Original article
Four-Year Incidence and Progression of Visual Impairment in Latinos: The Los Angeles Latino Eye Study

https://doi.org/10.1016/j.ajo.2009.12.011Get rights and content

Purpose

To determine the 4-year incidence of visual impairment (VI) and blindness and worsening of visual acuity in adult Latinos and Hispanics aged 40 years and older.

Design

Population-based, longitudinal study.

Methods

Participants underwent a detailed ophthalmologic examination including assessing both presenting binocular visual acuity (PVA) and best-corrected distance visual acuity (BCVA) in both eyes using a standard Early Treatment Diabetic Retinopathy protocol. The main outcome measures are 4-year incidence of visual impairment and blindness based on PVA or BCVA in the better-seeing eye and defined as (1) baseline visual acuity (PVA or BCVA) of 20/40 or better and a follow-up PVA or BCVA of less than 20/40 but better than 20/200, and (2) baseline PVA better than 20/200 and a follow-up PVA of 20/200 or less, respectively. Monocular worsening was defined as a decrease of 5 or more, 10, and 15 letters in either eye.

Results

Four thousand six hundred fifty-eight participants were examined at baseline and the 4-year follow-up. The 4-year incidence of presenting binocular VI and blindness was 2.9% and 0.3%. The 4-year incidence of best-corrected VI and blindness was 1.2% and 0.3%. The 4-year incidence of monocular worsening by 5 or more, 10, and 15 letters was 24.8%, 8.5%, and 3.1%, respectively. The incidence of VI and blindness increased with age at baseline (P < .01). The incidence of VI in the second eye (12.2%) was significantly higher than the incidence of VI in the first eye (2.9%; P < .001).

Conclusions

Overall, the annual incidence of VI in Latinos and Hispanics was higher than that reported in non-Hispanic white persons and the highest reported in a population-based study in the United States. Screening and intervention programs to reduce visual impairment and blindness should focus on the older Latino population.

Section snippets

Population

Details of the baseline LALES study design have been reported elsewhere.14 In summary, the data collection for the baseline population-based prevalence study was conducted from 2000 to 2003. Of the 7789 eligible residents (aged 40 years and older and self-identified Latinos) in 6 census tracts in La Puente, California, who were invited to participate, 6357 (82%) completed an in-home questionnaire and a clinical examination. All living eligible individuals from the baseline LALES were invited to

Study Cohort

Of the 6357 participants examined at baseline, 6100 living participants were eligible for this follow-up study. Of the 6100 living eligibles, 4658 (76%) completed a clinical examination and 4640 (76%) had complete visual acuity data (Figure 2). Participants were followed up for a mean of 4.2 ± 0.52 years. Sociodemographic and historical characteristics of participants who completed the interview and clinical examination at the 4-year follow-up (n = 4658) and nonparticipants (n = 1442) are

Discussion

LALES data provide the first observed incidence estimates of visual impairment and blindness in a large population of Latinos of primarily Mexican ancestry in the United States. The results demonstrate a high incidence of both visual impairment and blindness and high rates of worsening of visual acuity. The 4-year incidence of binocular visual impairment was 2.9% and of blindness was 0.3%. Based on US and WHO criteria, the overall 4-year incidence of monocular visual impairment in the first eye

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