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      Prevalence and Risk Factors of Idiopathic Epiretinal Membranes in Beixinjing Blocks, Shanghai, China

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          Abstract

          Background

          To determine the prevalence and risk factors associated with idiopathic epiretinal membranes (iERM) in a Chinese population aged 60 years or older in Beixinjing Blocks, Shanghai.

          Methods

          This population-based study consisted of 3727 participants (89.7% of the eligible). It was performed to describe the prevalence of iERM and possible demographic, systemic, and ocular factors associated with iERM. Each participant underwent a standardized interview and comprehensive ophthalmic examination. iERM was identified and graded from retinal photographs. Then, a case-control study comparing the participants with vs. without iERM was performed to further study the associations between iERM and blood biochemical test results (including fasting plasma glucose, serum creatinine, total cholesterol, and triglyceride), ocular biological parameters (including the axial length, corneal curvature, refractive diopter, intraocular press, and anterior chamber depth), and the data of optical coherence tomography.

          Results

          The prevalence of iERM was 1.02%. iERM was significantly associated with diabetes (OR: 2.457; 95% CI: 1.137, 5.309) and a higher level of education (OR: 1.48; 95% CI: 1.123, 1.952). Blood biochemical test results and ocular biological parameters showed no significant differences between the iERM and control groups, whereas the incidence of posterior vitreous detachment in the iERM group was much higher than in the control group (26.5% vs. 8.8%), but this difference was not statistically significant. Moreover, the eyes with iERM had poorer visual acuity than the eyes without iERM (P<0.05).

          Conclusions

          In Beixinjing Blocks, Shanghai, iERM was relatively rare, was associated with diabetes and a higher level of education, and caused a substantial decrease in visual acuity.

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          Most cited references40

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          Posterior vitreous detachment: evolution and complications of its early stages.

          To summarize emerging concepts regarding the onset and progression, traction effects, and complications of the early stages of age-related posterior vitreous detachment (PVD). Interpretive essay. Review and synthesis of selected literature, with clinical illustrations, interpretation, and perspective. Imaging of the vitreoretinal interface with optical coherence tomography has shown that PVD begins in the perifoveal macula. Recent longitudinal studies have demonstrated conclusively that early PVD stages persist chronically and progress slowly over months to years. Vitreous traction forces resulting from perifoveal PVD with a small vitreofoveolar adhesion (500 microm or less) may cause localized cystoid foveal thickening or one of several macular hole conditions. Traction associated with larger adhesion zones may cause or exacerbate a separate group of macular disorders. Ultrastructural studies suggest that epiretinal membrane develops from cortical vitreous remnants left on the retinal surface after PVD and plays an important role in traction vitreomaculopathies. Age-related PVD is an insidious, chronic event that begins in the perifoveal macula and evolves over a prolonged period before vitreopapillary separation. Although asymptomatic in most individuals, its early stages may be complicated by a variety of macular and optic disc pathologic features, determined in part by the size and strength of the residual vitreoretinal adhesion. (c) 2010 Elsevier Inc. All rights reserved.
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            Prevalence and risk factors for epiretinal membranes in a multi-ethnic United States population.

            To describe the prevalence of and risk factors for epiretinal membrane (ERM) in a multi-ethnic population and to evaluate possible racial or ethnic differences. Cross-sectional study. Participants of the Multi-Ethnic Study of Atherosclerosis (MESA), examined at the second visit of the MESA when retinal photography was performed. Data on 5960 participants aged 45 to 84 years from MESA, including white, black, Hispanic, and Chinese persons from 6 United States communities, were analyzed. Epiretinal membrane was assessed from digital nonstereoscopic fundus photographs and was defined as cellophane macular reflex (CMR) without retinal folds or preretinal macular fibrosis (PMF) with retinal folds. Risk factors were assessed from standardized interviews, clinical examinations, and laboratory investigations. Epiretinal membrane prevalence by ethnic or racial group and risk factors associated with ERM. The prevalence of any ERM was 28.9%, of which 25.1% were CMR cases and 3.8% were PMF cases. The prevalence of ERM was significantly higher in Chinese persons (39.0%), compared with Hispanic (29.3%), white (27.5%), or black (26.2%; P<0.001) persons. In multivariate models, increasing age (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.06-1.34, per year increase in age), diabetes (OR, 1.92; 95% CI, 1.39-2.65), and hypercholesterolemia (OR, 1.33; 95% CI, 1.04-1.69) were significantly associated with CMR. This study showed that ERM was significantly more common in Chinese persons compared with whites, blacks, and Hispanics. Risk factors for ERM were increasing age, presence of diabetes, and hypercholesterolemia. Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
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              Prevalence and causes of low vision and blindness in a rural chinese adult population: the Handan Eye Study.

              To describe the prevalence and causes of low vision and blindness in a rural population in Northern China. Population-based, cross-sectional study. A study of 6830 Han Chinese aged 30 years and older was conducted between October 2006 and October 2007 in rural Yongnian County in Handan, Northern China. Clustered samples of adults aged 30 years or more residing in 13 residential villages were selected randomly and were invited to participate the Handan Eye Study. Participants underwent a comprehensive eye examination, including standardized visual acuity (VA) tests using logarithm of the minimum angle resolution charts. Prevalence was age- and gender-standardized to the 2000 China Census. Low vision was defined as VA /=20/400, and blindness was defined as VA <20/400 following the Modified World Health Organization (WHO) definitions. Primary causes of low vision and blindness were determined by study ophthalmologists according to WHO definitions. Six thousand eight hundred thirty (90.4%) of 7577 eligible individuals participated in the study, and 6799 (89.7%) had VA data available. Population-weighted prevalence of presenting bilateral blindness was 0.6% and bilateral low vision was 4.7% for persons 30 years of age and older. Based on best-corrected visual acuity (BCVA), the corresponding prevalence of blindness was 0.5% and that of low vision was 1.0%. Blindness and low vision were strongly age related (P<0.05). Cataract was the predominant cause of presenting bilateral blindness (36.6%), whereas undercorrected refractive error was the predominant cause of presenting low vision (78.4%). After refractive correction, cataract became the first leading cause of blindness (41.9%), and low vision (48.2%), myopic retinopathy (16.1%), glaucoma (9.7%), and corneal opacity (9.7%) were other common causes of blindness defined using BCVA. A higher prevalence of blindness and low vision was seen in this rural Chinese sample than has been reported from urban Chinese populations. The estimated numbers with BCVA-defined low vision and blindness in 2020, based on best-corrected vision in rural Chinese adults aged 30 years or more, is expected to be 12.4 million and 2.9 million, respectively. Predominant causes of low vision and blindness in China are treatable.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2012
                10 December 2012
                : 7
                : 12
                : e51445
                Affiliations
                [1 ]Department of Ophthalmology, Shanghai First People's Hospital, Affiliated Shanghai Jiaotong University, Shanghai, China
                [2 ]Beixinjing Community Health Service Center, Shanghai, China
                Zhongshan Ophthalmic Center, China
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: HDZ XX XZ. Performed the experiments: HDZ JJP XFZ JF WWW. Analyzed the data: XFZ JJP HDZ. Contributed reagents/materials/analysis tools: HDZ XFZ. Wrote the paper: XFZ HDZ JJP.

                Article
                PONE-D-12-26323
                10.1371/journal.pone.0051445
                3519558
                23251536
                145cefa6-0ed4-4117-8e11-08d11f67fa98
                Copyright @ 2012

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 29 August 2012
                : 1 November 2012
                Page count
                Pages: 7
                Funding
                Funding was provided by a key grant from the Shanghai Health Bureau (20114007) and a grant from the Shanghai Leading Talent Reserve Program (40311). No conflicting relationship exists for any author. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology
                Computational Biology
                Population Modeling
                Neuroscience
                Sensory Systems
                Visual System
                Population Biology
                Population Metrics
                Medicine
                Anatomy and Physiology
                Ocular System
                Clinical Research Design
                Case-Control Studies
                Epidemiology
                Endocrinology
                Diabetic Endocrinology
                Non-Clinical Medicine
                Health Care Policy
                Health Risk Analysis
                Ophthalmology
                Retinal Disorders

                Uncategorized
                Uncategorized

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