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Prevalence of Vitreoretinal Disorders in a Rural Population of Southern India
The Aravind Comprehensive Eye Study
Praveen K. Nirmalan, MD, MPH;
Joanne Katz, PhD;
Alan L. Robin, MD;
James M. Tielsch, PhD;
Perumalsamy Namperumalsamy, MD;
Ramasamy Kim, MD;
V. Narendran, MD;
Rengappa Ramakrishnan, MD;
Ramasamy Krishnadas, MD;
Ravilla D. Thulasiraj, MBA;
Eric Suan, MD
Arch Ophthalmol. 2004;122:581-586.
Objective To determine the magnitude of vitreoretinal disorders in a rural southern Indian population.
Methods Cluster sampling was used to identify individuals 40 years and older in Tamil Nadu in southern India. Demographic details, vision measurement and refraction using logMAR charts, anterior segment slitlamp examination, dilated posterior segment slitlamp examination using a 78-diopter (D) lens, and indirect ophthalmoscopy using a 20-D lens were performed.
Results Complete retinal data were available for 4917 (95.5%) of the 5150 persons examined. The prevalence of any vitreoretinal disorder was 10.4% (95% confidence interval [CI], 9.5%-11.3%). The population prevalence of bilateral blindness among persons with vitreoretinal disorders was 0.3% (95% CI, 0.2%-0.5%). The prevalence of diabetic retinopathy was 0.5% (95% CI, 0.3%-0.7%) in the general population and 10.5% (95% CI, 6.5%-14.5%) in patients with diabetes mellitus. Only 6.7% of individuals with diabetic retinopathy had previous ophthalmic examinations. The prevalences of early and late age-related macular degeneration were 2.7% (95% CI, 2.2%-3.2%) and 0.6% (95% CI, 0.4%-0.8%), respectively.
Conclusions Vitreoretinal diseases appear to be a major public health problem in India. Emphasis on diabetic screening, diabetic therapy, and appropriate laser therapy of diabetic retinopathy must be explored.
From Aravind Medical Research Foundation, Aravind Eye Care System, Madurai, India (Drs Nirmalan, Namperumalsamy, Kim, Narendran, Ramakrishnan, and Krishnadas and Mr Thulasiraj); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md (Drs Katz, Robin, and Tielsch); the Dana Center for Preventive Ophthalmology, Johns Hopkins University Schools of Medicine and Public Health (Drs Katz and Tielsch); the Department of Ophthalmology, Johns Hopkins University School of Medicine (Dr Robin); and the Department of Ophthalmology, University of Maryland School of Medicine, Baltimore (Dr Suan). The authors have no relevant financial interest in this article.
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