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SRAI presentation

  1. 1. PREDICTORS AND CORRELATES OF VISION HEALTH IN THE UNITED STATES Noushin Ahmed, Research Mentor: Dr. Deodutta Roy Florida International University Honors College, Miami Florida.
  2. 2. Blindness and Vision Impairment 3.3 million Americans aged forty and older  Costs the federal government more than $4 billion  The leading causes of impairment and blindness in the United States are age related diseases:   Age-related Macular Degeneration  Cataracts  Glaucoma  Diabetic  Retinopathy Centers for Disease Control: “a substantial human and economic toll on individuals and society including significant suffering, disability, loss of production, and diminished quality of life for millions of people.”
  3. 3. Diabetic Retinopathy The leading cause of blindness in working– aged persons in the United States.  Over 4 million Americans have diabetic retinopathy. (CDC)  Common complication of diabetes.  Anyone with diabetes is susceptible. 
  4. 4. Signs of Diabetic Retinopathy       Microaneurisms and Retinal hemorrhages “Cotton wool” spots, capillary changes, arteriovenous shunts, and neovascularization It leads to damage to the blood vessels of the retina causing severe vision impairment. The vessels break or leak or become blocked, impairing vision over time. Serious damage when abnormal new blood vessels grow on the surface of the retina. This may result in vitreous hemorrhage, fibrosis, and fractional retinal detachment.
  5. 5. RESEARCH Purpose  Examine factors related to vision problems corresponding to Diabetic Retinopathy and their preventive correlates. Methods  The National Health and Nutrition Examination Survey (NHANES) is utilized to examine such factors.  The responses and tests of 4,131 individuals aged 30 years and over were examined. 85.4% No Diabetes  1.6% Borderline Diabetes with no Retinopathy  10.1% Diabetes and no Retinopathy  2.9% Diabetic Retinopathy 
  6. 6. Factors Contributing to Diabetic Retinopathy Socioeconomic Characteristics Age Group  Race/Ethnicity  Education Level  Income Group  Poverty Income Ratio  Clinical Indicators Vision Condition  Maintenance of Diabetes  Fasting Blood Glucose Level  Body Mass Index 
  7. 7. As age increased, the percentages within the age groups with diabetes and diabetic retinopathy increased. The highest percentages of individuals are within the 60 to 69.9 age group.
  8. 8. Race/Ethnicity was a factor as well, with higher percentages of diabetes among Non-Hispanic Black and Hispanics (12.5 and 12.8, respectively).
  9. 9. Those with less education had a much higher rate of diabetes and diabetic retinopathy. 13.9% of participants with less than a high school education had diabetes with no retinopathy, while 4.8% had diabetic retinopathy, the highest than any other education level. Having an education less than the twelfth grade could account for less understanding about healthy lifestyles.
  10. 10. As the income groups increased, the percentage of diabetic retinopathy and diabetes decreased.
  11. 11. The Poverty Income Ratio (PIR) drew a line between those who were living in poverty (PIR ≤ to 1) and those were not (PIR > 1). 13.9% of people living in poverty had diabetes with no retinopathy, while 5.1% had diabetic retinopathy. This could contribute to lack of access to a health services.
  12. 12. Diabetes also affected the general condition of eyesight as 17.9% with very poor vision had diabetic retinopathy.
  13. 13. Maintenance of diabetes through diet, insulin, and medication indicated a lower prevalence of diabetic retinopathy. Those who had diabetes with no retinopathy managed their diabetes better than those who had diabetes and retinopathy leading to the conclusion that glucose levels affect the eyes’ ability to perceive.
  14. 14. This was confirmed by comparing the average fasting blood glucose levels with different diabetes statuses. Higher blood glucose levels were directly related to poorer health.
  15. 15. Comparing Body Mass Index, those who are obese are more likely to have diabetes and retinopathy.
  16. 16. CONCLUSION Understanding the correlates of diabetic retinopathy will allow program planners to correctly assess different groups of people corresponding to race/ethnicity, income, and education  Make the appropriate suggestions to them regarding lifestyles choices.  Education Programs will better assist those in need by correctly assessing the patient population.  Furthermore, it will allow the individual to understand and make lifestyle changes that will ensure healthy vision. 
  17. 17. REFERENCES Arias, Donya C. "Vision Loss an Increasing Problem." The Nation's Health 34 (2004). Dodson, Paul M. "Diabetic Retinopathy: treatment and prevention." Diabetes and Vascular Disease Research 4 (2007). Ellish, Nancy J., Renee Royak-Schaler, Susan R. Passamore, and Eve J. Higginbotham. "Knowledge, Attitudes, and Beliefs about Dilated Eye Examinations among African-Americans." Invest Opthamol Vis Sci (2007). Lim, Marcus CC, Shu Yen Lee, Bobby CL Cheng, Doric WK Wong, Sze Guan Ong, Chong Lye Ang, and Ian YS Yeo. "Diabetic Retinopathy in Diabetics Referred to a Tertiary Centre from a Nationwide Screening Programme." Annals Academy of Medicine 37 (2008). Mohamed, Quresh, Mark C. Gillies, and Tien Y. Wong. "Management of Diabetic Retinopathy." Journal of the American Medical Association 298 (2007): 902-16. United States of America. Department of Health and Human Services. Centers for Disease Control and Prevention. Improving the Nation's Vision Health - A Coordinated Public Health Approach. 2006. Vision Problems in the U.S. - Prevalence of Adult Vision Impairment and Age-Related Eye Disease in America. Publication. Schaumburg: Prevent Blindness America, 2002. Will, Julie C., Robert R. German, Earl Schurman, Sharon Michael, Donn M. Kurth, and Larry Deeb. "Patient Adherence to Guidelines for Diabetes Eye Care: Results from the Diabetic Eye Disease Follow-Up Study." American Journal of Public Health 84 (1994): 1669-671. Yamamoto, Yumiko, Tsutomu Komatsu, Yuji Koura, Koji Nishino, Atsuki Fukushima, and Hisayuki Ueno. "Intraocular pressure elevation after intravitreal or posterior sub-Tenon triamcinolone acetonide injection." Canadian Journal of Ophthalmology 43 (2008): 42-47.