Factors Associated with Visual Impairment in Chinese American Adults: The Chinese American Eye Study

ABSTRACT

Purpose

To assess associations between multiple factors comprising a conceptual model of visual impairment (VI) in a population of Chinese Americans (CAs), and identify independent VI risk factors.

Methods

A population-based study of 4582 CAs aged 50 years and older residing in Monterey Park, California. A comprehensive eye examination was performed. VI was defined as best-corrected visual acuity <20/40 (US definition) in the better-seeing eye.

Results

Of five independent risk factors identified, age and self-reported history of ocular disease were most strongly associated with VI. Participants 70 years and older were 10.0 times as likely to have VI compared to those in their 50s (95% confidence interval (CI) 4.0–25.0), while those with a history of ocular disease were 4.2 times as likely to have VI (95% CI 2.2–7.8). Additional risk factors included low education (OR 2.8, 95% CI 1.7–4.8), low acculturation (OR 5.9, 95% CI 2.0–17.3) and self-reported history of diabetes (OR 2.0, 95% CI 1.2–3.2). A comparison to data previously described from the Los Angeles Latino Eye Study indicated that four of the factors that predict VI risk in CAs also represent clinically relevant risk factors for VI in Latinos.

Conclusions

Screening programs for individuals with advanced age and a history of ocular disease have the potential to reduce the burden of VI in CAs, as do educational programs for those with fewer years in school, a history of diabetes, and low acculturation.

KEYWORDS:

• Visual Impairment
• Chinese Americans
• Risk Factors

Acknowledgments

Group Information: The Chinese American Eye Study Group includes the following: USC Roski Eye Institute, University of Southern California, Los Angeles: Rohit Varma, MD, MPH (principal investigator); Roberta McKean-Cowdin, PhD (coinvestigator); Stanley P. Azen, PhD (coinvestigator); Mina Torres, MS (project director); Chunyi Hsu, MPH (project manager); David Dinh, BA (research assistant); Ruzhang Jiang, MD (examiner); Jie Sun, MD, PhD, MPH (examiner); Dandan Wang, MD (examiner); YuPing Wang, Certified Ophthalmic Technician (examiner); Justine Wong, BA (clinical interviewer); Shuang Wu, MS (statistician); Rucha Desai, MS (programmer). Battelle Survey Research Center, St. Louis, Missouri: Lisa V. John, PhD (recruitment director); Michelle Cheng, MS (field supervisor). Ocular Epidemiology Grading Center, University of Wisconsin, Madison: Stacy M. Meuer (senior grader); Ronald Klein, MD, MPH (coinvestigator). Chinese American Eye Study Data Monitoring and Oversight Committee: Alfred Sommer, MD, MHS (chair); Anne Coleman, MD, PhD; Dennis Han, MD; Craig Hanis, PhD; Louise Wideroff, PhD; Terri Young, MD.

Conflicts of Interest

All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest, and none were reported.

Role of the Funder/Sponsor

The funding sources had no role in the design or conduct of this study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication.

Additional information

Funding

This work was supported by grant EY-017337 from the National Eye Institute, National Institutes of Health, Bethesda, Maryland, and an unrestricted Departmental grant from Research to Prevent Blindness, New York, NY 10022.