Fifteen-year Incidence of Near vision Impairment and Presbyopia in Southern India: The Andhra Pradesh Eye Disease Study III

Abstract

Purpose : The Andhra Pradesh Eye Disease Study III (APEDS III) is a 15-year follow-up of participants examined in APEDS I (1996 to 2000). APEDS I survivors of all ages from three of the four original areas (n=5395; 83.7%), were included. The aim was to determine the incidence of near vision impairment (NVI) and presbyopia and their socio-demographic risk factors in those 16 years or more at baseline.

Methods : All participants underwent a comprehensive eye examination, including retinal imaging and diagnostic testing. Presenting visual acuity (PVA) was measured at three meters using standard logarithm of minimum angle of resolution (logMAR) charts; near visual acuity (NVA) was assessed unaided or with correction using logMAR near vision chart at 40 cm. Incident NVI was based on the presenting NVA (PNVA) in the better eye and was further classified as mild (PNVA <20/40 to 20/63) and “moderate or worse” (PNVA <20/63). Likewise, incident presbyopia was classified as mild (PNVA <20/40 to 20/63) and “moderate or worse” (PNVA <20/63) in participants whose distance VA improved to 20/40 or better with correction.

Results : The mean age of the participants were 37±12.8 years. The overall 15-year crude incident rate was as follows: any NVI 54.7 (95% confidence interval (CI): 54.2-55.2); mild NVI 37.4 (95% CI: 36.8-38.0), and moderate or worse 24.3 (95% CI: 23.9-24.6) per 100 person-years. The crude incidence rate of any presbyopia was as follows: any presbyopia 51.8 (95% CI: 51.2-52.3), mild presbyopia 31.4 (95% CI: 29.1-33.7), and moderate or worse presbyopia 23.7 (95% CI: 23.3-24.1) per 100 person-years. Baseline independent risk factors for incident NVI were increasing age 30-39 years (OR: 2.8 95% CI: 2.3-3.4), 40-49 years (OR: 2 95% CI: 1.5-2.8), 50-59 years (OR: 3.6 95% CI: 2.3-5.7) and 60 years and above (OR: 6.4 95% CI: 2.7-14.8). The other contributing risk factors were illiteracy (OR: 2.8; 95% CI: 1.9-4) and hypertension (OR: 1.2; 95% CI: 1-1.5). Similarly, the baseline independent risk factors for presbyopia were age at 30-39 years (OR: 2.9, 95% CI: 2.3-3.5), illiteracy (OR: 2.6; 95% CI: 1.8-3.8) and hypertension (OR: 1.3; 95% CI: 1-1.6).

Conclusions : The overall incidence of NVI and presbyopia was relatively higher in this Southern Indian population. These findings could be used to design future eye care strategies towards screening people at-risk and provide timely intervention.

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