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Title: Prevalence and risk factors for refractive errors and their associations with major age-related eye diseases in adult Singapore Indians
Keywords: myopia,refractive errors,epidemiology,Indian,meta-analysis,eye diseases
Issue Date: 29-Jun-2012
Citation: PAN CHENWEI (2012-06-29). Prevalence and risk factors for refractive errors and their associations with major age-related eye diseases in adult Singapore Indians. ScholarBank@NUS Repository.
Abstract: Myopia is a global public health concern and there may be an epidemic of myopia in Singapore. The aims of the thesis include: i) To determine the prevalence and risk factors for refractive errors in middle-aged to elderly Singaporeans of Indian ethnicity, ii) To describe the distribution and determinants of ocular biometric parameters in adult Singapore Indians, iii) To assess the influence of factors related to migration and acculturation on myopia in migrant Indians in Singapore. iv) To determine the associations of myopia and axial length (AL) with major age-related eye diseases including AMD, DR, age-related cataract and POAG. v) To determine the associations between refractive errors and AMD by a systematic review and meta-analysis of observational studies In this study, 28.0% of Singaporeans of Indian ethnicity aged over 40 years had myopia, which is similar to that of Singapore Malays but lower than Singapore Chinese of the same age. The higher myopia prevalence rates recorded among Indians in India compared with Singaporean Indians may be due to the high nuclear cataract rates in older adults in India. The prevalence of myopia decreased with age in adults without nuclear cataract and increased with age in adults with nuclear cataract, suggesting that the U-shape curve may be explained by differences in patterns for adults with and without nuclear cataract. A more myopic refraction was predominately explained by longer AL or greater AL/corneal radius (CR) ratio throughout the whole age range, although lens nuclear opacity was also a predictor of refraction in older age groups. Height, time spent reading and educational level were the most important predictors of AL. Myopia was more prevalent and ALs were longer among second (or higher) generation immigrants compared with first generation immigrants. Among first generation immigrants, those who migrated to Singapore at an early age and those who preferred to be and were interviewed in English were more likely to be myopic than their counterparts. Myopic eyes were less likely to have AMD and DR, but more likely to have nuclear cataract, posterior subcapsular cataract and POAG. In addition, the variation in AL explained most of the associations of refractive error with AMD, DR or POAG, but not the associations with age-related nuclear cataract, which results from changes in the refractive power of the lens associated with nuclear cataract.
Appears in Collections:Ph.D Theses (Open)

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