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R D Sperduto

Publications and source records attributed to R D Sperduto.

52 records · Page 3Linked to original sources

Systemic hypertension and age-related maculopathy in the Framingham Study.

Analysis of data on 1,828 subjects from the Framingham Heart and Eye Studies shows a small and consistent significant association between age-related maculopathy and systemic hypertension. The association was found using blood pressure and medical history data collected both 25 years before the eye examination and concurrently with the eye examination. Prevalence of age-related maculopathy progressively increases with increasing duration of systemic hypertension. Previous epidemiologic studies of the association between systemic blood pressure and age-related maculopathy have produced conflicting results. The failure of some studies to detect an association may have resulted from inadequate sample sizes to detect the small relative risks and problems in determining the duration of the systemic hypertension.

Aged↗

Epidemiologic associations with nuclear, cortical, and posterior subcapsular cataracts.

Data from the 1971-1972 National Health and Nutrition Examination Survey were used to examine the associations between specific cataract types and age, race, sex, number of years spent in school, diabetes, systolic blood pressure, urban versus rural residence, and average daily ultraviolet spectrum B (UV-B) radiation counts at the site of examination. Separate comparisons were made of persons with no lens changes (n = 1,299) and persons with cortical (n = 55), nuclear (n = 104), and posterior subcapsular cataracts (n = 18). Persons with more than one type of cataract were excluded from the analysis. Cortical cataracts were associated with age (relative risk (RR) = 11.4 for age 70 years vs. age 50 years), race (RR = 3.5 for blacks vs. whites), sex (RR = 3.0 for women vs. men), educational achievement (RR = 1.8 for less than nine years of schooling vs. college), and UV-B count (RR = 3.6 for 6.0 X 10(3) counts vs. (2.6 X 10(3) counts). Nuclear cataracts were associated with age (RR = 38.6 for age 70 years vs. age 50 years), race (RR = 1.8 for black vs. white), and residence (RR = 1.6 for rural vs. urban). Posterior subcapsular cataracts were associated with diabetes (RR = 6.6 for diabetes present vs. diabetes absent) and systolic blood pressure (RR = 2.2 for 160 mmHg vs. 120 mmHg). Cortical cataracts were more common in women and more often found in locations with increased UV-B radiation counts than either nuclear or posterior subcapsular cataracts. In diabetics, the risk of posterior subcapsular cataracts was greater than the risk of nuclear cataracts (p less than 0.05) and also appeared to be greater than the risk of cortical cataracts (p = 0.06).

Age Factors↗

Comparability of ophthalmic diagnoses by clinical and Reading Center examiners in the Visual Acuity Impairment Survey Pilot Study.

Technologic advances in ophthalmic equipment offer the possibility of replacing direct clinical examinations with Reading Center evaluations of data recorded in epidemiologic studies. Clinical and Reading Center examiners made independent ophthalmic diagnoses of 133 right and 132 left eyes of 138 adults in the Visual Acuity Impairment Survey Pilot Study, carried out in three US cities, Boston, Detroit, and Minneapolis, in August 1981-December 1982. The Reading Center diagnosed eye conditions using only photographic and visual field data collected at the time of the clinical examination. In the comparisons of clinical and Reading Center evaluations reported here, only eyes judged by the examiners to have pathology severe enough to reduce visual acuity to 6/9 or worse were classified as having pathology. (No visual acuity criterion was required for the diagnosis of glaucoma or diabetic retinopathy.) There was agreement in diagnostic assessments between clinical and Reading Center examiners in about 80% of eyes. The kappa statistic, which adjusts for chance agreement, was in the fair to good range: 0.60 for 133 right eyes and 0.62 for 132 left eyes. When the Reading Center examiners were provided with additional information on medical history, refractive error and best corrected visual acuity, the agreement between clinical and Reading Center assessments among the subset of eyes with 6/9 or worse vision again was in the fair to good range, with kappas of 0.61 for 45 right eyes and 0.68 for 48 left eyes. Inter-observer agreement between Reading Center examiners in diagnosing pathology was in the good to excellent range. Use of Reading Centers in future epidemiologic studies should be considered, but elimination of the clinical examinations is not recommended until modifications in the protocol described here have been made and shown to improve levels of agreement between clinical and Reading Center examiners.

Eye Diseases↗

The prevalence of nuclear, cortical, and posterior subcapsular lens opacities in a general population sample.

Data from the 1973 to 1975 Framingham Eye Study were used to estimate the prevalence rates of nuclear, cortical, and posterior subcapsular lens opacities in persons between ages 52 and 85 years. The rates for each of the opacities increased rapidly with age, so that for the oldest age group, 75 years and over, nuclear, cortical, and posterior subcapsular opacities were found in 65.5%, 27.7% and 19.7% of persons, respectively. Nuclear opacities were the most commonly diagnosed lens change. Each of the opacities was found more often in women than in men. Among persons with senile lens changes, the proportion with more than one type of change increased from 26.5% for ages 52 to 64 years, to 47.1% for ages 75 to 85 years. The high prevalence rates for senile lens opacities (over 75% for persons aged 75 to 85 years) and the frequent occurrence of opacities in combination create methodological problems for epidemiologic studies of lens opacities.

Age Factors↗

Prevalence of myopia in the United States.

Data from the 1971 to 1972 National Health and Nutrition Examination Survey were used to estimate myopia prevalence rates for persons in the United States between the ages of 12 and 54 years. When persons were classified by the refractive status of their right eye, 25% were myopic. Significantly lower prevalence rates were found for male subjects than for female subjects and for blacks than for whites. Myopia prevalence rose with family income and educational level. The importance of income and educational level may result from their association with near work, a factor that has been implicated in the pathogenesis of myopia.

Adolescent↗

Epidemiologic associations with cataract in the 1971-1972 National Health and Nutrition Examination Survey.

Data from the 1971-1972 National Health and Nutrition Examination Survey were used to examine the associations between cataract and age, race, sex, education, diabetes, systolic blood pressure, urban vs. rural residence, and average daily ultraviolet spectrum B (UV-B) radiation counts at the site of examination. The multivariate logistic risk function was applied to data on 2225 persons, aged 45-74, who had resided for at least half their lifetime in the state where their examination was conducted. Cataracts (cortical, nuclear or posterior subcapsular opacities consistent with best corrected visual acuity of 6/9 (20/30) or worse or aphakic status) were present in 413 persons. The multivariate analysis showed that they were more common among blacks, diabetics, and rural dwellers, and were positively associated with increasing age, increasing UV-B radiation counts at the site of the examination, and decreasing number of years spent in school. The association with cataracts was also present when latitude or sunlight hours was substituted for UV-B radiation counts.

Aged↗

Pseudoexfoliation, intraocular pressure, and senile lens changes in a population-based survey.

The prevalence rate of pseudoexfoliation among persons in the Framingham Eye Study, a population-based survey, increased from 0.6% for ages 52 to 64 years to 2.6% for ages 65 to 74 years to 5.0% for ages 75 to 85 years. Age-adjusted rates showed a statistically significant 2.3 to 1.0 female to male ratio. Pseudoexfoliation was associated with higher intraocular pressure levels and more frequent senile lens changes, but the latter relationship was not statistically significant. The age-specific prevalence rates for the Framingham population are similar to those reported from a mass screening of subjects in Norway, where the condition is thought to be especially common. Some of the previously reported geographic variations in prevalence rates may be due to differences in disease definitions, subject selection, and examination conditions.

Age Factors↗

Race, iris pigmentation, and intraocular pressure.

The association of intraocular pressure with age, sex, race, iris pigmentation, systemic blood pressure, and family income was evaluated using data from the Health and Nutrition Examination Survey of 1971-1972. In general, mean intraocular pressure was highest for blacks with brown irides and progressively lower for whites with brown irides, whites with neither brown nor blue irides, and whites with blue irides. Multilinear regression analysis showed positive associations of intraocular pressure with systolic blood pressure (p less than 0.0001), age (p less than 0.0001) and amount of iris pigmentation (p less than 0.0001). The association with iris pigmentation held for both a combined race/iris color variable and for iris color among white persons. When race rather than iris pigmentation was used in the regression equation, it was a weaker (p less than 0.03) but still significant risk factor for higher levels of intraocular pressure. Intraocular pressure was negatively associated with family income (p less than 0.004). Despite the significant associations, the proportion of variance in intraocular pressure that was explained by these variables was small (R2 = 0.06).

Adult↗

Lens opacities and senile maculopathy.

Analysis of data from a population survey, the Framingham Eye Study, shows that when the various senile lens changes are pooled, no associations with senile maculopathy are evident. Subgroup analysis shows the relative risk of senile maculopathy to be lower than 1.00 in the presence of nuclear sclerosis for all age groups and greater than 1.00 for persons between 52 and 74 years in the presence of cortical changes. Nuclear-cortical interaction tests are highly significant, indicating that nuclear sclerosis and cortical opacities have opposite effects on the relative risk of senile maculopathy.

Age Factors↗

Senile lens and senile macular changes in a population-based sample.

Eye examinations performed on the survivors of the Framingham Heart Study Cohort showed a prevalence of senile lens changes ranging from 42% at ages 52 to 64 years to 91% at ages 75 to 85 years. The prevalence of senile macular changes increased from 35% at 52 to 64 years to 50% at 75 to 85 years. Persons affected with either condition usually had bilateral involvement. No association between the two conditions was shown.

Age Factors↗

Radial keratotomy does not affect intraocular pressure.

BACKGROUND: Recent reports have suggested that a secondary effect of radial keratotomy may be a reduction in intraocular pressure (IOP) levels. METHODS: In an effort to study the relationship of radial keratotomy to IOP, we compared the mean IOP from the baseline and follow-up visits during 1 year after surgery of operated versus nonoperated eyes of patients enrolled in the Prospective Evaluation of Radial Keratotomy (PERK) study. To investigate if radial keratotomy had more of an effect on eyes with higher baseline IOPs, the same analysis was performed on a subset (134 patients) who had a baseline IOP of 15 mm Hg or greater. RESULTS: The average baseline IOP for both operated eyes and nonoperated eyes was 14.6 mm Hg. There was no significant difference in mean IOP between operated and nonoperated eyes across all time points (p = .18). Although mean IOP changed over time, it did not clinically differ in operated versus nonoperated eyes at any time point. These findings were similar in the analysis of eyes with higher baseline IOP (15 mm Hg or greater). CONCLUSION: We conclude that the radial keratotomy performed in the PERK study had no effect on IOP within 1 year after surgery.

Adult↗