Dataset Information

Variation in Intraocular Pressure and the Risk of Developing Open-Angle Glaucoma: The Los Angeles Latino Eye Study.

ABSTRACT: PURPOSE:To determine whether measures of intraocular pressure (IOP) variation are independently associated with the risk of developing open-angle glaucoma (OAG). DESIGN:A population-based, longitudinal study. METHODS:A total of 3666 Latinos free of OAG at the baseline of the Los Angeles Latino Eye Study were followed up 4 years later. Maximum IOP, standard deviation (SD) of IOP, range of IOP, and mean IOP were derived from 6 readings obtained at the 2 visits. OAG diagnosis at each visit was based on the consensus of experts who had access to all clinical examination data from that visit. Multivariate logistic regression was performed. RESULTS:Maximum, SD, and range of IOP were all associated with risk of developing OAG, and SD and range of IOP remained significantly associated even after adjustment for mean IOP. Maximum IOP provided the best fit to the data and other IOP measures were not associated with OAG risk in the model that had included maximum IOP. The effect of IOP variation varied by the level of IOP. Among participants with higher IOPs (?15 mm Hg), only higher levels of maximum IOP were associated with a higher OAG risk (P < .05), while SD and range of IOP were not associated with OAG risk. Among participants with lower IOPs (<15 mm Hg), higher levels of maximum, SD, and range of IOP were all associated with a higher risk of developing OAG (P < .05). Mean IOP was associated with OAG risk only in participants with higher IOPs and not in those with lower IOPs. Results were similar when participants were stratified as <18 and ?18 mm Hg. CONCLUSIONS:IOP variation was an independent risk factor for OAG. Maximum IOP was the most consistent IOP measure for predicting OAG risk across the entire spectrum of IOPs, possibly by capturing the effect of IOP variation among persons with relative lower IOPs as well as mean IOP effects in those with higher IOPs.

SUBMITTER: Jiang X

PROVIDER: S-EPMC5871564 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Variation in Intraocular Pressure and the Risk of Developing Open-Angle Glaucoma: The Los Angeles Latino Eye Study.

Jiang Xuejuan X Torres Mina M Varma Rohit R

American journal of ophthalmology 20180131

<h4>Purpose</h4>To determine whether measures of intraocular pressure (IOP) variation are independently associated with the risk of developing open-angle glaucoma (OAG).<h4>Design</h4>A population-based, longitudinal study.<h4>Methods</h4>A total of 3666 Latinos free of OAG at the baseline of the Los Angeles Latino Eye Study were followed up 4 years later. Maximum IOP, standard deviation (SD) of IOP, range of IOP, and mean IOP were derived from 6 readings obtained at the 2 visits. OAG diagnosis ...[more]

PMID: 29360458

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Project description:ObjectiveTo determine which baseline sociodemographic, lifestyle, anthropometric, clinical, and ocular risk factors predict the development of open-angle glaucoma (OAG) in an adult population.DesignA population-based, prospective cohort study.ParticipantsA total of 3772 self-identified Latinos aged ?40 years from Los Angeles, California, who were free of OAG at baseline.MethodsParticipants from the Los Angeles Latino Eye Study had standardized study visits at baseline and 4-year follow-up with structured interviews and a comprehensive ophthalmologic examination. We defined OAG as the presence of an open angle and a glaucomatous visual field abnormality and/or evidence of glaucomatous optic nerve damage in ?1 eye. Multivariate logistic regression with stepwise selection was performed to determine which potential baseline risk factors independently predict the development of OAG.Main outcome measuresOdds ratios for various risk factors.ResultsOver the 4-year follow-up, 87 participants developed OAG. The baseline risk factors that predict the development of OAG include older age (odds ratio [OR] per decade, 2.19; 95% confidence interval [CI], 1.74-2.75; P<0.001), higher intraocular pressure (IOP; OR per mmHg, 1.18; 95% CI, 1.10-1.26; P<0.001), longer axial length (OR per mm, 1.48; 95% CI, 1.22-1.80; P<0.001), thinner central cornea (OR per 40 ?m thinner, 1.30; 95% CI, 1.00-1.70; P = 0.050), higher waist-to-hip ratio (OR per 0.05 higher, 1.21; 95% CI, 1.05-1.39; P = 0.007) and lack of vision insurance (OR, 2.08; 95% CI, 1.26-3.41; P = 0.004).ConclusionsDespite a mean baseline IOP of 14 mmHg in Latinos, higher IOP is an important risk factor for developing OAG. Biometric measures suggestive of less structural support such as longer axial length and thin central corneal thickness were identified as important risk factors. Lack of health insurance reduces access to eye care and increases the burden of OAG by reducing the likelihood of early detection and treatment of OAG.Financial disclosure(s)The authors have no proprietary or commercial interest in any of the materials discussed in this article.

Project description:ObjectiveTo assess the impact of diabetic retinopathy (DR) and its severity on health-related quality of life (HRQOL) in a population-based sample of Latinos with type 2 diabetes mellitus (DM).DesignCross-sectional population-based study, the Los Angeles Latino Eye Study (LALES).ParticipantsWe included 1064 LALES participants with DM.MethodsWe measured HRQOL by the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and the Medical Outcomes Study 12-item Short Form Health Survey (SF-12). We assessed DR by masked standardized grading of stereoscopic photographs from 7 standard fields. Severity of DR in eyes was graded using a modified Airlie House classification. The severity scores from each eye were then concatenated to create a single per person grade ranging from 1 (no DR in either eye) to 15 (bilateral PDR). Multiple linear regression analyses were performed to determine the independent relationship between severity of DR and HRQOL after adjusting for covariates.Main outcome measuresScores on the NEI-VFQ-25 and SF-12.ResultsMore severe DR was associated with worse HRQOL scores on all of the NEI-VFQ-25 and SF-12 subscales (P<0.05). Individuals with DR from grade 2 (minimum nonproliferative diabetic retinopathy [NPDR]) through grade 8 (unilateral moderate NPDR) show a modest decline in HRQOL. However, the decline becomes significantly steeper between steps 8 (unilateral moderate NPDR) and 9-15 (bilateral moderate NPDR to bilateral PDR). The domains with the most significant impact were for vision-related daily activities, dependency, and mental health.ConclusionsGreater severity of DR was associated with lower general and vision-specific HRQOL. Persons with bilateral moderate NPDR had the most substantial decrease in quality of life compared with those with less severe DR. The prevention of incident DR and, more important, its progression from unilateral to bilateral NPDR is likely to have a positive impact on a person's HRQOL and should be considered an important goal in management of individuals with DM.

Project description:BackgroundPopulation structure and admixture have strong confounding effects on genetic association studies. Discordant frequencies for age-related macular degeneration (AMD) risk alleles and for AMD incidence and prevalence rates are reported across different ethnic groups. We examined the genomic ancestry characterizing 538 Latinos drawn from the Los Angeles Latino Eye Study [LALES] as part of an ongoing AMD-association study. To help assess the degree of Native American ancestry inherited by Latino populations we sampled 25 Mayans and 5 Mexican Indians collected through Coriell's Institute. Levels of European, Asian, and African descent in Latinos were inferred through the USC Multiethnic Panel (USC MEP), formed from a sample from the Multiethnic Cohort (MEC) study, the Yoruba African samples from HapMap II, the Singapore Chinese Health Study, and a prospective cohort from Shanghai, China. A total of 233 ancestry informative markers were genotyped for 538 LALES Latinos, 30 Native Americans, and 355 USC MEP individuals (African Americans, Japanese, Chinese, European Americans, Latinos, and Native Hawaiians). Sensitivity of ancestry estimates to relative sample size was considered.ResultsWe detected strong evidence for recent population admixture in LALES Latinos. Gradients of increasing Native American background and of correspondingly decreasing European ancestry were observed as a function of birth origin from North to South. The strongest excess of homozygosity, a reflection of recent population admixture, was observed in non-US born Latinos that recently populated the US. A set of 42 SNPs especially informative for distinguishing between Native Americans and Europeans were identified.ConclusionThese findings reflect the historic migration patterns of Native Americans and suggest that while the 'Latino' label is used to categorize the entire population, there exists a strong degree of heterogeneity within that population, and that it will be important to assess this heterogeneity within future association studies on Latino populations. Our study raises awareness of the diversity within "Latinos" and the necessity to assess appropriate risk and treatment management.

Dataset Information

Variation in Intraocular Pressure and the Risk of Developing Open-Angle Glaucoma: The Los Angeles Latino Eye Study.

Publications

Variation in Intraocular Pressure and the Risk of Developing Open-Angle Glaucoma: The Los Angeles Latino Eye Study.

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