1. Incidence, Incident Causes, and Risk Factors of Visual Impairment and Blindness in a Rural Population in India: 15-Year Follow-up of the Andhra Pradesh Eye Disease Study
- Author
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Clare Gilbert, Subhabrata Chakrabarti, Srinivas Marmamula, Konegari Shekhar, Gudlavalleti V S Murthy, Pooja Pendri, Seema Banerjee, Pyda Giridhar, Asha Latha Mettla, Gullapalli N Rao, and Rohit C Khanna
- Subjects
Male ,Rural Population ,Refractive error ,Visual acuity ,genetic structures ,Eye disease ,Visual Acuity ,Blindness ,0302 clinical medicine ,Risk Factors ,Prevalence ,Child ,Aged, 80 and over ,0303 health sciences ,education.field_of_study ,Incidence ,Incidence (epidemiology) ,Middle Aged ,Child, Preschool ,Population Surveillance ,Female ,medicine.symptom ,Cohort study ,Adult ,Adolescent ,Visual impairment ,Population ,Vision Disorders ,India ,Risk Assessment ,Young Adult ,03 medical and health sciences ,Age Distribution ,medicine ,Humans ,Sex Distribution ,Risk factor ,education ,Aged ,Retrospective Studies ,030304 developmental biology ,business.industry ,Infant, Newborn ,Infant ,medicine.disease ,eye diseases ,Ophthalmology ,030221 ophthalmology & optometry ,business ,Follow-Up Studies ,Forecasting ,Demography - Abstract
Purpose To report 15-year incidence rate of visual loss (blindness and visual impairment [VI]), causes, and risk factors for participants in Andhra Pradesh Eye Disease Study III (APEDS III). Design Population-based cohort study. Methods From 2012 to 2016, all rural participants were interviewed and underwent a comprehensive eye examination, including dilated fundus examination and imaging. Presenting visual acuity (PVA) and best-corrected visual acuity (BCVA) were measured using a standard logarithm of Minimum Angle of Resolution chart at 3 meters. World Health Organization (WHO) and United States of America (USA) categories of VI and blindness were used. Incident visual loss was defined as the development of or worsening of visual loss of one or more categories. Results In APEDS I, 7,771 rural participants were examined using stratified, random-cluster systematic sampling; in APEDS III, 5,395 participants (69.4% of rural or 52.4% of total participants) were re-examined. Using WHO categories, the crude incidence rate of any visual loss based on PVA and BCVA were 14.6 (95% confidence interval [CI]:13.6-15.7) and 6.3 (95% CI: 6.1-6.4) per 100 person-years, respectively. Using USA criteria, the values were 22.6 (95% CI: 22.3-23.0) and 10.6 (95% CI: 10.3-10.8) per 100 person-years, respectively. More than 90% of visual loss was attributable to cataract and uncorrected refractive error. Using WHO categories, significant independent risk factors for the incident visual loss were increasing age, female gender, illiteracy, past or current smoker, and current use of alcohol. Using the USA definition, an additional risk factor was lower level of education. Conclusions The high incidence likely reflects poor access to eye care in this population, which needs to be taken into account when planning eye care programs.
- Published
- 2021