Abstract
Purpose :
Few studies have examined the relative effects of risk factors for major age-related eye conditions, within the same population. The objective of this study was to investigate the relative influences of individual and ocular characteristics, metabolic profile, genetic background, behavioral patterns, and socio-economic status on the risk of visual impairment (VI), retinopathy, cataract, age-related macular degeneration (AMD) and glaucoma.
Methods :
Cross-sectional population-based study comprised of 3,353 Chinese aged 40-80 years. The examined determinants included individual factors (age, gender), ocular characteristics (axial length, vessel calibers, intraocular pressure (IOP)), metabolic profile (>200 untargeted metabolites), genetic background (principal components extracted from >6,000,000 variants), behavioral patterns (smoking, body mass index, alcohol intake) and socio-economic status (educational level, job category, number of household, religion). The relative influences of each risk factor on the occurrence of VI and eye diseases were investigated using boosted regression trees, a machine learning approach that handles nonlinear effects and interactions. The relative influence of each factors within the same determinant cluster were then added together.
Results :
The prevalence rates were 26.9% for VI, 7.9% for retinopathy, 34.0% for cataract, 8.0% for AMD, and 4.0% for glaucoma. In terms of relative influence, age was the main determinant for VI (32.2%), cataract (64.3%) and AMD (16.6%); diabetes was the main determinant for retinopathy (23.1%); and IOP was the main factor for glaucoma (20.9%) (Figure 1). By cluster, metabolic profile (52.6%) was the most important determinant for retinopathy, individual characteristics (64.3% and 32.4%) for cataract and VI, and ocular characteristics (39.1%) for glaucoma. (Figure 2). Finally, the relative influence of behavioral patterns was moderate for all conditions (3.3 to 10.9%).
Conclusions :
There is heterogeneity in the determinants of the major eye conditions, which may help identify risk factors that could be targeted for preventive measures.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.