Abstract
Importance: This study helps to better understand the need and trend in presbyopic add power in the aging society. Background: Distribution and progression of presbyopic add power in East Asian population is largely unknown. Design: Prospective cohort study. Participants: About 303 participants from a population-based study of residents aged 35 years and older in Guangzhou, China. Methods: Visual acuity (VA) test and non-cycloplegic automated refraction were performed at baseline in 2008 and the 6-year follow-up per standardized protocol. Participants with presenting near VA ≤ 20/40 underwent distance subjective refraction and add power measurement by increasing plus lens at a standard distance of 40 cm at each visit. Main outcome measures: Add power at baseline and follow-ups. Results: Mean (standard deviation) age of the study participants was 57.6 (11.1) years and 50.2% were female. The mean add power at baseline was 1.43, 1.73, 2.03 and 2.20 diopters (D) for individuals in the age groups of 35–44, 45–54, 55–64 and 65+ years, respectively. Participants with older age and lower educational level had significantly higher add power requirements (P < 0.001). The overall 6-year increase in add power was 0.15D (95% CI: 0.06 to 0.25), and was smaller in myopic subjects (P = 0.03). Baseline age and add power, but not changes in biometric factors, were associated with longitudinal change in add power (P < 0.001). Conclusions and Relevance: Distribution and progression of add power in Chinese was different from that previously suggested by Caucasian studies. More studies are needed to establish up-to-date age-related add power prescription norms for population of different ethnicities.
| Original language | English |
|---|---|
| Pages (from-to) | 882-887 |
| Number of pages | 6 |
| Journal | Clinical & Experimental Ophthalmology |
| Volume | 46 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - Nov 2018 |
| Externally published | Yes |
Keywords
- add power
- epidemiology
- longitudinal
- presbyopia
Cite this
- APA
- Author
- BIBTEX
- Harvard
- Standard
- RIS
- Vancouver
}
In: Clinical & Experimental Ophthalmology, Vol. 46, No. 8, 11.2018, p. 882-887.
Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Distribution and progression of add power among people in need of near correction
AU - Han, Xiaotong
AU - Lee, Pei Ying
AU - Liu, Chi
AU - He, Mingguang
N1 - Funding Information: Conflict of interest: None declared. Funding sources: This study was supported by the World Health Organization, Geneva, Switzerland (under National Institutes of Health, Bethesda, MD, contract No. N01-EY-2103) and the by Fundamental Research Funds of the State Key Laboratory of Ophthalmology at the Zhongshan Ophthalmic Center. Prof. He receives support from the University of Melbourne at Research Accelerator Program and the CERA Foundation. The Centre for Eye Research Australia receives Operational Infrastructure Support from the Victorian State Government. The sponsor or funding organization had no role in the design or conduct of this research. Funding Information: Details of the recruitment and study methodology of the population-based study conducted in Guangzhou, China had been reported elsewhere. Briefly, 1817 subjects aged 35 years or older participated in the baseline study in 2008 and all were invited for the 2-year (2010) and 6-year (2014) follow-up examinations. A subset of participants from this cohort with available add power measurements at both baseline and the 2014 follow-up examinations were included in the current study. Participants who had undergone refractive surgeries or were aphakic or pseudophakic at baseline or during the follow-up examination were excluded. Eyes with presenting distance visual acuity (VA) ?20/200 at either examination were also excluded. The study protocol was approved by the World Health Organization Secretariat Committee on Research Involving Human Subjects and by the institutional review board at Zhongshan Ophthalmic Center (ZOC) in Guangzhou, China. Approval for the follow-up survey was also obtained from the ZOC review ethics committee. Written informed consent was obtained from all participants and the study was conducted in accordance with the tenets of the Declaration of Helsinki. The participants did not receive any financial compensation. Details of the recruitment and study methodology of the population-based study conducted in Guangzhou, China had been reported elsewhere. Briefly, 1817 subjects aged 35 years or older participated in the baseline study in 2008 and all were invited for the 2-year (2010) and 6-year (2014) follow-up examinations. A subset of participants from this cohort with available add power measurements at both baseline and the 2014 follow-up examinations were included in the current study. Participants who had undergone refractive surgeries or were aphakic or pseudophakic at baseline or during the follow-up examination were excluded. Eyes with presenting distance visual acuity (VA) ?20/200 at either examination were also excluded. The study protocol was approved by the World Health Organization Secretariat Committee on Research Involving Human Subjects and by the institutional review board at Zhongshan Ophthalmic Center (ZOC) in Guangzhou, China. Approval for the follow-up survey was also obtained from the ZOC review ethics committee. Written informed consent was obtained from all participants and the study was conducted in accordance with the tenets of the Declaration of Helsinki. The participants did not receive any financial compensation. Questionnaires including information on age, gender, education background and detailed ophthalmic surgical history were administered by trained nurses at both baseline and follow-up examinations. Distance and near VA were measured indoor under ambient lighting with a LogMAR ETDRS tumbling E chart (Precision Vision, La Salle, IL, USA) per standardized protocol. Non-cycloplegic automated refraction was carried out for all participants at baseline and follow-up examinations using an auto kerato-refractometer (KR-8800; Topcon Corp, Tokyo, Japan). Five consecutive measurements were performed for each eye and the mean was recorded as the final value. Corneal refractive power was also measured and the mean of five readings was recorded for each eye. Participants with presenting near vision impairment (NVI), defined as presenting near VA of ?20/40, were further examined for add power at a standard testing distance of 40 cm after fully corrected for distance refractive error based on subjective refraction at both baseline and follow-up examinations. Plus lens was added at an increment of +0.25D and the minimum add power needed to obtain best-corrected near VA was recorded for each eye. Binocular add power was determined by the smaller add power in either eye. Anterior chamber depth (ACD) was measured in each eye using a non-contact partial coherence laser interferometry (IOLMaster, version 3.0, Carl Zeiss Meditec at baseline and Lenstar LS900, Haag-Streit AG, Switzerland at the 2014 follow-up) in a dark room (illumination <5 lx). Measurements with a ratio of signal to noise of less than 2.0 or those that differed from other values by more than 0.1 mm were re-measured. The mean of five measurements was recorded as the final result. In the 2010 follow-up study, both IOLMaster and Lenstar LS900 were used to measure ACD. We found that the ACD data measured by IOLMaster correlated well with the measurement obtained using Lenstar, therefore an equation is generated to relate these values. This allowed us to convert the ACD data measured by Lenstar in 2014 into equivalent values for comparison with the baseline ACD data measured by IOLMaster. Lens thickness (LT) was measured by anterior segment optical coherence tomography (AS-OCT) imaging (Visante; Carl Zeiss Meditec) at baseline and by non-contact partial coherence laser interferometry (Lenstar LS900, Haag-Streit AG, Switzerland) in 2014. Similar to the ACD measurements, both equipments were used in the 2010 follow-up study to measure LT and the data correlated well. An equation was generated to convert the LT data from 2014 for comparison with the baseline LT. Change in ACD, LT and corneal power were defined as the corresponding values at baseline subtracted from the values at the 2014 follow-up. Spherical equivalent (SE), calculated as spherical power plus half of cylindrical power, was used to represent refraction. Baseline refractive state was categorized into myopia (SE < ?0.5 diopter, D), emmetropia (?0.5D ? SE ? +0.5D) and hyperopia (SE > +0.5D). Age was categorized into four age groups: 35?44, 45?54, 55?64 and ? 65, based on the age obtained at baseline. Education level was dichotomized as less than high school and high school or above. All statistical analyses were performed using STATA Statistical Software: Release 12.0 (StataCorp LP, College Station, TX, USA). Group t-test and trend-analysis were used to assess the difference in baseline add power and the 6-year longitudinal changes in add power between different age groups, gender, education background and baseline SE status. Univariate and stepwise multiple regression (entry P value = 0.05) were used to analyse the association between longitudinal changes in add power and potential risk factors. P values of ?0.05 were considered statistically significant. Publisher Copyright: © 2018 Royal Australian and New Zealand College of Ophthalmologists
PY - 2018/11
Y1 - 2018/11
N2 - Importance: This study helps to better understand the need and trend in presbyopic add power in the aging society. Background: Distribution and progression of presbyopic add power in East Asian population is largely unknown. Design: Prospective cohort study. Participants: About 303 participants from a population-based study of residents aged 35 years and older in Guangzhou, China. Methods: Visual acuity (VA) test and non-cycloplegic automated refraction were performed at baseline in 2008 and the 6-year follow-up per standardized protocol. Participants with presenting near VA ≤ 20/40 underwent distance subjective refraction and add power measurement by increasing plus lens at a standard distance of 40 cm at each visit. Main outcome measures: Add power at baseline and follow-ups. Results: Mean (standard deviation) age of the study participants was 57.6 (11.1) years and 50.2% were female. The mean add power at baseline was 1.43, 1.73, 2.03 and 2.20 diopters (D) for individuals in the age groups of 35–44, 45–54, 55–64 and 65+ years, respectively. Participants with older age and lower educational level had significantly higher add power requirements (P < 0.001). The overall 6-year increase in add power was 0.15D (95% CI: 0.06 to 0.25), and was smaller in myopic subjects (P = 0.03). Baseline age and add power, but not changes in biometric factors, were associated with longitudinal change in add power (P < 0.001). Conclusions and Relevance: Distribution and progression of add power in Chinese was different from that previously suggested by Caucasian studies. More studies are needed to establish up-to-date age-related add power prescription norms for population of different ethnicities.
AB - Importance: This study helps to better understand the need and trend in presbyopic add power in the aging society. Background: Distribution and progression of presbyopic add power in East Asian population is largely unknown. Design: Prospective cohort study. Participants: About 303 participants from a population-based study of residents aged 35 years and older in Guangzhou, China. Methods: Visual acuity (VA) test and non-cycloplegic automated refraction were performed at baseline in 2008 and the 6-year follow-up per standardized protocol. Participants with presenting near VA ≤ 20/40 underwent distance subjective refraction and add power measurement by increasing plus lens at a standard distance of 40 cm at each visit. Main outcome measures: Add power at baseline and follow-ups. Results: Mean (standard deviation) age of the study participants was 57.6 (11.1) years and 50.2% were female. The mean add power at baseline was 1.43, 1.73, 2.03 and 2.20 diopters (D) for individuals in the age groups of 35–44, 45–54, 55–64 and 65+ years, respectively. Participants with older age and lower educational level had significantly higher add power requirements (P < 0.001). The overall 6-year increase in add power was 0.15D (95% CI: 0.06 to 0.25), and was smaller in myopic subjects (P = 0.03). Baseline age and add power, but not changes in biometric factors, were associated with longitudinal change in add power (P < 0.001). Conclusions and Relevance: Distribution and progression of add power in Chinese was different from that previously suggested by Caucasian studies. More studies are needed to establish up-to-date age-related add power prescription norms for population of different ethnicities.
KW - add power
KW - epidemiology
KW - longitudinal
KW - presbyopia
UR - https://www.scopus.com/pages/publications/85046371463
U2 - 10.1111/ceo.13301
DO - 10.1111/ceo.13301
M3 - Article
C2 - 29663613
AN - SCOPUS:85046371463
SN - 1442-6404
VL - 46
SP - 882
EP - 887
JO - Clinical & Experimental Ophthalmology
JF - Clinical & Experimental Ophthalmology
IS - 8
ER -