July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Six-year Incidence and Progression of Visual Impairment in a Multi-ethnic Asian Population: The Singapore Epidemiology Eye Disease (SEED) Study
Author Affiliations & Notes
  • Yih Chung Tham
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
  • Miao Li Chee
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
  • Nicholas YQ Tan
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
  • Charlene Wong
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
  • Wei Dai
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
  • Shivani Majitia
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
  • Charumathi Sabanayagam
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
    Duke-NUS Medical School, Singapore, Singapore
  • Ecosse Lamoureux
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
    Duke-NUS Medical School, Singapore, Singapore
  • Tien Y Wong
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
    Duke-NUS Medical School, Singapore, Singapore
  • Ching-Yu Cheng
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
    Duke-NUS Medical School, Singapore, Singapore
  • Footnotes
    Commercial Relationships   Yih Chung Tham, None; Miao Li Chee, None; Nicholas Tan, None; Charlene Wong, None; Wei Dai, None; Shivani Majitia, None; Charumathi Sabanayagam, None; Ecosse Lamoureux, None; Tien Wong, None; Ching-Yu Cheng, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 4101. doi:
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      Yih Chung Tham, Miao Li Chee, Nicholas YQ Tan, Charlene Wong, Wei Dai, Shivani Majitia, Charumathi Sabanayagam, Ecosse Lamoureux, Tien Y Wong, Ching-Yu Cheng; Six-year Incidence and Progression of Visual Impairment in a Multi-ethnic Asian Population: The Singapore Epidemiology Eye Disease (SEED) Study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4101.

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

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Abstract

Purpose : To describe the incidence and progression of visual impairment (VI) in a multi-ethnic Asian population in Singapore.

Methods : The SEED Study comprised of 3 major Asian ethnic groups: Malays, Indians, and Chinese. Of the 8,592 eligible participants from baseline examination, 6,762 (response rate 78.7%) were re-examined during the 6-year follow up (year 2011-2017.) All participants underwent standardized systemic and ophthalmic examinations which included best-corrected visual acuity (BCVA) measurement. VI was categorised into low vision (LV) and blindness which were defined as, BCVA <20/40 to >20/200, and BCVA ≤20/200 in the better-seeing eye, respectively. Incident VI was evaluated among those without VI at baseline. Incidence estimates were age-standardised to the Singapore Population Census 2010. Poisson binomial regression model was used to determine factors associated with incident VI.

Results : After excluding those with VI at baseline, 6,524 individuals (1,800 Malays, 2,143 Indians, 2,581 Chinese) were included in the final analysis. The overall age-standardized incidences of LV and blindness were 3.3% (95% CI, 2.9%-3.8%), and 0.2% (95% CI, 0.1%-0.4%), respectively. Malays had significantly higher (P<0.001) incidence rates of LV (5.1%) and blindness (0.4%), compared to Indians (LV: 2.1%; blindness: 0.1%) and Chinese (LV: 2.3%; blindness: 0.1%). Progression to blindness at 6-year follow up occurred in only 1.4% (95% CI, 0.6%-16.1%) of those with LV at baseline. Progression rate of unilateral LV to bilateral LV or worse, was 13.7% (95% CI, 8.9%-21.2%).

Older age (per decade, relative risk [RR], 2.64; 95% CI, 2.23-3.14), chronic kidney disease (CKD; RR, 1.48; 95% CI, 1.10-2.01), and lower socioeconomic status (RR, 2.56; 95% CI, 1.83-3.59) were significantly associated with best-corrected incident VI. Individuals with 2 or more systemic co-morbidities at baseline (any 2 of diabetes, hypertension, hyperlipidaemia, CKD or cardiovascular disease) were 1.95 times (95% CI, 1.16-3.30) likely to develop VI, compared to healthy individuals.

Conclusions : In this multi-ethnic Asian cohort in Singapore, the 6-year incidences of LV and blindness were 3.3% and 0.2%, respectively. Malays have the highest VI incidence rate. These findings will be useful in the planning and designing eye health services for Asia’s rapidly developing urban communities.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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