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Elena Rochtchina

Publications and source records attributed to Elena Rochtchina.

At least 19 recordsLinked to original sources
PubMed2007

Ten-year incidence and progression of age-related maculopathy: the blue Mountains Eye Study.

PURPOSE: To assess the 10-year incidence of age-related maculopathy (ARM) in an older Australian cohort. DESIGN: Population-based cohort study. PARTICIPANTS: Three thousand six hundred fifty-four Blue Mountains Eye Study participants > or =49 years old were examined during 1992 through 1994; 2335 (75% of survivors) were reexamined after 5 years (1997-1999) and 1952 (76% of survivors) after 10 years (2002-2004). METHODS: The same graders performed retinal photographic grading in all examinations, using the Wisconsin Age-Related Maculopathy Grading System. Photographs of participants with ARM lesions at any of the examinations were subsequently regraded using a side-by-side comparison method. MAIN OUTCOME MEASURES: The diagnosis of incident late ARM was given if neovascular ARM or geographic atrophy was detected at either follow-up examination in persons free of these lesions at baseline. Incident early ARM was diagnosed if early ARM (soft indistinct or reticular drusen or combined soft distinct drusen and retinal pigment abnormality) was present in persons free of early and late ARM at baseline. Age-related maculopathy incidence was calculated using Kaplan-Meier methods to incorporate information from both 5- and 10-year examinations. Discrete logistic models were used to assess the risk of incident late ARM according to various baseline factors, including early ARM lesion characteristics. RESULTS: After excluding 72 late ARM cases present at baseline, 2395 of 3582 subjects at risk of late ARM (67%) were reexamined at either follow-up time point or both follow-up time points. Over the 10-year period, 72 of 2395 subjects (3.7%) developed late ARM and 266 of 2255 subjects (14.1%) developed early ARM. After age standardization to the Beaver Dam Eye Study population, our 10-year incidences of late and early ARM were 2.8% and 10.8%, respectively. Baseline age and early ARM lesion characteristics and severity were strong predictors of late ARM incidence. CONCLUSIONS: Long-term follow-up of this older population confirms that the risk of ARM progression is related strongly to the severity of early-stage lesions. The study provides evidence-based criteria for identifying persons at high risk of developing late ARM.

Aged↗
PubMed2006

Retinal vein occlusion and vascular mortality: pooled data analysis of 2 population-based cohorts.

PURPOSE: To assess the association of retinal vein occlusion (RVO) with cardiovascular and cerebrovascular mortality. DESIGN: Pooled data from 2 population-based cohort studies. PARTICIPANTS: At baseline, the Beaver Dam Eye Study (BDES) examined 4926 persons aged 43 to 86 years (from 1988-1990) and the Blue Mountains Eye Study (BMES) examined 3654 persons aged 49 to 97 years (from 1992 to 1994). METHODS: Retinal vein occlusion was assessed from retinal photographs. Vascular deaths were determined using either death certificates (BDES) or the Australian National Death Index (BMES). Cox regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). MAIN OUTCOME MEASURE: Vascular (cardiovascular and cerebrovascular) mortality was determined. RESULTS: Of 8384 baseline participants, 96 (1.14%) had RVO at baseline (BDES, n = 38; BMES, n = 58). Over 12 years, 1312 (15.7%) died of cardiovascular-related conditions and 341 (4.1%) died of cerebrovascular-related conditions. Age-standardized vascular mortality rates were 26.0% and 5.3%, respectively, in persons with RVO and 17.1% and 4.5%, respectively, in those without RVO. After adjusting for age, gender, body mass index, hypertension, diabetes, smoking, glaucoma, and study site, RVO was not associated with cardiovascular-related mortality (HR, 1.2; 95% CI, 0.8-1.8) or cerebrovascular-related mortality (HR, 0.9; 95% CI, 0.4-2.1) among participants of all ages. However, in persons aged less than 70 years, baseline RVO was associated with higher cardiovascular mortality (combined BDES and BMES: HR, 2.5; 95% CI, 1.2-5.2; BDES: HR, 2.5; 95% CI, 0.9-6.9; BMES: HR, 2.1; 95% CI, 0.7-6.8). CONCLUSIONS: Retinal vein occlusion in persons aged 43 to 69 years may signal a doubling of the risk of cardiovascular mortality.

Adult↗
PubMed2006

Association between circulating white blood cell count and long-term incidence of age-related macular degeneration: the Blue Mountains Eye Study.

Inflammatory processes are implicated in the development and progression of age-related macular degeneration (AMD). However, there are limited data on longitudinal associations between systemic markers of inflammation and AMD. The authors examined the prospective relation between the circulating white blood cell (WBC) count and early and late AMD in a population-based cohort of 3,654 participants, aged 49-97 years, in the Blue Mountains region, Australia. The main outcome of interest was the 10-year incidence of early and late AMD among individuals free from corresponding disease at the baseline (1992-1994). An elevated baseline WBC count was associated with early AMD incidence, independent of smoking and other major confounders. The multivariable relative risk comparing tertile 3 of WBC count (>6.7 x 10(9) cells/liter) with tertile 1 (</=5.5 x 10(9) cells/liter) was 1.85 (95% confidence interval: 1.33, 2.58). The association between WBC count and early AMD was present consistently in analyses of different early AMD lesions, including incident pigmentary abnormalities and soft indistinct/reticular drusen. Moreover, this association persisted in subgroup analyses by gender and smoking. An elevated WBC count at baseline was not consistently associated with late AMD incidence. This study provides population-based evidence supporting a longitudinal association between the circulating WBC count, a widely available marker of inflammation, and incidence of early AMD.

Aged↗
PubMed2006

Positive association between plasma fibrinogen level and incident hypertension among men: population-based cohort study.

Elevated plasma fibrinogen is implicated in cardiovascular disease. However, it is not clear whether fibrinogen levels predict the development of hypertension. We examined the relationship between plasma fibrinogen level and hypertension in a population-based cohort study of 3654 participants (mean age: 61.5 years; range: 49 to 84 years) at the baseline examination (1992-1994) in the Blue Mountains region, west of Sydney, Australia, who were examined 5 years (1997-1999) later. Main outcomes of interest were prevalent hypertension (systolic blood pressure >or=140 mm Hg, diastolic blood pressure >or=90 mm Hg, or a combination of self-reported hypertension diagnosis and use of antihypertensive medications) at baseline (n=2212/3180) and 5-year incidence of hypertension among baseline normotensive individuals (n=361/637). Elevated plasma fibrinogen level was positively associated with prevalent hypertension both among men and women and positively associated with 5-year incident hypertension among men, independent of several cardiovascular risk factors. Multivariable odds ratio (95% CI) of 5-year incident hypertension comparing tertile 3 of plasma fibrinogen (>or=3.9 g/L) with tertile 1 (<or=3.2 g/L) was 1.95 (1.03 to 3.68; P trend=0.040). This prospective association, however, was not observed in women (odds ratio; 95% CI) comparing tertile 3 versus tertile 1 of plasma fibrinogen (1.00; 0.54 to 1.86; P trend=0.986). Subgroup analyses stratified by smoking, body mass index, diabetes, and blood pressure categories supported this male gender-specific pattern of association. These data provide prospective epidemiological evidence of an essential link between plasma fibrinogen level and incident hypertension among men but not among women, a finding consistent with that observed in the Atherosclerosis Risk in Communities Study.

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PubMed2006

Cataract surgery and the 10-year incidence of age-related maculopathy: the Blue Mountains Eye Study.

PURPOSE: To assess the long-term (10-year) risk of late age-related maculopathy (ARM) in eyes that had previously undergone cataract surgery (before the baseline examination). DESIGN: Population-based cohort study. PARTICIPANTS: In the Blue Mountains Eye Study (BMES) cohort, 2335 of 3654 baseline participants > or =49 years old (75% of survivors) were reexamined after 5 years and 1952 (76% of survivors) were reexamined after 10 years. METHODS: At the baseline examination, nonphakic (aphakic or pseudophakic) eyes were identified at slit-lamp examination and confirmed at lens photographic grading. Side-by-side grading of baseline and follow-up stereoretinal photographs was performed using the Wisconsin ARM grading system. Eye-specific data were analyzed using Kaplan-Meier estimates and generalized estimating equation models, adjusting for correlation between the 2 eyes. MAIN OUTCOME MEASURES: Incident late ARM was defined if either neovascular ARM or geographic atrophy developed in eyes without either lesion at baseline. RESULTS: After excluding eyes with either late ARM lesion at baseline or that had missing photographs at either examination, 4763 eyes were considered at risk of incident late ARM, including 132 eyes that had cataract surgery before the baseline examination. Late ARM developed in 10 of 132 nonphakic eyes (7.6%) compared to 96 of 4631 phakic eyes (2.1%). After adjusting for baseline age, gender, smoking, and presence of early ARM lesions, nonphakic (cataract surgical) eyes had a 3-fold risk of developing late-stage ARM (odds ratio [OR], 3.3; 95% confidence interval [CI], 1.1-9.9) or neovascular ARM (OR, 3.4; 95% CI, 1.1-10.9) compared to phakic eyes. CONCLUSIONS: Our findings support the hypothesis that the long-term risk of developing late ARM is higher in cataract surgical eyes, consistent with findings from the Beaver Dam Eye Study.

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PubMed2006

Retinal vessel signs and 10-year incident age-related maculopathy: the Blue Mountains Eye Study.

OBJECTIVE: To examine whether retinal vessel signs are independent predictors of the long-term development of age-related maculopathy (ARM). DESIGN: Prospective population-based cohort study. PARTICIPANTS: Blue Mountains Eye Study participants aged > or =49 years (n = 3654) were examined during 1992 through 1994; 2335 (75% of survivors) were reexamined after 5 years and 1952 (76% of survivors) were reexamined after 10 years. METHODS: Baseline focal arteriolar narrowing and arteriovenous (AV) nicking were assessed and vessel calibers were measured from retinal photographs. A side-by-side grading method was used to assess ARM incidence. Eye-specific data were analyzed using generalized estimating equation models, adjusting for age, gender, smoking, and blood pressure. MAIN OUTCOME MEASURES: Incident early ARM (soft indistinct or reticular drusen or combined soft distinct drusen and retinal pigment abnormality) was defined in eyes free of both early and late ARM at baseline. Incident late ARM (either geographic atrophy or neovascular macular degeneration) was defined in eyes free of these 2 lesions at baseline. RESULTS: Over a 10-year period, incident late ARM developed in 106/4745 eyes at risk of late ARM (2.2%). Eyes with mild (2.7%) or severe (4.6 %) AV nicking were more likely to develop late ARM than eyes without this sign (1.5%). The adjusted odds ratio (OR) was 1.4, 95% confidence interval (CI) 0.8 to 2.4 for mild and OR 2.6, 95% CI 1.2 to 5.5 for severe AV nicking. Eyes with focal narrowing were also more likely to develop late ARM (7.6% vs. 1.8%), adjusted OR 2.2, 95% CI 1.1 to 4.1. Incident early ARM developed in 398/4490 eyes at risk of early ARM (8.9%). Severe AV nicking, but not focal arteriolar narrowing, was associated with an increased long-term risk of early ARM (13.6% vs. 8.2%; OR 1.5; 95% CI 1.0-2.3). Neither arteriolar nor venular caliber was significantly associated with the incidence of either early or late ARM. CONCLUSIONS: These 10-year incidence data confirm our previous observation that structural retinal arteriolar changes may either contribute to ARM progression or share common pathologic pathways with ARM, independent of traditional vascular risk factors.

Aged↗
PubMed2006

Retinal arteriolar emboli and long-term mortality: pooled data analysis from two older populations.

BACKGROUND AND PURPOSE: To assess the relationship between retinal arteriolar emboli and mortality in older people. METHODS: Pooled data from 2 population-based cohort studies. At baseline, the Beaver Dam Eye Study (BDES) examined 4926 persons 43 to 86 years of age (1988 to 1990), and the Blue Mountains Eye Study (BMES) examined 3654 persons 49 to 97 years of age (1992 to 1994). Retinal arteriolar emboli were assessed by grading retinal photographs using standardized methods. Deaths and causes of death were determined from death certificates or Australian National Death Index. Cox regression models were used to estimate mortality hazard ratios (HRs) associated with emboli, adjusting for age, gender, body mass index, hypertension, diabetes, smoking, serum total cholesterol, high-density lipoprotein cholesterol, study site, and past histories of stroke, angina, and acute myocardial infarct. RESULTS: Of 8580 baseline participants, 8384 (98%) had retinal photographs available, and 111 showed retinal arteriolar emboli (BDES n=61; BMES n=50). Over 10 to 12 years, 2506 participants (30%) died, including 344 (4%) from stroke-related and 1315 (16%) from cardiovascular causes. The cumulative mortality rates were higher in participants with than without emboli (all-cause 56% versus 30%; stroke-related 12% versus 4.0%; cardiovascular 30% versus 16%). The increased mortality risk associated with emboli was independent of age, gender, other vascular risk factors, and past histories of stroke or heart disease for all-cause (multivariate-adjusted HR, 1.3; CI, 1.0 to 1.8) and stroke-related mortality (HR, 2.0; CI, 1.1 to 3.8) but not for cardiovascular mortality (HR, 1.2; CI, 0.8 to 1.7). CONCLUSIONS: Our pooled data from 2 older populations suggest that retinal emboli predict a modest increase in all-cause and stroke-related mortality independent of cardiovascular risk factors.

Adult↗
PubMed2006

The association between circulating white blood cell count, triglyceride level and cardiovascular and all-cause mortality: population-based cohort study.

OBJECTIVES: To examine the individual and combined relationship between elevated white blood cell count (WBC), triglyceride level and cardiovascular and all-cause mortality among older Australians. DESIGN: Prospective population-based cohort study. SETTING: Community in Blue Mountains region, Australia. PARTICIPANTS: 2904 individuals, aged 49-84 years, free of cardiovascular disease and cancer at the baseline examination. MAIN OUTCOME MEASURES: Cardiovascular (n=242) and all-cause mortality (n=575). RESULTS: Elevated WBC count and triglyceride level were found to be associated with cardiovascular and all-cause mortality, independent of several important confounders. Multivariable relative risk [RR] (95% confidence interval [CI]) comparing fourth (6.8 x 10(9) cells/L and above) versus first quartile (4.8 x 10(9) cells/L and below) of WBC count was 2.01 (1.40-2.90) for cardiovascular mortality and 1.68 (1.35-2.09) for all-cause mortality. Multivariable RR (95% CI) comparing fourth (1.98 mmol/L and above) versus first quartile (0.95 mmol/L and below) of triglyceride level was 1.58 (1.08-2.30) for cardiovascular mortality and 1.40 (1.11-1.77) for all-cause mortality. Furthermore, a combined exposure to the fourth quartiles of both WBC count and triglyceride level was found to be related to more than three-fold risk of cardiovascular mortality (RR [95% CI]: 3.15 [2.17-4.57], p-interaction=0.01), independent of traditional risk factors. CONCLUSIONS: Elevated WBC count and triglyceride level were associated with cardiovascular and all-cause mortality among older Australians. These data provide new epidemiological evidence regarding cardiovascular risk stratification using simple, inexpensive, and routinely available measures, suggesting that a combined exposure to both high WBC count and triglyceride level is related to more than three-fold risk of cardiovascular mortality, independent of traditional risk factors.

Aged↗
PubMed2006

Comparison of age-specific cataract prevalence in two population-based surveys 6 years apart.

BACKGROUND: In this study, we aimed to compare age-specific cortical, nuclear and posterior subcapsular (PSC) cataract prevalence in two surveys 6 years apart. METHODS: The Blue Mountains Eye Study examined 3654 participants (82.4% of those eligible) in cross-section I (1992-4) and 3509 participants (75.1% of survivors and 85.2% of newly eligible) in cross-section II (1997-2000, 66.5% overlap with cross-section I). Cataract was assessed from lens photographs following the Wisconsin Cataract Grading System. Cortical cataract was defined if cortical opacity comprised > or = 5% of lens area. Nuclear cataract was defined if nuclear opacity > or = Wisconsin standard 4. PSC was defined if any present. Any cataract was defined to include persons who had previous cataract surgery. Weighted kappa for inter-grader reliability was 0.82, 0.55 and 0.82 for cortical, nuclear and PSC cataract, respectively. We assessed age-specific prevalence using an interval of 5 years, so that participants within each age group were independent between the two surveys. RESULTS: Age and gender distributions were similar between the two populations. The age-specific prevalence of cortical (23.8% in 1st, 23.7% in 2nd) and PSC cataract (6.3%, 6.0%) was similar. The prevalence of nuclear cataract increased slightly from 18.7% to 23.9%. After age standardization, the similar prevalence of cortical (23.8%, 23.5%) and PSC cataract (6.3%, 5.9%), and the increased prevalence of nuclear cataract (18.7%, 24.2%) remained. CONCLUSION: In two surveys of two population-based samples with similar age and gender distributions, we found a relatively stable cortical and PSC cataract prevalence over a 6-year period. The increased prevalence of nuclear cataract deserves further study.

Age Distribution↗
PubMed2006

Associations between elevated intraocular pressure and glaucoma, use of glaucoma medications, and 5-year incident cataract: the Blue Mountains Eye Study.

PURPOSE: To examine incident relationships between elevated intraocular pressure (IOP), open-angle glaucoma (OAG), and use of glaucoma medications with 5-year incident cataract. DESIGN: Population-based cohort study. PARTICIPANTS: The Australian Blue Mountains Eye Study examined 3654 participants > or =50 years old at baseline (82.4% response; 1992-1994); 2335 eligible participants were reexamined after 5 years (75.1% response; 1997-1999). METHODS: A detailed medical and ocular history, including current medications, was taken, and a comprehensive eye examination, including applanation tonometry, automated perimetry, and lens photography, was performed at each examination. The Wisconsin system was used to grade lens photographs in assessing incident nuclear, cortical, and posterior subcapsular cataract (PSC). Data from both eyes were assessed using generalized estimating equation analyses. MAIN OUTCOME MEASURES: Elevated IOP was defined as > or =21 mmHg. Open-angle glaucoma was diagnosed from typical glaucomatous field loss with matching optic disc cupping, without reference to IOP. Subjects without OAG or secondary or angle-closure glaucoma with IOP > 21 mmHg in either eye were classified as having ocular hypertension (OH), as were non-OAG subjects with IOP < 22 mmHg using glaucoma medications. Wisconsin levels 4 to 5 were graded as nuclear cataract, at least 5% lens involvement was graded as cortical cataract, and any PSC defined its presence. RESULTS: The 5-year incidence of nuclear cataract was 23.4% (592/2532), or 23.1% (574/2486) after excluding subjects using glaucoma medication. A marginally significant association was found for elevated IOP or OH at baseline and incident nuclear cataract (odds ratio [OR], 1.93 [95% confidence interval (CI), 0.97-3.89], and OR, 1.83 [95% CI, 0.96-3.48], respectively) in subjects not using glaucoma medications, after multivariate adjustment. Age- and gender-adjusted analyses showed similar but statistically significant associations. The association between elevated IOP or OH and nuclear cataract was significant in multivariate analyses (OR, 2.07 [95% CI, 1.04-3.12], and OR, 1.78 [95% CI, 1.05-3.01], respectively). Use of glaucoma medications was associated with nonsignificantly increased adjusted odds for incident nuclear cataract (OR, 1.90 [95% CI, 0.92-3.92]). No associations, however, were found with incident cortical cataract or PSC. CONCLUSIONS: Elevated IOP may increase the risk of nuclear cataract, but not that of other types. The use of glaucoma medications could magnify this risk.

Aged↗
PubMed2006

Ten-year incidence of retinal emboli in an older population.

BACKGROUND AND PURPOSE: To assess 10-year incidence of retinal emboli and its predictors in an older population. METHODS: Survivors of 3654 Blue Mountains Eye Study participants > or =49 years of age were re-examined 5 and 10 years later. Incident emboli were assessed from retinal photographs. RESULTS: Cumulative 10-year incidence was 2.9% (95% CI, 2.1% to 3.6%) among 2361 at risk. Age was associated with incident emboli (Ptrend=0.0001). After multivariate adjustment, hypertension (odds ratio [OR], 1.8; CI, 1.0 to 3.1), hypercholesterolemia (OR, 1.3; CI, 1.0 to 1.6), overweight (OR, 3.3; CI, 1.6 to 6.9), current smoking (OR, 2.5; CI, 1.1 to 5.9), increasing fibrinogen level (OR per mg/dL, 1.1; CI, 1.0 to 1.2), and retinal vascular signs (arteriovenous nicking OR, 2.0; CI, 1.2 to 3.6; arteriolar wall opacification OR, 2.3; CI, 1.1 to 5.0; retinal vein occlusion OR, 3.2; CI, 1.0 to 9.9) were significantly associated with incident emboli. CONCLUSIONS: The 3% incidence of retinal arteriolar emboli found in this older population is likely to be an underestimate attributable to the transient nature of emboli and differential loss to follow-up. Most cardiovascular risk factors predict retinal embolism.

Adult↗
PubMed2006

Association between circulating white blood cell count and cancer mortality: a population-based cohort study.

BACKGROUND: Inflammatory processes are implicated in the development and progression of cancer. However, it is not clear whether systemic markers of inflammation predict cancer. We examined the prospective relationship between circulating white blood cell (WBC) count and cancer mortality. METHODS: Population-based cohort study of 3189 individuals, aged 49 to 84 years and free of cancer at the baseline examination (January 1, 1992, to December 31, 1994), in the Blue Mountains region, west of Sydney, Australia. The main outcome of interest was all cancer mortality ascertained from vital status as of December 31, 2001. RESULTS: Higher WBC count was found to be associated with all cancer mortality. In proportional hazards models adjusting for age, sex, education, body mass index, hematocrit level, alcohol consumption, physical inactivity, smoking, weekly aspirin use, diabetes mellitus or fasting hyperglycemia status, and fasting glucose levels, the multivariable relative risk of all cancer mortality comparing quartile 4 of WBC count ( > or = 7400 cells/microL) with quartile 1 (< or = 5300 cells/microL) was 1.73 (95% confidence interval [CI], 1.18-2.55). In subgroup analyses, the relative risk of cancer mortality comparing quartile 4 of WBC count with quartile 1 was higher among those with diabetes or fasting hyperglycemia (3.03 [95% CI, 1.01-9.15]) than among those with normoglycemia (1.68 [95% CI, 1.12-2.52]). Also, the relative risk of cancer mortality associated with joint exposure to quartile 4 of WBC count and aspirin nonuse was 2.42 (95% CI, 1.46-4.01) compared with their absence. CONCLUSION: These data provide new epidemiological evidence of an association between circulating WBC count, a widely available marker of inflammation, and subsequent cancer mortality.

Aged↗
PubMed2006

Association between vision and hearing impairments and their combined effects on quality of life.

OBJECTIVES: To assess associations between age-related vision and hearing impairments and whether combined sensory losses magnify effects on health-related quality of life. METHODS: Seventy-five percent of survivors (n = 2334) were reexamined at Blue Mountains Eye Study 5-year examinations and 86.3% (2015) attended hearing assessments. Visual impairment was defined as visual acuity less than 20/40 (better eye), and hearing impairment as average pure-tone air conduction threshold greater than 25 dB (500-4000 Hz, better ear). RESULTS: Persons with visual impairment, compared with those without visual impairment, had lower mean audiometric thresholds across all frequencies (P< or =.05). For each 1-line (5-letter) reduction in best-corrected visual acuity and presenting visual acuity, hearing loss prevalence increased by 18% and 13%, respectively. Cataract and age-related maculopathy were also associated with hearing loss (respectively, multivariate-adjusted odds ratio, 1.3 and 1.6; 95% confidence interval, 1.0-1.7 and 1.1-3.1). The association between age-related maculopathy and hearing loss was stronger at younger ages (<70 years). Combined impairments were associated with poorer health-related quality of life than were single impairments (multivariate-adjusted 36-Item Short-Form Health Survey mean physical and mental component scores; Ptrend = .001 and <.001, respectively). CONCLUSIONS: Older persons with visual impairment were also more likely to have hearing loss in this study, which suggests that these sensory impairments could share common risk factors or biologic aging markers. Combined sensory impairments also cumulatively affect health-related quality of life.

Aged↗
PubMed2006

Ten-year incidence of retinal vein occlusion in an older population: the Blue Mountains Eye Study.

OBJECTIVE: To assess the 10-year incidence of retinal vein occlusion (RVO) and its predictors in an older population. METHODS: The Blue Mountains Eye Study examined 3654 residents aged 49 years and older (82.4% response) from 1992 to 1994, reexamined 2335 residents (75.1% of survivors) from 1997 to 1999, and reexamined 1952 residents (75.6% of survivors) from 2002 to 2004. Incident RVO was assessed from stereoscopic retinal photographs. Kaplan-Meier cumulative 10-year incidence was calculated. RESULTS: After excluding 47 residents with RVO at baseline and 171 residents with no photographs at either follow-up examination, 2346 residents were considered at risk of developing RVO. The cumulative 10-year incidence of RVO was 1.6%. Age was significantly associated with the incidence of RVO (P = .03, Mantel-Haenszel chi(2) test for trend). Factors predicting the incidence of RVO included mean arterial blood pressure (age-adjusted odds ratio [OR], 1.41 per 10-mm Hg increase), ocular perfusion pressure (OR, 1.71 per 10-mm Hg increase), obesity (OR, 2.16), and presence of retinal arteriolar wall signs (focal narrowing: OR, 3.37; arteriovenous nicking: OR, 4.09; and opacification: OR, 4.89). CONCLUSIONS: Older age (> or =70 years), increasing mean arterial blood pressure, and atherosclerotic retinal vessel signs were significant predictors of incident RVO.

Aged↗
PubMed2006

Dietary fatty acids and the 5-year incidence of age-related maculopathy.

OBJECTIVE: To assess longitudinal associations between dietary fat and incident age-related maculopathy (ARM) in an older, population-based, historical cohort. METHODS: A total of 3654 persons, 49 years or older, participated in the Blue Mountains Eye Study (1992-1994); 2335 (75.1% of survivors) were reexamined after 5 years (1997-1999). Dietary data were collected from 2895 people (79%) at baseline by means of a semiquantitative food frequency questionnaire to calculate dietary fat intakes. Presence of ARM was graded from retinal photographs (Wisconsin ARM Grading System). Logistic regression adjusted for age, sex, vitamin C intake, and smoking. RESULTS: Participants with the highest vs lowest quintiles of n-3 polyunsaturated fat intake had lower risk of incident early ARM (odds ratio [95% confidence interval], 0.41 [0.22-0.75). A 40% reduction of incident early ARM was associated with fish consumption at least once a week (odds ratio [95% confidence interval], 0.58 [0.37-0.90]), whereas fish consumption at least 3 times per week could reduce the incidence of late ARM (odds ratio [95% confidence interval], 0.25 [0.06-1.00]). We found no association between incident ARM and butter, margarine, or nut consumption. CONCLUSIONS: A regular diet high in n-3 polyunsaturated fat, especially from fish, suggests protection against early and late ARM in this older Australian cohort. Our study could not confirm deleterious effects of higher polyunsaturated fat intakes reported by other clinic-based studies.

Aged↗
PubMed2006

Prevalence of eye disorders in young children with eyestrain complaints.

PURPOSE: To determine whether eyestrain symptoms predict eye conditions in 6-year-old children. DESIGN: Cross-sectional population-based study. METHODS: Reports of eyestrain symptoms were sought in parental questionnaires; 1740 children (79% response) underwent eye examinations (visual acuity, cover testing, cycloplegic autorefraction, and fundus examination). RESULTS: Eyestrain information was available for 1448 children; 220 (15.2%) reported eyestrain symptoms, including 60 (3.4%) who reported near work-associated headaches. Most children (82.3%) had a normal eye examination, while refractive errors, amblyopia, and strabismus were found in 15.0%, 3.6%, and 7.3%, respectively. Corresponding rates for children without eyestrain were 9.9%, 1.4%, and 1.8%, respectively. Moreover, 78.7% of children with refractive errors, 68% with amblyopia, and 58% with strabismus reported no eyestrain. CONCLUSIONS: Most children complaining of eyestrain had a normal eye examination; whereas most children with refractive error, amblyopia, or strabismus were free of eyestrain, making this complaint a poor marker of eye conditions in young children.

Asthenopia↗
PubMed2006

Influence of birth parameters on peripapillary nerve fiber layer and macular thickness in six-year-old children.

PURPOSE: To examine influences of gestational age and birth parameters on peripapillary nerve fiber layer (NFL) and macular thickness at age six. DESIGN: Cross-sectional study. METHODS: The Sydney Childhood Eye Study examined a random-cluster sample of 1765 six-year-old Sydney school children. Peripapillary NFL and macular thickness were measured (StratusOCT, Zeiss, Dublin, California, USA). Birth parameters were extracted from health records. Multivariate analyses were performed. RESULTS: Higher birth weight children had greater peripapillary NFL, inner and outer (all P(trend) < 0.03), but not central or average macular thickness (both P(trend) > 0.1). Peripapillary NFL (P(trend) = 0.001), inner (P(trend) = 0.01), outer (P(trend) = 0.002), and average macular thickness (P(trend) = 0.02), but not central macular thickness (P(trend) = 0.5) was greater in children with larger head circumference at birth. The central macula was thicker in prematurely (<37 weeks) born children (195.0 microm) than those born at term (191.2 microm), P = 0.04. CONCLUSION: Birth weight and head circumference predicted peripapillary NFL and macular thickness. Prematurity was weakly associated with central macular thickness.

Birth Weight↗