compare the results to those from a similar assessment of VI risk in a Latino population using data from the Los Angeles Latino Eye Study (LALES).
A population-based study of 4582 CAs aged 50 yrs. and older residing in Monterey Park, California. A clinical eye exam with visual acuity assessment was performed. VI was defined as best-corrected visual acuity >20/40 (US definition) in the better-seeing eye.
Of 6 independent risk factors identified for VI, age and self-reported history of ocular disease were most strongly associated with VI. Participants 80 yrs. and older were 11.3 times as likely to have VI compared to those in their 50s (95% confidence interval (CI) 4.3-29.8), while those with a history of ocular disease were 4.1 times as likely to have VI (95% CI 2.1-8.0). Additional risk factors included low education, low acculturation, high pulse pressure, and diabetes. Using the same modeling approach, five independent risk factors for VI were identified in LALES; 4 variables (age, history of ocular disease, education and diabetes) overlapped with those identified for CAs, showing an association similar in magnitude and direction. Marital status was uniquely associated with VI in Latinos, with widows having 2.5 times the risk of prevalent VI compared to those married/living with a partner (95% CI 1.5-4.2). Latinos have a greater age-adjusted prevalence of VI compared to CAs (2.7 vs 1.8%, p=0.01), but a multivariable model shows VI risk is similar after controlling for age, history of ocular disease, diabetes, education and marital status.
While many risk factors for VI in CAs are shared with Latinos, these factors have differential impacts on our study populations. CAs benefit from a lower prevalence of diabetes and higher levels of education relative to Latinos, but have more ocular disease. High pulse pressure and low levels of acculturation are risk factors for CAs but not Latinos. Intervention programs that promote cardiovascular health and that are designed to address cultural values may help reduce the burden of VI in CAs.
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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