Abstract
Purpose :
To determine the prevalence and causes of visual impairment (VI) and blindness for African Americans (AAs), and to identify independent VI risk factors for AAs.
Methods :
The African American Eye Disease Study (AFEDS) is a population-based study conducted from 2014 to 2018 of 6,347 AAs ≥ 40 years old residing in Inglewood, California. Data on demographic and behavioral characteristics, medical and ocular history, insurance status and access to care were collected, and a comprehensive eye examination was conducted that included corrected and uncorrected distance visual acuity assessment. VI was defined as best-corrected visual acuity (BCVA) ≤ 20/40 in the better-seeing eye (BSE), and blindness as BCVA ≤ 20/200 in the BSE.
Results :
The overall prevalence for VI was 2.6% (n = 166), with age-specific prevalence ranging from 0.4% for AAs 40 - 49 years old to 9.7% for those 80 and older. The overall prevalence of blindness was 0.4% (n = 28); age-specific prevalence ranged from 0.3% in 40 - 49 year olds to 1.1% in those ≥ 80 years old. VI was higher in older versus younger age groups (p<0.0001 for trend) and in men (p=0.02). Cataract was the leading cause of VI (28.9%), and glaucoma the leading cause of blindness (32.1%). Multivariable logistic regression modeling indicated that independent risk factors (odds ratio [95% confidence interval]) associated with higher prevalence of VI were older age (2.9 [1.2–6.6] for ≥ 70 versus 40 - 49 year olds), male gender (2.0 [1.4–2.8]), history of ocular disease (4.1 [2.7–6.2]), presence of diabetes (1.8 [1.2–2.5]), a High School or lesser level of education (1.8 [1.2–2.5]), being separated/divorced, widowed or never married (2.0 [1.3–2.9]), and being unemployed (3.3 [1.8–6.0]); being overweight/obese was protective (0.5 [0.4-0.8]).
Conclusions :
The prevalence of VI in African Americans in the AFEDS is significantly lower than what has been previously reported in studies of persons of African ancestry. This may be due in part to a high prevalence of cataract extraction in AFEDS, given the high health insurance coverage (91%) in this population. In spite of this, cataract remained the leading cause of VI in African Americans in AFEDS, suggesting that a lack of access and utilization of visually impairing cataract surgery persists in this population. It is likely that an increase in cataract extraction can further reduce the burden of VI in this population.
This is a 2020 ARVO Annual Meeting abstract.