June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Prevalence of Visually Significant Cataract and Unmet Need for Cataract Surgery in African Americans
Author Affiliations & Notes
  • Bruce Burkemper
    Population and Public Health Sciences, University of Southern California, Los Angeles, California, United States
  • Roberta McKean-Cowdin
    Population and Public Health Sciences, University of Southern California, Los Angeles, California, United States
  • Xuejuan Jiang
    Population and Public Health Sciences, University of Southern California, Los Angeles, California, United States
  • Kaili Ding
    Population and Public Health Sciences, University of Southern California, Los Angeles, California, United States
  • Mina Torres
    SCEI, CHA Medical and Surgical Group, PC, California, United States
  • Rohit Varma
    SCEI, CHA Medical and Surgical Group, PC, California, United States
  • Footnotes
    Commercial Relationships   Bruce Burkemper None; Roberta McKean-Cowdin None; Xuejuan Jiang None; Kaili Ding None; Mina Torres None; Rohit Varma None
  • Footnotes
    Support  U10 EY-023575
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 434. doi:
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      Bruce Burkemper, Roberta McKean-Cowdin, Xuejuan Jiang, Kaili Ding, Mina Torres, Rohit Varma; Prevalence of Visually Significant Cataract and Unmet Need for Cataract Surgery in African Americans. Invest. Ophthalmol. Vis. Sci. 2023;64(8):434.

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

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Abstract

Purpose : Cataract is a leading cause of visual impairment (VI), and those with visually significant cataract (VSC) have an unmet need for cataract surgery (UNCS). We use data from a large population-based sample of AAs to assess the poorly understood scope of VSC and UNCS in this largely underserved racial/ethnic group.

Methods : The African American Eye Disease Study (AFEDS) is a population-based study of adult AAs from Inglewood, California. Participants completed a detailed questionnaire and comprehensive ophthalmic examination that included a slit lamp-based assessment of the presence and severity of lens opacification, with grading based on the Lens Opacities Classification System II (LOCS II). Participants were classified as having VSC if one or both eyes met these criteria: LOCS II grading ≥ 2 for one or more opacity types (nuclear, cortical, PSC), visual impairment (VI) defined as best-corrected visual acuity in the better-seeing eye worse than 20/40, cataract was the primary cause of VI as determined by expert review, and vision was self-reported as being “fair” or worse. UNCS was estimated based on the sample ratio of those with VSC to the at-risk population, defined as those with VSC and those who had prior cataract surgery.

Results : Of the 6347 AAs who completed the ophthalmic examination, 33 were excluded due to missing LOCS II grades. The overall prevalence of VSC in this study was 0.4% (n = 28). Both eyes met the criteria for VSC in 11 of 28 VSC subjects; only one eye met the criteria in the remaining 17 subjects. There was a significant trend of increasing VSC prevalence with older age (p for trend: <.0001); among those in their 40s prevalence was 0.1%, while in those 80+ prevalence was 1.9%. There was no significant difference in the prevalence of VSC stratified by sex. The overall prevalence of any prior cataract surgery in AFEDS was 4.1% (n = 661). The UNCS prevalence was calculated to be 2.8% (28/689).

Conclusions : The present study indicates that VSC prevalence in African Americans is low, despite another AFEDS study showing a high prevalence of lens opacities. This suggests that most opacities are low in severity and not vision compromising. This is consistent with the low estimate of UNCS in AFEDS and suggests a high rate of health care utilization, likely enabled by the high levels of health and vision insurance coverage reported by study participants.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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