Author(s): Wu SY, Yoo YJ, Nemesure B, Hennis A, Leske MC Barbados Eye
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Abstract PURPOSE: To describe 9-year changes in refractive errors and estimate incidence of myopia and hyperopia in adults of African-descent, along with associated risk factors. METHODS: The 9-year follow-up of the Barbados Eye Studies (1997-2003) reexamined 2793 surviving cohort members (81\% participation). Refractive errors were determined by automated refraction. Myopia/hyperopia were defined as spherical equivalent < -0.5 diopters (D)/> +0.5 D, and the cutoff for moderate-high myopia/hyperopia was 3.0 D. Incidence rates of myopia/hyperopia were estimated by the product-limit approach, based on eyes without such conditions at baseline. Risk factors were evaluated by logistic regression in discrete time hazard models. RESULTS: Nine-year refraction changes varied by age. Persons aged 40 to 49 years experienced hyperopic shifts (median, +0.38 D), whereas persons > or =60 years had myopic shifts (median, -0.75D). Overall 9-year incidence was 12.0\% for myopia and 29.5\% for hyperopia; rates were 3.6\% and 2.0\% for moderate-high myopia and hyperopia, respectively. Myopia risk increased with age, baseline nuclear lens opacities (risk ratio [RR] = 1.7; 95\% confidence interval [CI]: 1.01-2.9), glaucoma (RR = 6.0, 95\% CI: 3.9-9.3), and ocular hypertension (RR = 2.0, 95\% CI: 1.3-3.0), while cortical lens opacities decreased risk (RR = 0.6, 95\% CI: 0.4-0.9). Incidence of moderate-high myopia was also related to baseline age, nuclear opacities, glaucoma, male gender (RR = 1.7, 95\% CI: 1.0-2.8), and diabetes history (RR = 1.9, 95\% CI: 1.01-3.5). Hyperopia risk decreased with older age, male gender, and glaucoma diagnosis. CONCLUSIONS: Refractive errors continue to develop frequently in older adults. Nuclear lens opacities, glaucoma, and diabetes increase the risk of older-onset myopia, a result of public health relevance to this and similar African-origin populations.
This article was published in Invest Ophthalmol Vis Sci
and referenced in Journal of Clinical & Experimental Ophthalmology