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Rohit Varma

Publications and source records attributed to Rohit Varma.

36 records · Page 2Linked to original sources
PubMed2005

Refractive error, ocular biometry, and lens opalescence in an adult population: the Los Angeles Latino Eye Study.

PURPOSE: To characterize age- and gender-related differences in refractive error, ocular biometry, and lens opalescence (NOP) in a population-based sample of adult Latinos. Also assessed were the determinants of age-related refractive differences. METHODS: Participants in the Los Angeles Latino Eye Study (LALES), a population-based study of Latinos aged 40 years and more, underwent an ophthalmic examination, including ultrasonic measurements of axial length (AL), vitreous chamber depth (VCD), anterior chamber depth (ACD), lens thickness (LT), and noncycloplegic automated and subjective refraction. Corneal curvature/power (CP) was measured using an autorefractor. NOP was graded at the slit lamp by an ophthalmologist using the Lens Opacity Classification System II. Age- and gender-related differences were calculated. Multiple regression models were used to identify the determinants of age-related refractive differences. RESULTS: Of the 6357 LALES participants, 5588 phakic individuals with biometric data were included in this analysis. Older individuals had shallower ACDs, thicker lenses, more NOP, and more hyperopia compared to younger individuals (P < 0.001). There was no age-related difference in AL (P > or = 0.05). Women had significantly shorter AL, shallower ACD and VCD, than did men (P < or = 0.01). The strongest determinants of refractive error were AL (primarily VCD) and CP. NOP was a small but significant determinant of refractive error in older individuals. CONCLUSIONS: Age- and gender-related differences in ocular biometric, refractive error, and NOP measurements are present in adult Latinos. While the relative contribution of NOP in determining refractive error is small, it is greater in older persons compared to younger individuals.

Adult↗
PubMed2004

Prevalence of age-related macular degeneration in Latinos: the Los Angeles Latino eye study.

OBJECTIVE: To estimate the age- and gender-specific prevalence of early age-related macular degeneration (AMD; drusen and retinal pigmentary abnormalities) and advanced AMD (exudative AMD and geographic atrophy) in Latinos. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in Los Angeles, California. METHODS: The study cohort consisted of self-identified Latinos 40 years and over. Participants underwent a complete ophthalmologic examination, including stereoscopic macular photographs. Photographs were graded using a modified Wisconsin Age-Related Maculopathy Grading System. MAIN OUTCOME MEASURES: Prevalence of early AMD, drusen, geographic atrophy, and exudative AMD. RESULTS: Of the 7789 eligible subjects, 6357 participants (82%) completed an interview and clinical examination, and 5875 (75%) had gradable photographs. Prevalence of advanced AMD increased from 0% in those 40-49 years of age to 8.5% in those 80 or older; that of early AMD from 6.2% to 29.7%, that of retinal pigment abnormalities from 4.1% to 19.3%, that of large drusen (> or =125 microm in diameter) from 8.5% to 45.3%, that of soft drusen from 15.4% to 58.1%, and that of soft indistinct drusen from 3.6% to 30.8%. The prevalence of early AMD and advanced AMD lesions increased with age (P<0.0001). Early AMD was significantly more common in males than in females. Of all participants with early or late AMD, only 57% reported ever visiting an eye care practitioner, and only 21% in the last year. CONCLUSION: Detailed population-based estimates of AMD in Latinos are provided. Despite relatively high rates of early AMD, corresponding rates of advanced AMD are not high. Data on progression of the high rates of early AMD in Latinos require further study.

Adult↗
PubMed2004

Prevalence of lens opacities in Latinos: the Los Angeles Latino Eye Study.

OBJECTIVE: To estimate the age- and gender-specific prevalence of posterior subcapsular (PSC), nuclear, cortical, and mixed lens opacities in a population-based sample of Latinos 40 years and older. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in Los Angeles, California. METHODS: A population-based sample of Latinos underwent a complete eye examination, including assessment of presence and severity of lens opacification, using the slit lamp-based Lens Opacities Classification System II (LOCS II). All lens changes (including pseudophakia/aphakia); any nuclear, PSC, and cortical opacities; and nuclear-only, PSC-only, and cortical-only opacities were evaluated. Frequency distributions and chi-square test analyses were used to determine the age- and gender-specific prevalences for each opacity type. MAIN OUTCOME MEASURES: Prevalences of cortical, nuclear, and posterior subcapsular opacities. RESULTS: Of the 7789 eligible subjects, 6357 completed a clinical examination (82% participation rate). Of all participants with LOCS II grading, 20% had all lens changes, 7.6% had cortical-only opacities, 3.5% had nuclear-only opacities, 0.4% had PSC-only opacities, and 5.9% had mixed-type opacities. The prevalence of all types of lens opacities increased with age (P<0.0001). Of all participants with mixed opacities, 49% had monocular visual impairment and 20% had binocular impairment. Of all 6357 participants, 3.9% had undergone cataract extraction in at least one eye. CONCLUSION: Our data provide the first population-based estimates of the prevalence and severity of lens opacities in Latinos. Cortical opacities were the most common type. The high rate of visual impairment from lens opacities suggests that programs that increase access to cataract surgery for older Latinos could help to reduce the burden of visual impairment in the United States.

Adult↗
PubMed2004

Prevalence of open-angle glaucoma and ocular hypertension in Latinos: the Los Angeles Latino Eye Study.

OBJECTIVE: To estimate age- and gender-specific prevalences of ocular hypertension and open-angle glaucoma (OAG) in adult Latinos. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in Los Angeles, California. METHODS: The study cohort consisted of all self-identified Latinos of primarily Mexican ancestry 40 years and older residing in 6 census tracts in La Puente, California. All participants underwent a complete ophthalmologic examination, including measurement of intraocular pressure (IOP), visual field (VF) testing using an automated field analyzer, and simultaneous stereoscopic fundus photography of the optic disc. Ocular hypertension was defined as IOP of >21 mmHg and the absence of optic disc damage or abnormal VF test results. Open-angle glaucoma was defined as the presence of an open angle and various criteria that included a glaucomatous VF abnormality and/or evidence of glaucomatous optic disc damage in at least one eye. MAIN OUTCOME MEASURES: Prevalence of open-angle glaucoma and ocular hypertension. RESULTS: For the 6142 participants who underwent a complete ophthalmologic examination at the clinical center, the prevalence of OAG was 4.74% (95% confidence interval [CI], 4.22%-5.30%). The prevalence of ocular hypertension was 3.56% (95% CI, 3.12%-4.06%). The prevalences of OAG and ocular hypertension were higher in older Latinos than in younger Latinos (P<0.0001). No gender-related differences in prevalences of OAG and ocular hypertension were present. The mean IOP, mean deviation, and mean vertical cup-disc ratio in persons with OAG were 17 mmHg, -9.6 decibels, and 0.6, respectively. Seventy-five percent of Latinos with OAG and 75% of Latinos with ocular hypertension were previously undiagnosed. Further, 17% of Latinos with OAG and 23% of Latinos with ocular hypertension had received treatment for "glaucoma." CONCLUSION: Our data suggest that the prevalence of OAG is high among Latinos of Mexican ancestry. The higher prevalence of OAG in older Latinos emphasizes the public health importance of providing eye care services for the early diagnosis and management of this condition in Latinos.

Adult↗
PubMed2004

The Los Angeles Latino Eye Study: design, methods, and baseline data.

OBJECTIVE: To describe the study design, operational strategies, procedures, and baseline characteristics of the Los Angeles Latino Eye Study (LALES), a population-based assessment of the prevalence of visual impairment, ocular disease, and visual functioning in Latinos. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in Los Angeles, California. METHODS: A detailed interview and eye examination were performed on each eligible participant. The interview included an assessment of demographic, behavioral, and ocular risk factors and health-related and vision-related quality of life. The eye examination included a measurement of visual acuity, intraocular pressure, and visual fields; fundus and optic disc photography; a detailed anterior and posterior segment examination; and measurement of blood pressure, glycosylated hemoglobin levels, and blood glucose levels. MAIN OUTCOME MEASURES: Prevalence of visual impairment, blindness, cataract, glaucoma, diabetic retinopathy, and age-related macular degeneration constitute the study's primary outcome variables. Secondary outcomes include odds ratios for risk factors associated with eye disease, health-related quality of life, and vision-related quality of life. Response rates and baseline characteristics are presented. RESULTS: Of the 7789 individuals eligible for LALES, 6357 (82%) had a clinical examination; an additional 524 completed only an in-home interview. The majority of participants were female (58%), the average (+/- standard deviation) age was 54.9 (+/-10.8) years, and 80.0% were of Mexican origin and 0.4% self-identified as American Indian or Alaskan Native. The age distribution of LALES participants was similar to that of Latinos of Mexican origin in the rest of the United States. CONCLUSION: The LALES has recruited Latinos 40 and older for an ophthalmic epidemiologic study. The LALES cohort will provide information about the prevalence and risk factors of ocular disease in the largest and fastest growing minority in the United States.

Adult↗
PubMed2004

Prevalence and risk indicators of visual impairment and blindness in Latinos: the Los Angeles Latino Eye Study.

OBJECTIVE: To determine the age- and gender-specific prevalence and risk indicators of visual impairment and blindness in urban Latinos 40 years and older. DESIGN: Population-based cross-sectional study. PARTICIPANTS: Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in Los Angeles, California. METHODS: Of the 6357 study participants, 6122 underwent a complete ophthalmologic examination at the clinical center, including measurement of best-corrected distance visual acuity (VA) using a standard Early Treatment Diabetic Retinopathy Study protocol. Age- and gender-specific prevalence of visual impairment and blindness were contrasted using Mantel-Haenszel procedures. Sociodemographic and clinical risk indicators of visual impairment were explored using stepwise logistic regression. MAIN OUTCOME MEASURES: Prevalence and odds ratios for risk indicators of visual impairment and blindness. RESULTS: The overall prevalence for visual impairment (best-corrected VA of <==20/40 in the better eye) was 3.0% (n = 182) (range, 0.9% [40-49 years]-27.8% [>/=80 years]). The overall prevalence for blindness (best-corrected VA of <==20/200 in the better eye) was 0.4% (n = 26) (range, 0.2% [40-49 years]-4.2% [>/=80 years]). Visual impairment increased with age (P<0.0001) and was greater in women (P = 0.02). Independent risk indicators (odds ratio [95% confidence interval]) for visual impairment were age 70-79 years (2.8 [1.3-5.8]) or >/=80 years (8.7 [3.9-19.6]), history of ocular disease (3.2 [2.1-4.8]), being unemployed (3.3 [1.7-6.3]), diabetes (2.2 [1.5-3.2]), and being separated/divorced (1.8 [1.0-3.1]) or widowed (2.8 [1.8-4.4]). Participants with >/=12 years of education (0.5 [0.3-0.8]) were less likely to be visually impaired. CONCLUSIONS: Rates of visual impairment and blindness in Latinos are high, especially in older individuals. Better education and employment are likely to decrease the burden of visual impairment in Latinos.

Adult↗
PubMed2004

The impact of visual impairment on self-reported visual functioning in Latinos: The Los Angeles Latino Eye Study.

OBJECTIVE: To assess the association between presenting binocular visual acuity (VA) and self-reported visual function as measured by the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). DESIGN: A population-based, prevalence study of eye disease in Latinos 40 years and older residing in La Puente, California (Los Angeles Latino Eye Study [LALES]). PARTICIPANTS: Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in La Puente. METHODS: All participants completed a standardized interview, including the NEI-VFQ-25 to measure visual functioning, and a detailed eye examination. Two definitions of visual impairment were used: (1) presenting binocular distance VA of 20/40 or worse and (2) presenting binocular distance VA worse than 20/40. Analysis of variance was used to determine any systematic differences in mean NEI-VFQ-25 scores by visual impairment. Regression analyses were completed (1) to determine the association of age, gender, number of systemic comorbidities, depression, and VA with self-reported visual function and (2) to estimate a visual impairment-related difference for each subscale based on differences in VA. MAIN OUTCOME MEASURES: The NEI-VFQ-25 scores in persons with visual impairment. RESULTS: Of the 5287 LALES participants with complete NEI-VFQ-25 data, 6.3% (including 20/40) and 4.2% (excluding 20/40) were visually impaired. In the visually impaired participants, the NEI-VFQ-25 subscale scores ranged from 46.2 (General Health) to 93.8 (Color Vision). In the regression model, only VA, depression, and number of comorbidities were significantly associated with all subscale scores (R(2) ranged from 0.09 for Ocular Pain to 0.33 for the composite score). For 9 of 11 subscales, a 5-point change was equivalent to a 1- or 2-line difference in VA. Relationships were similar regardless of the definition of visual impairment. CONCLUSION: In this population-based study of Latinos, the NEI-VFQ-25 was sensitive to differences in VA. A 5-point difference on the NEI-VFQ-25 seems to be a minimal criterion for a visual impairment-related difference. Self-reported visual function is essentially unchanged if the definition of visual impairment includes or excludes a VA of 20/40.

Adult↗
PubMed2004

Prevalence of diabetic retinopathy in adult Latinos: the Los Angeles Latino eye study.

OBJECTIVE: To estimate age- and gender-specific prevalence of diabetic retinopathy (DR) and to determine the association of type, duration, and treatment of diabetes with the prevalence of DR in adult Latinos. DESIGN: Population-based cross-sectional study. PARTICIPANTS: Six thousand three hundred fifty-seven Latinos aged 40 years and older from 6 census tracts in Los Angeles, California. METHODS: The study cohort consisted of all self-identified Latinos of primarily Mexican ancestry aged 40 years and older residing in 6 census tracts in La Puente, Los Angeles County, California. All participants diagnosed with diabetes underwent a complete ophthalmologic examination, including stereoscopic fundus photography (7 standard Early Treatment Diabetic Retinopathy Study fields). Photographs were graded in a masked manner using a modified Airlie House Grading System to assess presence and severity of DR. MAIN OUTCOME MEASURES: Prevalence of nonproliferative DR, proliferative DR, and macular edema. RESULTS: Of 1263 participants with definite diabetes mellitus, gradable fundus photographs were available in 1217 participants (96%). Of those 1217 participants, 46.9% had DR. Severe nonproliferative DR and proliferative DR were present in 4.4% and 6.1% of diabetics, respectively. Macular edema was observed in 10.4% and clinically significant macular edema was observed in 6.2% of all diabetics. No age- or gender-related differences were present. After adjusting for duration of diabetes, the prevalence of DR was similar in persons with type 1 and type 2 diabetes. CONCLUSIONS: Our data suggest that the prevalence of DR is high among Latinos of primarily Mexican ancestry. The increase in prevalence of DR with longer duration of diabetes emphasizes the public health importance of early diagnosis and management in Latinos. Further data on incidence and progression are required to understand better the natural history of DR in Latinos.

Adult↗
PubMed2004

Prevalence and associations of epiretinal membranes in latinos: the Los Angeles Latino Eye Study.

PURPOSE: To determine age- and gender-specific prevalence and associations of epiretinal membranes (ERMs) in adult Latinos. METHODS: The Los Angeles Latino Eye Study (LALES) is a population-based study of eye disease among Latinos aged 40 or more years. Complete ophthalmic examinations included stereoscopic fundus photography. Masked photographic grading was used to identify and classify ERMs as cellophane macular reflex (CMR) without retinal folds or preretinal macular fibrosis (PMF) with folds. RESULTS: Of the 6142 persons examined at the clinic, 5982 (97%) had gradable retinal photographs. The mean age of the participants was 54.7 +/- 10.7 years; 58% were women. ERMs were present in 18.5% (95% confidence interval [CI]: 17.5%-19.5%) of the participants. Of the participants with ERMs, 19.9% had bilateral ERMs. The prevalence of ERMs increased from 10.1% in persons 40 to 49 years of age to 35.7% in those aged 70 to 79 years and was 22.5% in persons aged 80 years or more. The prevalence was similar in men and women. CMR was present in 16.3% (95% CI: 15.3%-17.2%) and PMF in 2.2% (95% CI: 1.9%-2.6%). Retinal folds involved the fovea in 11% of PMF cases. On average, eyes with central PMF had poorer visual acuity than did eyes without (P < 0.0002). Epiretinal membranes (ERMs) were present in 71% of eyes with macular holes. ERMs were also more common in individuals who had undergone cataract surgery (39.9%), those with proliferative diabetic retinopathy (25.7%), and those with any retinal disease (27.5%). CONCLUSIONS: ERMs occur frequently in Latinos, often bilaterally. The associations of ERMs with proliferative retinopathy, retinal lesions, macular holes, and cataract surgery were confirmed. Central PMF is associated with reduced visual acuity.

Adult↗
PubMed2004

Compliance with recommendations for follow-up care in Latinos: the Los Angeles Latino Eye Study.

PURPOSE: To determine rates of follow-up eye and health care in the Los Angeles Latino Eye Study (LALES), a population-based sample of Latinos. METHODS: Participants received a complete ophthalmic examination and were referred to a local healthcare provider for follow-up care, if ocular or systemic disease was found. Participants receiving referrals were later contacted by telephone and interviewed in their language of choice (English or Spanish) by a trained bilingual interviewer, to determine follow-up rates, and to discuss the barriers preventing follow-up care. RESULTS: Of 430 referred participants, 335 (78%) completed the follow-up survey; 278 (68%) of the responders obtained follow-up care. Among the 108 (32%) individuals who did not seek follow-up care, 54 (50%) cited cost of care as the main reason, while 30 (28%) indicated a lack of knowledge as to where to go for care, and 18 (17%) indicated the unavailability of health care. Logistic regression analyses (controlling for acculturation, co-morbid conditions, and patients' prior knowledge of their diagnoses) revealed that participants with insurance coverage, diagnosis with a systemic disease, and higher educational level were more likely to have received follow-up care. CONCLUSION: More than two thirds of the participants reported seeking the recommended follow-up care. Although cost, availability of services, and convenience of accessing care were found to be major barriers to obtaining health care, higher education, insurance coverage, and prior knowledge of the disease, were associated with receiving recommended care. Knowledge of barriers to seeking health care is important when developing community based healthcare programs directed toward the Latino population.

Acculturation↗
PubMed2003

Relationship between self-reported depression and self-reported visual function in Latinos.

OBJECTIVE: To validate and assess the relationship between self-reported depression as measured by a single item on the Medical Outcomes Study Short-Form 12 (SF-12) and self-reported visual function. METHODS: The Los Angeles Latino Eye Study is population-based and designed to assess the prevalence of visual impairment, ocular disease, and visual functioning in Latinos. Both the 25-item National Eye Institute-Visual Function Questionnaire (NEI VFQ-25) (self-reported visual function) and the SF-12 (health-related quality of life) were administered. A single item from the SF-12 was used to measure self-reported depression and validated against the Center for Epidemiologic Studies-Depression measure of depression. Covariate-adjusted NEI VFQ-25 subscale scores were contrasted across the 6 response choices of the SF-12, as well as across 3 combined response categories of the SF-12 using analysis of covariance. Covariate-adjusted regression analyses assessed the contribution of self-reported depression in explaining self-reported visual function. RESULTS: The sensitivity and specificity of the SF-12 single item with the Center for Epidemiologic Studies-Depression measure was 0.96 and 0.50, respectively. Using the 3 combined response categories of the SF-12 single item, it was found that (1) all covariate-adjusted subscales of the NEI VFQ-25 were statistically significantly different across the self-reported depression categories (P<.001) and (2) covariate-adjusted self-reported depression was a significant predictor of self-reported visual function (P<.001). CONCLUSIONS: A single SF-12 item may be used as a measure of self-reported depression. In addition, self-reported depression is an important covariate to consider when assessing self-reported visual function in Latinos.

Adult↗
PubMed2003

Intraocular pressure control and complications with two-stage insertion of the Baerveldt implant.

PURPOSE: To evaluate intraocular pressure (IOP) control and the prevalence of complications associated with the two-stage insertion of the Baerveldt implant. DESIGN: Retrospective, noncomparative, interventional case series. METHODS: We reviewed the medical records of all patients who underwent the two-stage Baerveldt implantation for advanced glaucoma between January 1995 and November 1998 at the Doheny Eye Institute, Los Angeles, California. All eyes with a minimum of 6 months of follow-up were included in the study. Eyes that failed before 6 months after stage II were also included in the study. MAIN OUTCOME MEASURES: The criterion for surgical success was postoperative IOP of 6 mmHg or more and 21 mmHg or less on two or more consecutive measurements with or without the use of glaucoma medications and without loss of light perception or further surgical intervention to lower IOP. RESULTS: Nineteen eyes from 19 patients were included. Median postoperative follow-up was 17 months (range, 3-56 months). The cumulative probability of success was 89% at both 12 and 24 months. The median preoperative IOP of 21 mmHg (range, 12-33 mmHg) was reduced to a median postoperative IOP of 12 mmHg (range, 1-17 mmHg; P < 0.0001). The median number of glaucoma medications before surgery was three and after surgery was one (P < 0.0001). Visual acuity remained the same or improved in 13 eyes (68%). One eye experienced hypotony (5%), and in two eyes (11%) suprachoroidal hemorrhages developed. CONCLUSIONS: The two-stage insertion of the Baerveldt implant effectively reduced IOP, produced few complications, and preserved visual acuity in more than two thirds of eyes with advanced glaucomatous damage.

Adult↗
PubMed2003

Psychometric performance of the NEI VFQ-25 in visually normal Latinos: the Los Angeles Latino Eye Study.

PURPOSE: To characterize the psychometric performance of the National Eye Institute 25-item Visual Function Questionnaire (NEI VFQ-25) in visually normal Latinos (Mexican Americans). METHODS: The Los Angeles Latino Eye Study (LALES) is a population-based study to assess the prevalence of eye disease and self-reported visual functioning in Latinos aged 40 or more years. Self-reported visual functioning was assessed by using English and Spanish versions of the NEI VFQ-25. Psychometric properties of the NEI VFQ-25, including internal consistency of the subscales and the individual items, were assessed through the Multi-trait Analysis Program-Revised (MAP-R) analysis. Adjusted mean and median subscale scores were compared between English and Spanish speakers to identify any systematic differences. RESULTS: Of the 1917 participants from two census tracts, 1171 participants with no visual impairment were included in this analysis. The mean age of the participants was 52.3 years, 57% of the participants were female, and 67.5% of the participants were Spanish speaking. Median scores for Spanish-speaking participants were significantly lower than those of the English-speaking participants on four subscales: Ocular Pain, General Vision, Vision-Specific Mental Health, and General Health (P < 0.05). Internal consistency for three of eight measurable subscales for the study group was poor (Cronbach alpha < 0.6). CONCLUSIONS: This study reveals psychometric inconsistencies in the NEI VFQ-25 when administered to visually normal Latinos. The difference in mean subscale scores between Spanish and English speakers must be integrated into the development of population norms of visual function. Further detailed psychometric evaluation is needed to determine the validity of this instrument in Latino populations.

Activities of Daily Living↗
PubMed2003

Central corneal thickness in Latinos.

PURPOSE: To characterize central corneal thickness (CCT) in Latinos aged 40 or more years. METHODS: A population-based cohort of Latinos from two census tracts in La Puente, California, underwent measurements of CCT and intraocular pressure (IOP). CCT was measured with an ultrasonic pachymeter, and IOP was measured by applanation tonometry. One eye of each of 1699 participants was included in the analyses. RESULTS: The mean (+/-SD) CCT was 546.9 +/- 33.5 micro m. Older participants (>or=70 years) had significantly thinner CCs compared with participants 40 to 49 years of age (P < 0.05). Eyes with ocular hypertension had thicker CCs than did normal and glaucomatous eyes (P < 0.05). Multivariate adaptive regression spline analyses and analysis of variance contrasting IOP subgroups revealed that eyes with thinner CCs had lower IOP than did eyes with thicker CCs (P < 0.001). The absolute range of interocular differences in CCT in the same subject was as high as 24 micro m. CONCLUSIONS: On average, CCT in Latinos was less than that previously reported in whites but greater than that reported in African Americans and Asians. Older Latinos had thinner corneas compared with younger Latinos. Asymmetry in CCT of 25 micro m or more should be evaluated for potential corneal disease. Spline analyses suggest that although the relationship between IOP and CCT is best explained by a nonlinear equation, when measuring IOP with the Goldmann tonometer, it is likely that IOP is underestimated in eyes with thinner CCs and overestimated in eyes with thicker CCs.

Adult↗
PubMed2003

Optical tomography-measured retinal nerve fiber layer thickness in normal latinos.

PURPOSE: To measure retinal nerve fiber layer (RNFL) thickness in normal Latinos using optical coherence tomography (OCT). METHODS: Three hundred twelve Latino participants, aged 40 years or more, underwent a detailed ophthalmic examination, including measurement of visual acuity, intraocular pressure, visual field perimetry, and stereoscopic optic disc photography. None of the participants had any evidence of ocular hypertension, glaucoma, or other ocular disease. Nine scans were performed on one eye of each participant by optical coherence tomography (OCT Model 2000; Carl Zeiss Meditec, Dublin, CA, software version A 6.1): three circumferential peripapillary scans and six radial scans of the macula. The average RNFL thicknesses in the peripapillary region and macula were measured. A paired t-test and linear regression analyses were used to analyze the data. RESULTS: The mean age of the participants was 52 years (range, 40-79 years). The average peripapillary RNFL thickness 1.74 mm from the center of the disc was 132.7 +/- 14.4 micro m, and the average macular RNFL thickness was 44.8 +/- 14.8 micro m. The average macular retinal thickness was 173 +/- 28.5 micro m. The average peripapillary RNFL thickness in the four quadrants was as follows: superior 157.7 +/- 17.8 micro m, nasal 109.3 +/- 19.1 micro m, inferior 159.8 +/- 18.9 micro m, and temporal 102.5 +/- 19.0 micro m. There were no gender-related differences in macular or peripapillary RNFL thickness (P = 0.12 and P = 0.35, respectively). The average macular and peripapillary RNFL thickness was thinner in older Latinos than in younger Latinos (P = 0.04 and P = 0.0001, respectively). CONCLUSIONS: Regional and age-related differences in the peripapillary and macular RNFL thickness should be considered when diagnosing and monitoring individuals with diseases that affect the RNFL.

Adult↗
PubMed2002

Using focus groups to develop a culturally sensitive methodology for epidemiological surveys in a Latino population: findings from the Los Angeles Latino Eye Study (LALES).

BACKGROUND: Many standardized survey instruments are initially developed in English-speaking populations. These instruments may not be culturally appropriate for other ethnic groups, such as Latinos. METHODS: The Los Angeles Latino Eye Study (LALES) was designed to determine the prevalence of blindness, visual impairment, and ocular diseases; risk factors for these diseases; and general and ocular healthcare use among non-institutionalized adult Latinos in suburban Los Angeles County, California. The LALES investigators used focus groups to develop questionnaires and to devise culturally sensitive methods for implementing this epidemiologic study in a Latino population. Eighty-four respondents were administered the in-home questionnaire and then scheduled into one of 6 in-home focus groups, allowing participants to reflect in groups about the study, their participation, and the state of the instruments and the translations. FINDINGS: Overall, respondents reported that the questionnaire was well written, easy to understand, and very clear. Recommendations from participants included: 1) keep questions brief; 2) minimize the number of response choices; 3) keep phrasing clear; 4) simplify technical terms; 5) provide test results immediately after the clinical examination; and 6) hire Spanish-speaking staff to increase participants' trust and confidence. CONCLUSION: Focus groups assisted in yielding a culturally appropriate survey research tool and methodology for this population-based study in a Latino community.

Adult↗
PubMed2002

Binocular visual acuity summation and inhibition in an ocular epidemiological study: the Los Angeles Latino Eye Study.

PURPOSE: To characterize binocular visual acuity summation and inhibition in participants of a population-based ocular epidemiologic study. METHODS: A complete ophthalmic examination of Latinos, aged 40 or more years, measured binocular and monocular distance visual acuities by a standard early-treatment diabetic retinopathy study (ETDRS) protocol. The proportions of participants who demonstrated binocular summation (i.e., binocular visual acuity was better than the better eye visual acuity by five or more letters), binocular inhibition (i.e., binocular visual acuity was worse than the better eye visual acuity by five or more letters), and visual impairment (visual acuity worse than 20/40) were calculated. RESULTS: In 1831 individuals, on average, binocular visual acuity was better than better eye visual acuity. Prevalence rates of binocular summation and inhibition were 21% and 2%, respectively. Compared with participants less than 65 years old or those with equivalent interocular visual acuity, older participants (> or =65 years) and those with interocular differences in visual acuity were more likely to demonstrate binocular inhibition (P < 0.01). The rate of visual impairment was significantly lower, when using binocular visual acuity than when using better eye or the American Medical Association (AMA) algorithm (5.2% vs. 6.9% and 9.5%, respectively P < 0.01). Participants with binocular inhibition had greater self-reported problems with driving activities (P < 0.05). CONCLUSIONS: The large proportion of individuals demonstrating binocular summation and inhibition suggests that in clinical or research settings, binocular visual acuity should be considered a primary measure of visual impairment, because it better equates the state in which the person usually functions.

Adult↗