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Catherine A McCarty

Publications and source records attributed to Catherine A McCarty.

30 records · Page 2Linked to original sources
PubMed2003

Five-year incidence of bilateral cause-specific visual impairment in the Melbourne Visual Impairment Project.

PURPOSE: To describe the age-, gender-, and cause-specific 5-year incidence of bilateral visual impairment in participants in the Melbourne Visual Impairment Project, Victoria, Australia. METHODS: Participants aged 40 years and older were recruited from Melbourne, Victoria, Australia, by random cluster sampling. The mean age of the 3271 (83% of the eligible) participants was 59 +/- 12 (SD) years. Of the participants, 54% were female. The initial baseline study (1992-1994) was followed by a 5-year incidence study (1997-1999). At both time points of the study, participants underwent a standardized testing procedure. Distance and near vision was tested using logarithm of the minimum angle of resolution (logMAR) charts, followed by refraction if needed. Visual fields were assessed by the 24-2 Humphrey field test (FastPac, Humphrey Field Analyzer; Carl Zeiss Meditec, Dublin, CA). Also, intraocular pressure, ocular motility, dilated ophthalmoscopy, and photography of the lens and the fundus were conducted. Furthermore, an interview included demographic characteristics, history of eye disease, medical history, and medication use. For classification of visual impairment, both visual acuity (VA) and visual fields (VF) examination results were used. Four levels of bilateral presenting visual impairment were defined: mild (VA, <20/40-20/60, and/or VF, homonymous hemianopia), moderate (VA, <20/60-20/200, and/or VF, constriction <20 degrees to 10 degrees from fixation), severe (VA, <20/200-10/200, and/or VF, constriction <10 degrees to 5 degrees from fixation), and profound (VA, <10/200, and/or VF, constriction <5 degrees from fixation). For all participants found to be visually impaired, the major cause was identified. RESULTS: Of the 3040 people eligible to attend follow-up 2594 (85%) participated. Data were available for 2530 (98%) participants. In 105 participants (4.22%; 95% confidence limit 2.58-5.85) some degree of visual impairment developed. The main causes were undercorrected refractive error (59%), age-related macular degeneration, cataract and neuro-ophthalmic disorders (7% each), glaucoma (3%), and diabetic retinopathy (1%). The main cause of severe and profound visual impairment was age-related macular degeneration (37%). CONCLUSIONS: Undercorrected refractive error was the primary cause of new cases of visual impairment in this population. Further research is needed to understand the origin of this and to develop appropriate prevention measures. Age-related macular degeneration is the primary cause of severe or profound vision loss in Australia. This disease requires further investigation for effective cure and preventive strategies.

Adult↗
PubMed2003

Risk factors associated with the incidence of open-angle glaucoma: the visual impairment project.

PURPOSE: To assess the relationship between potential risk factors and the development of open-angle glaucoma (OAG) in Australian residents aged 40 and or more years. METHODS: A total of 3271 participants were recruited at baseline from nine urban areas through cluster random sampling and subjected to comprehensive standardized interviews and ophthalmic examination, both at baseline and at 5-year follow-up. The participation rate at follow-up was 85% of the surviving baseline cohort. OAG was diagnosed with definite, probable, or possible certainty by a consensus panel of six ophthalmologists. Potential risk factors identified at baseline included various sociodemographic, anthropometric, dietary, familial, medical, and ocular characteristics of the participants. Risk factor analyses were performed for development of at least possible OAG (possible, probable, and definite OAG) and then at least probable OAG (probable and definite OAG) to represent a higher level of certainty. Univariate and multivariate analyses were performed. RESULTS: Increased age and increased intraocular pressure (IOP) were associated with increased risk of development of OAG, according to multivariate analyses. A family history of glaucoma (relative risk [RR] = 2.1, 95% confidence interval [CI] = 1.03-4.2), the presence of age-related macular degeneration (RR = 2.2, 95% CI = 1.2-3.9), the presence of pseudoexfoliation (RR = 9.4, 95% CI = 2.6-34.4), and a cup-disc ratio (CDR) greater than 0.7 (RR = 7.9, 95% CI = 4.4-14.1) were associated with greater risk of development of at least possible OAG. Having ever taken alpha-blockers (RR = 4.8, 95% CI = 1.2-18.8), the presence of pseudoexfoliation (RR = 11.2, 95% CI = 2.0-63.3), and a CDR higher than 0.7 (RR = 11.0, 95% CI = 4.6-26.8) also indicated significant risk of development of at least probable OAG. CONCLUSIONS: Certain nonmodifiable risk factors may be used to identify high-risk individuals, and increased IOP remains an important modifiable risk factor for OAG. However, more prospective studies on risk factors are required to clarify further the etiological picture of OAG.

Adrenergic beta-Antagonists↗
PubMed2003

Differences in preventive screening rates in Wisconsin farm and non-farm resident women.

PURPOSE: To determine the proportion of rural women who met screening recommendations for Pap smears, mammograms, blood cholesterol, and blood pressure measurements. METHODS: Women aged 25-75 were recruited for a population-based study of chronic diseases in rural residents. In addition to a self-administered health questionnaire and a brief examination, the most recent Pap smear, mammogram, blood pressure, and blood cholesterol measurements were documented from electronic medical records. RESULTS: The study population was comprised of 675 farm and 825 non-farm residents. Fifty-five women (3.7%) had no documentation in their medical records of having ever had a Pap smear, and 19.3% (95% CL 16.9, 21.7) of women aged 40 and older had no documentation of a mammogram. Ninety-two percent of the women (95% CL = 90.2, 93.7) had a blood pressure measurement in the previous 2 years and 74.9% (95% CL = 72.2, 77.6) had a blood cholesterol measurement in the previous 5 years. Age was inversely related to Pap smears and positively correlated with mammograms, blood pressure, and blood cholesterol measurements. Farm residents were significantly less likely to have Pap smears or blood pressure measurements at recommended time intervals. DISCUSSION: To increase the proportion of rural women in compliance with preventive screening recommendations, public health education efforts should target farm residents and younger women.

Adult↗
PubMed2002

Vitamin E supplementation and macular degeneration: randomised controlled trial.

OBJECTIVE: To determine whether vitamin E supplementation influences the incidence or rate of progression of age related maculopathy (AMD). DESIGN: Prospective randomised placebo controlled clinical trial. SETTING: An urban study centre in a residential area supervised by university research staff. PARTICIPANTS: 1193 healthy volunteers aged between 55 and 80 years; 73% completed the trial on full protocol. INTERVENTIONS: Vitamin E 500 IU or placebo daily for four years. MAIN OUTCOME MEASURES PRIMARY OUTCOME: development of early age related macular degeneration in retinal photographs. Other measures included alternative definitions of age related macular degeneration, progression, changes in component features, visual acuity, and visual function RESULTS: The incidence of early age related macular degeneration (early AMD 3) was 8.6% in those receiving vitamin E versus 8.1% in those on placebo (relative risk 1.05, 95% confidence interval 0.69 to 1.61). For late disease the incidence was 0.8% versus 0.6% (1.36, 0.67 to 2.77). Further analysis showed no consistent differences in secondary outcomes. CONCLUSION: Daily supplement with vitamin E supplement does not prevent the development or progression of early or later stages of age related macular degeneration.

Aged↗
PubMed2002

Five-year incidence of open-angle glaucoma: the visual impairment project.

PURPOSE: To determine the incidence of open-angle glaucoma (OAG) in Melbourne, Victoria, Australia. DESIGN: Population-based cohort study. PARTICIPANTS: Total of 3271 participants aged 40 years and older from Melbourne, Victoria, Australia. MAIN OUTCOME MEASURES: Five-year incidence of OAG. METHODS: Participants were recruited through a cluster random sampling from nine urban clusters. Baseline examination was conducted from 1992 through 1994, and the follow-up data were collected from 1997 through 1999. Each participant both at baseline and follow-up underwent a standardized ophthalmic examination including intraocular pressure measurement, visual field assessment, cup-to-disc ratio measurement, and paired stereo photographs of the optic disc. Glaucoma was assessed by a consensus group of six ophthalmologists that included two glaucoma specialists. Glaucoma was diagnosed as possible, probable, or definite. RESULTS: The overall incidence of definite OAG was 0.5% (95% confidence limits [CL], 0.3, 0.7); probable and definite incidence of OAG was 1.1% (95% CL, 0.8,1.4); and possible, probable, and definite OAG incidence was 2.7% (95% CL, 1.8, 3.7). The incidence of possible, probable, and definite OAG increases significantly as age increases (P < 0.001). The incidence of definite OAG increases from 0% of participants aged 40 to 49 years to 4.1% of participants aged 80 years and older. The incidence of probable and definite OAG increases from 0.2% of participants aged 40 to 49 years to 5.4% of participants aged 80 years and older. The incidence of possible, probable, and definite OAG increases from 0.5% of participants aged 40 to 49 years to 11% of participants aged 80 years and older. A nonsignificant but higher incidence of definite OAG among men was observed in this study when compared with women (odds ratio, 2.2; 95% CL, 0.9, 5.9). Fifty percent of the definite OAG participants were undiagnosed. CONCLUSIONS: The incidence of OAG increases significantly with age. The undiagnosed cases suggest the need to develop novel community screening strategies for glaucoma.

Adult↗
PubMed2002

Population-based assessment of refractive error in India: the Andhra Pradesh eye disease study.

PURPOSE: To assess the prevalence, distribution, and demographic associations of refractive error in the population of the southern Indian state of Andhra Pradesh. METHODS: From 94 clusters in one urban and three rural areas of Andhra Pradesh, 11 786 persons of all ages were sampled using a stratified, random, cluster, systematic sampling strategy in the Andhra Pradesh Eye Disease Study, a population-based cross-sectional study. A total of 10 293 people underwent an interview and detailed dilated eye examination. Refraction was performed by ophthalmic personnel trained in the study procedures. Objective refraction under cycloplegia was assessed for participants < or = 15 years of age and subjective refraction for those > 15 years of age. Myopia was defined as spherical equivalent worse than -0.50 D and hyperopia as spherical equivalent worse than +0.50 D. RESULTS: In the participants < or = 15 years of age, the prevalence of myopia was 3.19% (95% confidence interval [CI] 2.24-4.13%) and of hyperopia was 62.62% (95% CI 57.10-68.13%). In this age group, myopia increased with increasing age and was more prevalent in the urban study area, and hyperopia prevalence was greater in the participants < 10 years of age. In participants > 15 years of age, the prevalence of myopia was 19.45% (95% CI 17.88-21.02%) and of hyperopia was 8.38% (95% CI 6.91-9.85%). Myopia and hyperopia increased with increasing age. Myopia was more common in males, those with education higher than class 12, those with nuclear cataract, and those living in rural study areas. Hyperopia was more common in females, those with any level of formal education, and those living in the urban area and in the well-off rural study area. CONCLUSIONS: There is significant refractive error in this population. These data on the distribution and associations of refractive error can be useful for the planning of refractive eye-care services.

Adolescent↗
PubMed2002

Eye health in rural Australia.

A review of the current literature relating to eye health in rural Australia was conducted. Few studies have been undertaken, with most information provided by the Australian Institute of Health and Welfare databases, The National Trachoma and Eye Health Program of 1980 and the Visual Impairment Project in Victoria in the mid 1990s. Key findings were that the rural population has an increased prevalence of pterygium, cataract, ocular trauma and glaucoma, but no difference in refractive error or diabetic retinopathy (although data are limited). Rural residents are more likely to have seen an optometrist but less likely to have seen an ophthalmologist. Interventions have been undertaken in ophthalmologist training to increase the rural workforce and tele-ophthalmology to provide city-based metropolitan ophthalmological support for rural practitioners. Further epidemiological data and evaluated interventions are urgently required to help identify and address the needs of rural Australian communities.

Australia↗
PubMed2002

Cataract in the 21st Century: lessons from previous epidemiological research.

BACKGROUND: Cataract surgery is currently the most commonly performed ophthalmic procedure in Australia. The purpose of this paper is to review Australian data on cataract prevalence and risk factors and to project potential future demand for cataract services. METHODS: Age- and gender-specific cataract prevalence data from the Melbourne Visual Impairment Project (VIP) and the Blue Mountains Eye Study (BMES) were applied to population estimates from the Australian Bureau of Statistics. Published cataract risk factor data from the two studies were reviewed. RESULTS: Although the projected number of cataracts varies substantially based on the definition used, the relative number of cataracts will double over the next 50 years due to the aging of the population. Risk factors for cortical cataract identified in both the VIP and the BMES included female gender, sunlight exposure and myopia. Concordant findings for nuclear cataract included female gender, brown irides, cigarette smoking and myopia. The only risk factor for posterior subcapsular cataract (PSC) that was identified in both studies was myopia. Some of the discrepant findings between the two studies included alcohol intake, diabetes and medication use. DISCUSSION: These data suggest that supply and demand for cataract surgery must be considered and managed to maintain the current level of cataract surgery delivery as the number of people with cataract increases at a proportionately greater rate than the total population. The supply of cataract surgical services could be increased through an increase in the number of ophthalmologists, an increase in the efficiency with which cataract surgical services are delivered, or improved technology. The demand for cataract surgery could be decreased through the implementation of effective primary prevention strategies, although successful strategies are currently unknown and/or untested. Given our current state of knowledge about cataract, it seems most feasible immediately to alter the health service delivery side of the equation to reduce the public health burden of cataract.

Adult↗
PubMed2002

Predictors of falls in the Melbourne visual impairment project.

OBJECTIVE: To assess factors associated with falls in the past month, including visual acuity and other vision-related variables. METHODS: A household census was used to recruit permanent residents aged 40 years and older for baseline examinations of the Melbourne Visual Impairment Project conducted from 1992-94. At the five-year follow-up examinations, returning participants were asked to recall all falls that they had ever experienced and also how many falls they had experienced in the past month. Falls history was divided into those that occurred at home and away from home. Standardised examination of visual acuity was performed. RESULTS: Of the original cohort of 3,271, 231 (7.1%) were reported to have died, leaving 3,040 eligible. Of these, 2,594 (85%) were examined, 51 (2%) had moved interstate or overseas, 83 (3%) could not be traced, and 312 (10%) refused to participate. A history of having ever fallen at home was reported by 466 (20%) participants, and 406 (17.3%) reported having fallen away from home at least once. Five per cent of the cohort (129/2,343) had fallen in the previous month. Factors significantly related to falls at home in the past month in a multivariate logistic regression model included age (OR=1.56 for 10-year age groups) and nuclear cataract (OR=2.87). CONCLUSIONS: Irrespective of visual acuity, cataract is major risk factor for falls at home. IMPLICATIONS: Interventions aimed at decreasing the incidence of falls in the community should include assessment of both visual acuity and cataract status and referral for treatment if functional impairment is evident.

Accidental Falls↗
PubMed2002

A review of the epidemiologic evidence linking ultraviolet radiation and cataracts.

BACKGROUND/AIMS: Cataract is the most common cause of blindness in the world and there are currently no strategies to prevent it. The aim of this paper is to review the epidemiologic evidence linking ultraviolet (UV) radiation and cataract. METHODS: Published epidemiologic research articles on UV and cataract were reviewed against the epidemiologic criteria for causality: biological plausibility, strength of the association, specificity, experimental evidence, temporal sequence of events, dose-response relationship, and consistency. RESULTS: The majority of the 22 epidemiologic studies reviewed met most of the epidemiologic criteria for causality and support an association between UV-B and the development of cortical cataract and perhaps posterior subcapsular cataract. CONCLUSIONS: The epidemiologic data justify the implementation of public health campaigns to raise public awareness of the risk of cortical cataract due to ocular UV-B exposure. Future researchers should be careful to avoid potential bias by measuring personal ocular UV exposure and by quantifying cataract carefully.

Cataract↗
PubMedDate not supplied

Progression of visual field loss in open angle glaucoma in the Melbourne Visual Impairment Project.

PURPOSE: To quantify the progression of visual field loss in participants with open angle glaucoma. METHODS: Cluster random samples of 3271 participants participated in this study. Each participant underwent a standardized ophthalmic examination, which included intraocular pressure measurement, Humphrey 24-2 Fastpac visual field testing and stereophotography of the optic disc. At baseline 118 participants were identified as possible, probable or definite open angle glaucoma and 74 (62.7%) of these were seen again at the follow-up examination. Progression of visual field loss was defined using three methods: the Advanced Glaucoma Intervention Study criteria, the modified Anderson criteria and the Blumenthal method. RESULTS: In total, 49% of subjects showed progressive visual field loss with at least one method. The Blumenthal criteria yielded the highest rate of progression (37%), followed by the modified Anderson method (33%) and the Advanced Glaucoma Intervention Study method (16%). The progressive visual field loss was associated with baseline glaucoma status (P = 0.02); 65% of the definite glaucoma progressed, compared with 57% of the probable glaucoma and 25% of the possible glaucoma. Participants who had been previously diagnosed with glaucoma had a higher rate of progression (54%) when compared with those who had not been diagnosed previously (47%). In total, 50% (four of eight) of those receiving glaucoma medication at baseline had progressive visual field loss; all were in the definite glaucoma category. CONCLUSION: Despite use of glaucoma medications the majority of glaucoma patients managed by their regular ophthalmologist experienced progressive visual field loss over a 5-year period.

Aged↗