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Alisa T Thavikulwat, Tiarnan D L Keenan, Panos G Christakis, David Peprah, Alan B Zonderman, Michele K Evans, Emily Y Chew; Retinal Photography in a Cohort of Urban Middle-Aged Adults. Invest. Ophthalmol. Vis. Sci. 2021;62(8):69.
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The Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study is an ongoing prospective cohort study initiated in 2004 to evaluate the influences of socioeconomic status and race on the incidence of age-related diseases in the United States. Participants are urban African American and white adults recruited from 13 neighborhoods in Baltimore City. An ophthalmic component was added in 2017 to evaluate the prevalence and characteristics of eye disease in this population.
In the HANDLS study, mobile research vehicles are used to evaluate all participants every 4 years. Detailed testing is performed to assess nutrition, cognition, and biologic biomarkers. Participants in wave 5 also underwent color fundus photography (TopCon TRC-NW400 non-mydriatic camera) at their study visit. The images were graded by ophthalmologists who were masked to the other clinical data. Presenting visual acuities (VA) were collected beginning in 2019. Data were analyzed using R statistical software.
A total of 965 participants (mean age: 59.3±8.8 years) underwent fundus photography. The participants were 60.8% women (587) and 63.4% African American (612). The image quality was gradable in 1646/1930 (85.3%) of photos.Roughly half of eyes (1018) were found to have abnormal findings, most commonly glaucoma/glaucoma suspect (295 eyes [15.3%]), hypertensive retinopathy (156 eyes [8.1%]), macular degeneration (100 eyes [5.2%]), and retinal hemorrhage (39 eyes, [2.0%]). Cup-to-disc ratios of the optic nerves were graded as ≥0.5 in 434/1761 eyes (24.6%).Of the 427 participants with VA data, the majority (375; 87.8%) had VA ≥20/40 in at least one eye. Moderate visual impairment was seen in 51 (11.9%) participants who had VA between 20/50 and 20/200 in the better seeing eye.
Fundus photography in this cohort identified potential ocular pathology with recommendation for follow-up with an ophthalmologist in about half of participants. Future work will assess the influences of socioeconomic status and race on eye disease. Analysis of the retinal images will determine their correlations with other medical tests, including cognitive testing, nutrition, and biologic biomarkers.
This is a 2021 ARVO Annual Meeting abstract.
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