253638 Visual impairment in the U.S. and its relationship with demographic factors, diabetes, and other systemic risk factors in NHANES 1999-2000 and NHANES 2005-2008

Wednesday, November 2, 2011: 8:48 AM

Fang Ko, MD , The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
Susan Vitale, PhD, MHS , Division of Epidemiology and Clinical Applications, National Eye Institute, Bethesda, MD
Chiu-Fang Chou, Dr PH , The Vision Health Initiative, Division of Diabetes Translation/The Ginn Group, Northrop Grumman Corporation, Centers for Disease Control and Prevention, Atlanta, GA
Mary Frances Cotch, PhD , National Eye Institute, National Institutes of Health, Bethesda, MD
Jinan B. Saaddine, MD, MPH , National Vision Program, Centers for Disease Control and Prevention, Atlanta, GA
David Friedman, MD, MPh, PhD , The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore
Objective: Estimate prevalence of non-refractive visual impairment (NRVI) and describe its relationship with demographic and systemic risk factors, including diabetes.

Design, Setting, and Participants: The National Health and Nutrition Examination Survey (NHANES) examines a representative sample of the U.S. population.

Results: In persons aged 20 years and older, the prevalence of NRVI increased significantly: from 1.1% (95% confidence interval (CI), 0.8-1.5) in 1999-2000 to 1.8% in 2005-2008 (CI 1.6-2.1, p < 0.01). In multivariable analyses, statistically significant risk factors for NRVI in 1999-2000 included age (odds ratio (OR), 1.11; CI, 1.07-1.14), Mexican-American and non-Hispanic Black race/ethnicity (ORs, 3.30 and 3.36; CI, 1.50-7.23 and 1.34-8.41, respectively), and diabetes duration (OR, 3.57; CI, 1.40-9.09); in 2005-2008, statistically significant risk factors for NRVI were age (OR, 1.07; CI, 1.04-1.09), poverty (OR, 2.23; CI, 1.35-3.69), education less than high school (OR, 1.93; CI, 1.23-3.03), and diabetes duration (OR, 2.77; CI, 1.59-4.80). The prevalence of identified risk factors for NRVI were similar in both time periods, with the exception of diabetes (6.6% vs. 8.3%, p=0.01) and diabetes duration (5.8% vs. 7.1%, p=0.02), which were significantly more prevalent in 2005-2008 than in 1999-2000.

Conclusions: Prevalence of visual impairment not attributed to refractive error was significantly higher in 2005-2008 than in 1999-2000. A similar pattern was observed for diabetes, a known risk factor for visual impairment. Taken together, these results suggest that higher prevalence of NRVI may be attributable in part to the higher prevalence of diabetes.

Learning Areas:
Chronic disease management and prevention

Learning Objectives:
Identify barriers and enablers to the delivery of efficacious and cost-effective eye care that prevent vision loss and promote eye health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I oversee eye disease programs at Johns Hopkins University.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.