Ural Eye Research Articles

Myopic Macular Atrophy in the Two-Continent Population-Based Study.

To examine the prevalence of Bruch's membrane defects (BMDs) and subretinal proliferations (SRPs) in highly myopic eyes with myopic macular atrophy (myopic macular degeneration [MMD] stage 4) and myopic patchy atrophies (MMD stage 3) in three ethnically different cohorts recruited in a population-based manner. The Ural Eye and Medical Study (UEMS) and Beijing Eye Study (BES) included individuals aged 40+years, and the Ural Very Old Study (UVOS) examined individuals aged 85+years. Main outcome measures were the prevalence of BMDs and SRPs. Among 5794 UEMS participants, 19 eyes had MMD stage 4, with 17 (89%) eyes showing a foveal BMD; two eyes could not fully be explored. All 19 eyes showed localized SRPs. Among 21 eyes with MMD stage 3, BMD and SRP prevalence was 9 of 21 (44%) and 7 of 21 (33%), respectively. Among 930 UVOS participants, 17 eyes had MMD stage 4, with 16 (94%) eyes showing foveal BMDs and SRPs; one eye could not be assessed. Among 18 eyes with MMD stage 3, BMD and SRP prevalence was 3 of 18 (17%) and 2 of 18 (11%), respectively. Among 3468 BES participants, 8 eyes had MMD stage 4, with all eyes showing foveal BMDs and SRPs. Among 14 eyes with MMD stage 3, BMD and SRP prevalence was 10 of 14 (71%) and 7 of 21 (33%), respectively. All eyes with assessable myopic macular atrophy showed foveal BMDs associated with SRPs, while patchy atrophies could be differentiated into those with BMDs and SRPs and those without BMDs and without SRPs. Independent of the MMD stage, the prevalences of BMDs and SRPs were highly significantly associated with each other.

Positive and Negative Associations of Myopia with Ocular Diseases in Population-Based Studies

ObjectivePrevalence of myopia and vision impairment due to myopic macular degeneration and myopia-related optic neuropathies have markedly increased worldwide. We evaluated whether myopia is associated with the prevalence of other ocular disorders in a positive or negative sense. DesignPopulation-based studies conducted in Russia, China and India. ParticipantsThe Russian Ural Eye and Medical Study (UEMS) and the Beijing Eye Study (BES) included 5899 individuals and 4439 individuals (all aged 40+ years), respectively, and the Central India Eye and Medical Study (CIEMS) consisted of 4711 individuals, aged 30+ years. The studies were conducted in rural and urban regions in Bashkortostan/Russia, Nagpur/India, and Beijing/China. MethodsThe participants underwent a series of ophthalmological and general medical examinations. Main Outcome MeasuresAxial length as surrogate for myopia, and prevalence of diabetic retinopathy (DR), age-related macular degeneration (AMD), angle-closure glaucoma (ACG), and open-angle glaucoma (OAG). ResultsIn the UEMS, DR prevalence (OR:0.73;95%CI:0.56,0.96), AMD prevalence (OR:0.85;95%CI:0.74,0.98) and ACG prevalence (OR:0.72;95%CI:0.55,0.95) decreased, and OAG prevalence (OR:1.65;95%CI:1.45,1.88) increased with longer axial length in multivariable analyses. In the CIEMS, lower AMD prevalence (OR:0.81;95%CI:0.69,0.95) and lower ACG prevalence (OR:0.55;95%CI:0.36,0.83), and higher OAG prevalence (OR:1.45;95%CI:1.15,1.83) were associated with longer axial length. DR prevalence (0.33%;95%CI:0.16,0.50) was too low for statistical analysis in the CIEMS. In the BES, prevalence (OR:0.64;95%CI:0.50,0.81) and 10-year incidence of DR (OR:0.48;95%CI:0.33,0.71) and prevalence (OR:0.83;95%CI:0.77,0.89) and 5-year incidence of AMD (OR:0.996;95%CI:0.993,0.999) decreased, and prevalence (OR:1.35;95% CI:1.17,1.56) and 10-year incidence of OAG (OR:1.40;95%CI:1.22,1.61) increased with longer axial length. In all three studies, the association between higher OAG prevalence and longer axial length was nonlinear with a slight increase for the moderate myopia range, and a steep increase in the highly myopic range. Conclusions and RelevanceMyopia is associated with a lower prevalence of DR, AMD and ACG and lower incidence of DR and AMD, while high myopia more than moderate myopia is associated with a higher prevalence and incidence of OAG. Future studies may assess whether in myopia, in particular in moderate myopia, the myopia-related advantages, i.e., lower prevalence of DR, AMD and ACG, may outweigh the increased risks for OAG and other myopia-related disorders.

Atrial fibrillation and flutter and ocular diseases. The Ural eye and medical study and the Ural very old study.

To assess associations between atrial fibrillation/atrial flutter (AF) and ocular parameters and diseases. The population-based Ural Eye and Medical Study (UEMS) and the Ural Very Old Study (UVOS) included 4894 individuals (age: 40+ years) and 835 individuals (age: 85+ years), respectively. In the UEMS, AF prevalence (80/4894; 1.6%; 95% CI: 1.3, 2.0) increased from 1/1029 (0.1%) in the age group of 40 to <50 years to 29/619 (4.7%) and 12/159 (7.5%) in the age groups of 70 to <80 years and 80+ years, respectively. Higher AF prevalence correlated with older age (OR: 1.08; 95% CI: 1.04, 1.12; p < 0.001), urban region of habitation (OR: 1.08; 95% CI: 1.04, 1.12; p < 0.001), higher prevalence of cardiovascular disease/stroke (OR: 2.50; 95% CI: 1.32, 4.72; p < 0.001) and lower prevalence of neck pain (OR: 0.35; 95% CI: 0.14, 0.85; p = 0.02), higher serum concentration of bilirubin (OR: 1.03; 95% CI: 1.02, 1.05; p < 0.001) and lower prothrombin index (OR: 0.96; 95% CI: 0.93, 0.99; p = 0.003), higher stage of arterial hypertension (OR: 1.52; 95% CI: 1.01, 2.28; p = 0.04) and higher ankle-brachial index (OR: 22.1; 95% CI: 4.45, 1.10; p < 0.001). In that model, AF prevalence was not associated with ocular parameters such as intraocular pressure (p = 0.52), retinal nerve fibre layer thickness (p = 0.70), refractive error (p = 0.13), axial length (p = 0.14), nuclear cataract degree (p = 0.50) and prevalence (p = 0.40), cortical cataract degree (p = 0.43) and presence (p = 0.17), lens pseudoexfoliation (p = 0.58), status after cataract surgery (p = 0.38), age-related macular degeneration prevalence (p = 0.63), open-angle glaucoma presence (p = 0.90) and stage (p = 0.55), angle-closure glaucoma prevalence (p = 0.99) and stage (p = 0.99), diabetic retinopathy prevalence presence (p = 0.37) and stage (p = 0.32), and myopic macular degeneration (p = 0.98). In the UVOS, similar results were obtained. In these multi-ethnic populations from Russia, AF prevalence was not associated with any major ocular disease and may not play a major role in the pathogenesis of these disorders.

Unintentional injuries and falls in populations in Russia. The Ural eye and medical study and the Ural very old study

BackgroundTo explore the prevalence of self-reported unintentional injuries and falls (UIFs) in medium-aged and old populations in Russia and factors associated with them. MethodsTwo population-based studies (Ural Eye and Medical Study (UEMS), Ural Very Old Study (UVOS)) were carried out urban and rural areas in Bashkortostan/Russia. They consisted of 5899 individuals (age: 40+ years) and 1526 participants (age: 85+ years), respectively. We assessed previous falls as part of an interview with standardized questions, conducted in the framework of a series medical and ophthalmological assessments. ResultsIn the UEMS with 5894 individuals (age:59.0 ± 10.7 years), UIF prevalence was 1101/5894 (18.7 %; 95 % confidence interval (CI)CI:17.7,19.7), with 1,2,3,4,5,6,7,8,9, or 10+ UIFs reported by 766 (69.6 %),146 (13.3 %),56 (1.4 %),15 (1.4 %),19 (1.7 %),3 (0.3 %),2 (0.2 %),1 (0.01 %), and 10 (0.9 %) participants, respectively. The UIFs had occurred as outdoor incidents (n = 594; 53.8 %), at home (n = 162; 14.7 %), on the road or traffic accidents (n = 109; 9.9 %), at work (n = 77; 7.0 %), during garden work (n = 24; 2.2 %) or as falls from a higher level (n = 17; 1.5 %) or from house roofs (n = 16; 1.4 %). In 100 (1.7 % of the total study population; 9.1 % of the group with UIFs) participants, low vision was reported as a major cause for the UIF. Higher UIF prevalence was associated (multivariable analysis) with older age (odds ratio (OR):1.01; 95%CI:1.005,1.02;P < 0.001), urban region of habitation (OR:1.59; 95%CI:1.37,1.85;P = 0.001), higher smoking package number (OR:1.01; 95%CI:1.004,1.01;P = 0.001), longer waist circumference (OR:1.01; 95%CI:1.002,1.01;P = 0.008), higher prevalence of a history of arthritis (OR:1.38; 95%CI:1.18,1.62;P < 0.001) and backache (OR:1.73; 95%CI:1.49,2.02;P < 0.001), and higher depression score (OR:1.05; 95%CI:1.03,1.07;P < 0.001). Out of 1525 UVOS participants (age:88.8 ± 2.9 years; range:85–103.1 years), the UIF prevalence was 780/1525 (51.1 %; 95%CI: 48.6, 53.6), with 390 (50.0 %), 116 (14.8 %), 49 (6.3 %), 12 (1.5 %), 8 (1.0 %), 2 (0.3 %), 4 (0.5 %), 1 (0.1 %), and 15 (1.9 %) participants reported about 1,2,3,4,5,6,7,8,9,or 10+ UIFs, respectively. The UIFs had occurred as outdoor incidents (n = 386; 25.3 %), at home (n = 214; 14.0 %), on the road or traffic accidents (n = 22; 1.4 %), at work (n = 21; 1.4 %), during garden work (n = 10; 0.7 %) or as falls from a higher level (n = 11; 0.7 %) or from house roofs (n = 1; 0.1 %). A higher UIC prevalence correlated with female sex (OR:1.65; 95%CI:1.30,2.09;P < 0.001) and Russian ethnicity (OR:1.26; 95%CI:1.02,1.56;P = 0.03). ConclusionsUIFs have occurred to a substantial part of the adult and very old population in Russia.

Prevalence and associations of keratokonus among children, adults and elderly in the population‐based ural eye studies

Aims/Purpose: To estimate prevalence and associations of keratoconus in populations in Russia with an age from childhood to seniority.Methods: The study population consisted of the cohorts of three population‐based studies performed in urban and rural areas within the same geographical region in Bashkortostan/Russia: The Ural Children Eye Study (UCES; age: 6–18 years; n = 4890), Ural Eye and Medical Study (UEMS; age: 40+ years; n = 5314) and Ural Very Old Study (UVOS; age: 85+ years; n = 651). Based upon Scheimflug imaging, keratoconus was defined by a keratometric reading of ≥48 D in any eye.Results: The mean maximal and minimal corneal refractive power increased from the UCES (43.58 ± 1.50 dioptres (D) and 42.70 ± 1.42D, respectively) to the UEMS (44.26 ± 1.70 D and 43.61 ± 1.76D, resp.) and to the UVOS (45.1 ± 1.72D and 43.98 ± 1.68D, resp.). Correspondingly, keratoconus prevalence increased from the UCES (42/4890; 0.086%; 95% CI: 0.060, 0.112) to the UEMS (112/5314; 2.11%; 95% CI: 1.72, 2.49) and to the UVOS (42/651; 6.45%; 95% CI: 4.56, 8.34). In the UCES, higher keratoconus prevalence was associated (multivariable analysis) with higher birth order (OR: 2.34; 95% CI: 1.32, 4.15; p = 0.004), lower birthweight (OR: 0.99; 95% CI: 0.99, 0.99; p &lt; 0.001), and shorter axial length (OR: 0.15;9 5% CI: 0.08, 0.30; p &lt; 0.001). In the UEMS, keratoconus prevalence correlated with shorter axial length (OR: 0.15; 95% CI: 0.10, 0.23; p &lt; 0.001), larger corneal volume (OR: 1.17; 95% CI: 1.09, 1.25; p = 0.001), thicker lens (OR: 2.27; 95% CI:1.06, 5.28; p = 0.04), cortical cataract degree (OR: 1.02; 95% CI:1.01, 1.04; p = 0.01), and higher stage of age‐related macular degeneration (OR: 1.65; 95% CI: 1.09, 2.51; p = 0.02). In the UVOS, keratoconus prevalence correlated with lower educational level (OR: 0.84; 95% CI:0.71, 0.99; p = 0 0.04) and lower dynamometric hand grip force (OR: 0.92; 95% CI: 0.88, 0.97; p = 0.003).Conclusions: In this study on multiethnic groups from Russia, keratokonus prevalence increased from the paediatric group (0.09%) to the adult group (2.11%) and seniority group (6.45%), correlated mostly with biometric ocular parameters, and was in all age groups statistically independent of most systemic parameters.

Исследование распространенности сочетанного поражения органов зрения, слуха и нарушений когнитивной функции у населения Южного Урала в возрасте 85 лет и старше

Material and methods. This study was carried out as part of the research project Ural Eye Study of Very Old People. The study involved 1526 respondents aged 85 years and older. Results. This study was conducted on 731 (47.9%) respondents (mean age 88.1±2.7 years; median 87 years, range 85–98 years) with available data on measures of vision, hearing, and cognitive function. The prevalence of low vision and blindness, hearing impairment, combined disorders and the presence of dementia was 51.8% (95% CI 48.2 to 55.5%), 33.1% (95% CI 29.7 to 36.5%), 20.5% (95% CI 17.8 to 23.5%) and 48.2% (95% CI 44.5 to 51.8%), respectively. A lower cognitive function score was associated with lower visual acuity (p&lt;0.001) and a higher degree of hearing loss (p=0.03), adjusted for older age (p=0.001), rural region of residence (p=0.003), lower level of education (p&lt;0.001) and higher depression scores (p&lt;0.001). Higher prevalence of dementia was associated with higher incidence of hearing impairment (OR 2.18, 95% CI 1.59 to 2.98; p&lt;0.001), higher incidence of low vision/blindness (OR 2.09, 95% CI 1.55 to 2.81; p&lt;0.001) and a higher prevalence of combined visual and hearing impairment (OR 2.80, 95% CI 1.92 to 4.07; p&lt;0.001). Conclusion. This study showed a stronger association of combined visual and hearing impairment (prevalence 20.5%) (OR 2.80) with dementia compared with hearing impairment alone (OR 2.18) or visual impairment alone (OR 2.09). The findings show the importance of correcting sensory impairments for the prevention of dementia. Key words: very old population, population-based study, blindness, low vision, hearing loss, dementia

Prevalence and Associations of Keratoconus Among Children, Adults, and Elderly in the Population-Based Ural Eye Studies.

To estimate prevalence and associations of keratoconus in populations in Russia with an age from childhood to seniority. The study population consisted of the cohorts of 3 population-based studies performed in urban and rural areas within the same geographical region in Bashkortostan/Russia: the Ural Children Eye Study (UCES; age = 6-18 y; n = 4890), the Ural Eye and Medical Study (UEMS; age = >40 y; n = 5314), and the Ural Very Old Study (UVOS; age = >85 y; n = 651). Based on Scheimflug imaging, keratoconus was defined by a keratometric reading of ≥48 diopters (D) in any eye. The mean maximal and minimal corneal refractive power increased from the UCES (43.58 ± 1.50 D and 42.70 ± 1.42 D, respectively) to the UEMS (44.26 ± 1.70 D and 43.61 ± 1.76 D, respectively) and to the UVOS (45.1 ± 1.72 D and 43.98 ± 1.68 D, respectively). Correspondingly, keratoconus prevalence increased from the UCES (42/4890; 0.086%; 95% CI = 0.060, 0.112) to the UEMS (112/5314; 2.11%; 95% CI = 1.72, 2.49) and to the UVOS (42/651; 6.45%; 95% CI = 4.56, 8.34). In the UCES, higher keratoconus prevalence was associated (multivariable analysis) with higher birth order [odds ratio (OR) = 2.34; 95% CI = 1.32, 4.15; P = 0.004], lower birth weight (OR = 0.99; 95% CI = 0.99, 0.99; P < 0.001), and shorter axial length (OR = 0.15; 95% CI = 0.08, 0.30; P < 0.001). In the UEMS, keratoconus prevalence correlated with shorter axial length (OR = 0.15; 95% CI = 0.10, 0.23; P < 0.001), larger corneal volume (OR = 1.17; 95% CI = 1.09, 1.25; P = 0.001), thicker lens (OR = 2.27; 95% CI = 1.06, 5.28; P = 0.04), cortical cataract degree (OR = 1.02; 95% CI = 1.01, 1.04; P = 0.01), and higher stage of age-related macular degeneration (OR = 1.65; 95% CI = 1.09, 2.51; P = 0.02). In the UVOS, keratoconus prevalence correlated with lower educational level (OR = 0.84; 95% CI = 0.71, 0.99; P = 0.04) and lower dynamometric handgrip force (OR = 0.92; 95% CI = 0.88, 0.97; P = 0.003). In this study on multiethnic groups from Russia, keratoconus prevalence increased from the pediatric group (0.09%) to the adult group (2.11%) and seniority group (6.45%), correlated mostly with biometric ocular parameters and was in all age groups statistically independent of most systemic parameters.

Anterior chamber depth and angle and associations in a pediatric and adult population in Russia

PurposeTo investigate the normative data of anterior chamber depth (ACD) and angle (ACA) and their associations in multiethnic cohorts spanning three generations in Russia. MethodsThe study cohort included the participants of three population-based studies performed in urban and rural Bashkortostan/Russia: The Ural Eye and Medical Study (UEMS; age:40+ years), Ural Children Eye Study (UCES; age:6–18 years), and Ural Very Old Study (UVOS; age:85+ years). Using Scheimflug camera-based anterior chamber imaging, we measured ACD and ACA as part of a comprehensive ophthalmological and systemic examination. Exclusion criterion was previous cataract surgery. ResultsThe study included 4869 (98.7 %) children out of 4933 children of the UCES, 5426 (92.0 %) out of 5899 UEMS participants, and 268 (16.3 %) out of 1526 UVOS participants. In the UEMS, shallower ACD (mean:3.14 ± 0.37 mm) correlated (multivariable analysis; r[2] = 0.57) with older age (beta: 0.08;P < 0.001), shorter body height (beta:0.03;P = 0.003), shorter axial length (beta:0.34;P < 0.001), lower corneal volume (beta:0.06;P < 0.001) and corneal refractive power (beta:0.12;P < 0.001), thicker lens (beta: 0.09;P < 0.001), higher IOP (beta: 0.03;P = 0.02), higher prevalence of angle-closure glaucoma (beta: 0.03;P = 0.003) and lower prevalence of open-angle glaucoma (beta:0.03;P = 0.007). Similar associations were found in the UCES (ACD mean:3.70 ± 0.27 mm) and UVOS (ACD mean:2.96 ± 0.56 mm). ConclusionsIn this population-based cohort of three generations from rural and urban Bashkortostan, ACD decreased from the children cohort (mean:3.70 ± 0.27 mm) to the adult cohort (mean:3.14 ± 0.37 mm) and to the very old cohort (2.96 ± 0.56 mm). Determinants of shallow ACD were older age and lower body height, in addition to the ocular biometric parameters of shorter axial length, lower corneal volume, corneal refractive power, and thinner lens thickness.

Prevalence of depression, anxiety and suicidal ideas and associated factors, in particular sensory impairments, in a population of Bashkortostan in Russia

To assess prevalence and associated factors of depression, anxiety and suicidal ideas in populations from Russia, we conducted in rural and urban regions in Bashkortostan/Russia two population-based studies (Ural Eye and Medical Study (UEMS), performed from 2015 to 2017; Ural Very Old Study (UVOS), performed from 2017 to 2020) which included participants aged 40 + years and 85 + years, respectively. Depression was assessed using the questionnaire of the Center for Epidemiologic Studies Depression Scale Scoresheet, and anxiety was examined applying the State Trait Inventory Anxiety Test. Suicidal ideas were explored by the question whether suicide had previously been thought of or attempted (and if yes, for what reasons). In the statistical analysis we assessed the mean of the main outcome parameter (depression score and anxiety score) and searched for associations between these parameters and other parameters in univariable and multivariable regression analyses. In the UEMS with 5893 individuals (age: 59.0 ± 10.7 years; range 40–94 years), higher depression score and anxiety score were associated (multivariable analysis) with more marked hearing loss (beta: 0.07; P < 0.001, and beta: 0.07; P < 0.0012, respectively) and worse visual acuity (beta: 0.04; P = 0.02; and beta: 0.03; P = 0.03, resp.), in addition to female sex, Russian ethnicity, lower educational level, less alcohol consumption, weaker hand grip strength, less physical activity, and higher prevalence of dry eye disease. Attempted suicide was reported by 88 (1.5%; 95% CI 1.2, 1.8) participants. Having thought of suicide within the last 6 months was reported by 63 (1.1%) individuals. Out of 1491 UVOS participants (age: 88.2 ± 2.8 years; range 85–100 years) with a mean depression score of 20.0 ± 10.3 (median 18; range 0–58), 916 (61.4%; 95% CI 59.0, 63.9) fulfilled the definition of depression (depressions core ≥ 16). Higher depression score and higher anxiety score correlated (multivariable analysis) with higher hearing loss score (beta: 0.07; P = 0.02, and beta: 0.08; P = 0.009, resp.) and worse visual acuity (beta: 0.13; P < 0.001, and beta: 0.09; P = 0.007, resp.), in addition to female sex, urban region, less physical activity, less fruit intake, and lower cognitive function. Overall, 15 (1.0%; 95% CI 0.50, 1.50) individuals had attempted or thought of suicide. In conclusion, the findings suggest that besides female sex, lower level of education and lower cognitive function, it was sensory impairment, namely vision and hearing impairment, which belonged to the determinants of depression and anxiety in these populations from Russia.

Prevalence and Associations of Nonglaucomatous Optic Nerve Atrophy in High Myopia: The Ural Eye and Medical Study

To assess the prevalence of non-glaucomatous optic nerve atrophy (NGOA) and its associations in highly myopic individuals. Population-based study. The Ural Eye and Medical Study included 5899 (80.5%) out of 7328 eligible individuals. The participants underwent an ophthalmological and general examination. NGOA, graded into five arbitrary stages, was characterized by decreased visibility of the retinal nerve fiber layer (RNFL) on fundus photographs and on red-free fundus photographs, neuroretinal rim pallor, abnormally thin retinal arteriole diameter, and abnormally thin peripapillary RNFL as measured by optical coherence tomography. NGOA prevalence and degree. Out of 5709 (96.9%) participants with axial length measurements, 130 (2.3%) individuals were highly myopic, of which 116 (89.2%) participants (age:57.8±11.1 years; range:41.0-84.2 years; axial length:27.0±1.2mm; range:26.01-32.87mm) had available fundus photographs and OCT images and were included into the present study. NGOA prevalence was 34/116 (29.3%;95%CI:21.0,38.0), and mean NGOA degree in eyes with NGOA was 1.7±1.0 arbitrary units. Higher NGOA degree correlated (multivariable analysis; regression coefficient r2:0.59) with longer axial length (beta:0.22; B:0.18; 95%CI:0.05,0.31; P=0.007), wider temporal parapapillary gamma zone width (beta:0.50; B:0.45; 95%CI:0.30,0.59; P<0.001), higher prevalence of diabetes (beta:0.20; B:0.63; 95%CI:0.20,1.06; P=0.005), and higher systolic blood pressure (beta:0.15; B:0.01; 95%CI:0.001,0.02; P=0.03). Higher NGOA prevalence was associated with longer axial length (odds ratio (OR):7.45; 95%CI:2.15,25.7; P=0.002), wider temporal parapapillary gamma zone (OR:6.98; 95%CI:2.61,18.7; P<0.001), and higher systolic blood pressure (OR:1.05; 95%CI:1.01,1.10; P=0.02). In this ethnically mixed population from Russia with an age of 40+ years, high axial myopia showed a relatively high prevalence of NGOA, increasing with longer axial length and wider temporal parapapillary gamma zone. For each millimeter of axial elongation and widening of gamma zone, the odds for NGOA increased 7.45-fold and 6.98-fold, respectively. The axial elongation-associated and gamma zone-related increase in the distance between the retinal ganglion cells and the optic disc may lead to a lengthening and stretching of the retinal ganglion cell axons and may pathogenetically be of importance. In highly myopic eyes, NGOA may be a reason for visual field and central visual acuity loss, unexplainable by myopic macular pathologies.

Факторы риска и распространенность возрастной макулярной дегенерации по данным российского популяционного исследования в сравнительном аспекте с мировыми данными

Age-related macular degeneration is one of the most common causes of visual impairment and blindness worldwide. As the population ages, AMD is becoming an increasingly significant and frequent disease. The pathogenesis of this process remains not fully elucidated and is more related to genetic factors and environmental influences. This article highlights data on the prevalence and risk factors of AMD according to the results of global population studies. The prevalence of AMD according to the data of the only population study in Russia, the Ural Eye and Medical Study (UEMS), in which 5899 urban and rural residents of the Republic of Bashkortostan aged 40 years and older participated, was 10.5%, which was lower than the same indicator in Western Europe (12.3 %), and higher than in East Asia (7.4 %) and Africa (7.5 %). Risk factors for AMD development according to the UEMS are older age, rural region of residence, shorter eye axial length and lower prevalence of diabetes. Keywords: age-related macular degeneration, population study, prevalence, risk factors

Анализ частоты сопутствующей офтальмопатологии у лиц с катарактой (результаты популяционного исследования)

Aim: to assess the prevalence and characteristics of various types of cataracts and to analyze most common eye comorbidities from the population study "Ural Eye and Medical Study" (UEMS). Patients and Methods: this population study included 5899 individuals (3400 living in the rural area and 2499 living in the city). Eye examinations included uncorrected and best-corrected visual acuity measurements, autorefractometry, slit lamp examination, A-scan ultrasound biometry, non-contact tonometry, fundoscopic examination, corneal topography, fundus photography, static perimetry, and optical coherence tomography. Results: cataracts were diagnosed in 2616 patients (44.3%). These patients were more commonly rural residents and women. Nuclear cataracts (n=1575, 60.2%) were detected 1.5 times more often than cortical cataracts (n=1041, 39.8%). Eye comorbidities were diagnosed in 975 patients (37.3%). The most common eye comorbidities were retinal diseases. Among them, age-related macular degeneration (AMD) ranked first (13.46%). Glaucomatous optic neuropathy (GON)/glaucoma) and myopic macular degeneration/myopia were also common (6.77% and 4.93%, respectively). Diabetic retinopathy (DR) was reported less common (2.26%). The rate of eye comorbidities in patients was 43.6% in cortical cataracts and 33.1% in nuclear cataracts. As to individual conditions, the greatest difference was reported for AMD rate (19.12%) and macular hole/MH (1.8%), which were diagnosed twice more often in cortical cataracts (p&lt;0.05) than in nuclear cataracts (9.71% and 0.8%, respectively). Conclusion: the structure of eye comorbidities in patients with nuclear and cortical cataracts was almost similar to that in patients with cataracts overall. However, the rate of eye comorbidities in patients with cortical cataracts was significantly higher than in patients with nuclear cataracts. This particularly applies to AMD and MH. In general, the rate of AMD, GON, DR, and MH in patients with complicated cataracts increases with age. These diseases were most often diagnosed in women and urban residents, except for AMD (more patients with AMD live in rural areas). KEYWORDS: cataract, nuclear, cortical, eye comorbidities, population study. FOR CITATION: Bikbov M.M., Orenburkina O.I., Gilmanshin T.R., Babushkin A.E. The rate of eye comorbidities in patients with cataracts (results of a population study). Russian Journal of Clinical Ophthalmology. 2023;23(3):146–151 (in Russ.). DOI: 10.32364/2311-7729-2023-23-3-6

Hand grip strength and ocular associations: The Ural eye and medical study

AbstractPurpose: To explore associations between the hand grip strength (HGS) and ocular parameters and diseases.Methods: Participants of the population‐based Ural Eye and Medical Study, including 5899 (80.5%) out of 7328 eligible individuals aged 40+ years, underwent systemic and ophthalmological examinations including dynamometric HGS measurement.Results: The study included 5381 (90.4%) individuals (age: 58.6 ± 10.6 years; range: 40–94 years) with HGS measurements. Higher HGS (mean: 30.6 ± 11.7 dekaNewton) correlated (multivariable analysis) with better visual acuity (beta: 0.02; p = 0.02), longer ocular axial length (beta: 0.03; p = 0.003), higher intraocular pressure (beta: 0.03; p = 0.001), thicker peripapillary retinal nerve fibre layer (beta: 0.03; p = 0.001), and lower prevalence of diabetic retinopathy (beta: −0.03; p = 0.007), after adjusting for younger age, male sex, Russian ethnicity, higher body height and waist‐hip ratio, higher educational level, higher physical total score, lower smoking package years, higher serum concentration of haemoglobin, higher prothrombin index, lower leucocyte cell count, lower prevalence of non‐alcoholic fatty liver disease, lower depression score, and lower arthritis prevalence. In that model, HGS was not correlated with the prevalence of nuclear cataract (p = 0.38), cortical cataract (p = 0.67), subcapsular posterior cataract (p = 0.50), open‐angle glaucoma (p = 0.22), or angle‐closure glaucoma (p = 0.27).Conclusions: In addition to parameters such as lower physical activity, higher depression score and worse general health status, a reduced HGS is associated with visual impairment, shorter axial length, lower intraocular pressure, thicker peripapillary retinal nerve fibre layer, and higher prevalence of diabetic retinopathy. HGS dynamometry or a handshake may give additional clinical information for the ophthalmologist about the general health and ocular parameters of the patient.

Prevalence and associations of dry eye disease and meibomian gland dysfunction in the ural eye and medical study

To assess the prevalence of dry eye disease (DED) and Meibomian gland dysfunction (MGD) in a population in Russia. The population-based Ural Eye and Medical Study was conducted in an urban and rural region in Bashkortostan/Russia and included 5899 (80.5%) out of 7328 eligible persons, aged 40 + years. DED and MGD were assessed by Schirmer´s test, slit-lamp based examination of the Meibomian glands, and an interview with DED-related questions. The study included 5153 (87.4%) individuals with DED and MGD assessments (mean age: 58.5 ± 10.5 years). The mean Schirmer´s test result was 11.8 ± 6.8 mm and 12.5 ± 7.1 mm for the right/left eye, with a result of ≤ 5 mm measured in 1098 (21.3%; 95% confidence intervals (CI) 20.2, 22.4) of the worse eyes. The mean subjective dry eye symptoms score was 1.37 ± 1.82. MGD grade 1 (telangiectasia at the lid margin), 2, 3, 4 or any grade in the worse eye was diagnosed in 901 (21.1%), 1161 (27.1%), 158 (3.7%), 32 (0.7%), and 2252 (52.6%; 95% CI 51.1, 54.1) eyes respectively. The prevalence of DED diagnosis #1, #2 and #3 (Schirmer´s test ≤ 5 mm, and dry eye score ≥ 1, ≥ 2, and ≥ 3, respectively), #4 (dry eye score ≥ 1, Schirmer test ≤ 5 mm, MGD grade 1 +), and #5 (dry eye score ≥ 1, Schirmer test ≤ 5 mm, MGD grade 2 +) were 598/5142 (11.6%), 426/5153 (8.3%), 273/5142 (5.3%), 335/5142 (6.5%), and 186/5142 (3.6%), respectively. Mean depression score as applied was 5.1 ± 3.8. Higher DED prevalence (definition #4) was associated (multivariable analysis) with female sex (odds ratio (OR) 1.71; 95% CI 1.31, 2.22; P < 0.001), higher depression score (OR 1.04; 95% CI 101, 1.07; P = 0.009), and higher prevalence of thyroid disease history (OR 1.63; 95% CI 1.19, 2.24; P = 0.006). DED and MGD were common in this rural and urban population, and their prevalence was associated with female sex, thyroid disease, and depression.

Morphometric Characteristics of Axial Length of Eye in Population of the Southern Urals (according to “Ural Very Old Study” and “Ural Eye and Medical Study” Research)

INTRODUCTION: Currently, ametropias are the most important medical and social problem, which occupies one of the leading places in modern ophthalmology. Determination of the length of the anteroposterior eyeball axis (APEA) in myopia ― a type of ametropia directly associated with increase in the axial length of the eyeball ― is an objective method of its diagnosis and identification of progression. Due to the fact that myopia is a multifactorial disease, the study of correlation relationships of the length of the eyeball seems to be extremely relevant.&#x0D; AIM: To give a statistical assessment of the peculiarities of the axial length of the eyeball in the population of the Southern Urals, depending on age, gender and the respondents' settlement sites, and to determine the correlation relationships of this parameter.&#x0D; MATERIALS AND METHODS: The analysis was conducted on the base of Ufa Research Institute of Ophthalmology within large clinical and population studies Ural Eye and Medical Study (UEMS) and Ural Very Old Study (UVOS). Inclusion criteria: signing of voluntary consent to participation in the project, permanent residence in the territory of study; for inclusion in UEMS ― age from 40 to 85 years, in UVOS ― age above 85. UEMS study involved 5899 respondents, UVOS ― 1526. The study protocol suggested evaluation of 683 criteria, 293 of which were answers of respondents to questions of the questionnaire and the results of the general somatic examination, 355 criteria concerned the results of the ophthalmologic examination, 35 ― of laboratory tests. Axial length of the eyeball was measured by the method of ultrasound echo-biometry (A-scanning) (Ultra-compact A/B/P ultrasound system, Quantel Medical, France).&#x0D; RESULTS: The mean length of the APEA in the UEMS population was 23.31 1.08 mm, in the UVOS population ― 23.11 1.08 mm (p 0.001). The length of the eyeball axis was 23.31 1.08 mm in the age group 40-84 years and 23.11 1.08 mm in patients in the age category 85 years and older. The multivariate linear regression analysis in UEMS study showed the highest statistically significant association of APEA length with such factors as age (p 0.001), height (p 0.001), presence of arterial hypertension (p = 0.02), education level (p 0.001 ), intraocular pressure (IOP) (p 0.001), spherical refractive error (p0.001), depth of anterior chamber (p 0.001) and angle of anterior chamber (p 0.001), mosaicism of the eye fundus in the macular region (p 0.001), presence of myopic maculopathy (p 0.001), refractive power of the cornea (p 0.001), corneal volume (p 0.001), macular pigment density (p 0.001), thickness of peripapillary layer of nerve fibers (p 0.001), presence of the epiretinal membrane (p = 0.01). The multivariate linear regression analysis in UVOS study showed statistically significant association of the APEA length with such factors as height (p 0.001), education level (p = 0.002), corneal refractive power (p 0.001), spherical refraction error (p 0.001).&#x0D; CONCLUSION: In the population of the Southern Urals, statistically significant association of the length of the eyeball axis with such factors as height, education level, refractive power of the cornea and spherical refractive error, was demonstrated. Besides, in the population of UEMC study, there was also noted association with age, the presence of arterial hypertension, intraocular pressure, the depth of the anterior chamber and the angle of the anterior chamber, mosaicism of the eye fundus in the macular region, the presence of myopic maculopathy, corneal volume, density of macular pigment, thickness of the peripapillary layer of nerve fibers, presence of the epiretinal membrane.

Hand grip strength and ocular associations: the Ural Eye and Medical Study

PurposeTo explore the associations between hand grip strength (HGS) and ocular parameters and diseases.DesignPopulation-based cohort study.MethodsParticipants of the Ural Eye and Medical Study, including 5899 (80.5%) out of 7328 eligible...

Prevalence and associated factors of osteoarthritis in the Ural Eye and Medical Study and the Ural Very Old Study

To determine the prevalence of osteoarthritis and its associated factors in populations from Russia. The population-based Ural Eye and Medical Study (UEMS) and the population-based Ural Very Old Study (UVOS) were conducted in a rural and urban region in Bashkortostan/Russia and included participants aged 40+ and 85+ years, respectively. As part of a detailed systematic examination, we assessed the osteoarthritis prevalence in an interview including questions on the self-reported presence of osteoarthritis, the joints affected and osteoarthritis-related pain-relieving therapy taken. Out of 5898 participants of the UEMS, 1636 individuals had osteoarthritis [prevalence: 27.7%; 95% confidence interval (CI) 26.7, 28.7], with 816 individuals (13.8%; 95% CI 12.8, 14.8) taking pain-relieving medication. A higher osteoarthritis prevalence was associated (multivariable analysis) with older age [odds ratio (OR 1.04; 95% confidence interval (CI) 1.03, 1.05], urban region of residence (OR 1.25; 95% CI 1.07, 1.45), higher body mass index (BMI) (OR 1.04; 95% CI 1.03, 1.06), lower monthly income (OR 0.78; 95% CI 0.68, 0.90), higher physical activity score (OR 1.02, 95% CI 1.01, 1.03), higher prevalence of a history of cardiovascular disease including stroke (OR 1.55; 95% CI 1.33, 1.81), previous bone fractures (OR 1.20; 95% CI 1.04, 1.40) and previous falls (OR 1.22; 95% CI 1.03, 1.45), higher hearing loss score (OR 1.01; 95% CI 1.01, 1.02), and less alcohol consumption (OR 0.78; 95% CI 0.65, 0.93). Out of 1526 UVOS participants, 567 individuals had osteoarthritis (prevalence: 37.2%; 95% CI 35.0, 40.0), with 195 (12.8%; 95% CI 11.3, 14.3) individuals taking pain-relieving medication. Higher osteoarthritis prevalence was associated with rural region of habitation (OR 1.69; 95% CI 1.20, 2.38), lower monthly income (OR 0.62; 95% CI 0.46, 0.84), higher prevalence of cardiovascular disease (OR 1.75; 95% CI 1.30, 2.36), and higher anxiety score (OR 1.04; 95% CI 1.03, 1.06). Osteoarthritis and use of pain-relieving medication are common in these populations in Russia. Main associated factors were older age and lower monthly income in both study populations, female sex, higher BMI, urban region, and previous falls and bone fractures in the UEMS population, and rural region and a higher anxiety score in the UVOS study population.

Эпидемиологические аспекты и оптимизация организации офтальмологической помощи лицам с катарактой

Purpose. To study the epidemiological features of cataracts and the organization of medical care for people with this pathology. Material and methods. In the population cross-sectional study Ural Eye and Medical Study on the basis of the Ufa Research Institute of Eye Diseases, 5899 people aged 40 years and older took part, among them men – 43.7% (2580 people), women – 56.3% (3319 people). Statistical data analysis was performed using the IBM SPSS Statistic software package. Results. According to the results of the study, the prevalence of cataract in people older than 40 years was 42.8% (95% CI: 41.4–44.2%), the prevalence of cataract surgery was 6.1% (95% CI: 4.0–9.3%). The coverage of surgical treatment of patients with cataracts among the study population was 39.8%, the rate of its effectiveness was 32.1%. The main reason that reduces patients’ adherence to timely treatment is the lack of interest of the patient himself and insufficient awareness of the complications and methods of modern cataract treatment. Conclusion. The introduction of medical and organizational measures contributed to an increase in the overall coverage of surgical treatment of people with cataracts by 25.6% (from 39.8 to 65.4%), the rate of effective coverage of surgical treatment of patients with cataracts – from 32.1 to 57, 7% and the target for maximum visual acuity fr om 80.6 to 88.2%. Key words: population study, cataract surgery, prevalence of cataract surgery

Prevalence of non-alcoholic fatty liver disease in the Russian Ural Eye and Medical Study and the Ural Very Old Study

Information about prevalence and associated factors of non-alcoholic fatty liver disease (NAFLD) has been scarce for the Russian, Eastern European and Central Asian world region. We assessed prevalence and associated factors of NAFLD in two population-based studies (Ural Eye and Medical Study (UEMS), Ural Very Old Study (UVOS)), which were conducted in rural and urban regions in Bashkortostan/Russia and included participants aged 40 + years and 85 + years, respectively. Defining NAFLD by an absence of regular alcohol consumption, and by abnormally high alanine transaminase (ALT) and aspartate transaminase (AST) concentrations or an AST/ALT ratio of > 1.0, 2341 out of 5852 UEMS participants (40.0%; 95% confidence intervals (CI) 38.8, 41.3) had NAFLD. A higher NAFLD prevalence correlated (multivariable analysis) with older age (odds ratio (OR) 1.02; 95%CI 1.01, 1.03; P < 0.001), female sex (OR 1.87; 95%CI 1.58, 2.21; P < 0.001), higher waist-hip circumference ratio (OR 2.64; 95%CI 1.11, 6.27; P = 0.03), lower depression score (OR 0.98; 95%CI 0.96, 0.999; P = 0.04), higher serum concentrations of creatinine (OR 1.004; 95%CI 1.000, 1.008; P = 0.03) and bilirubine (OR 1.009; 95%CI 1.002, 1.015; P = 0.008), lower prothrombin index (OR 0.99; 95%CI 0.985, 0.998; P = 0.01), lower ankle-brachial index (OR 0.49; 95%CI 0.32, 0.75; P = 0.001), higher prevalence of a grain-rich diet (OR 1.88; 95%CI 1.50, 2.36; P < 0.001) and iron deficiency-related anemia (OR 1.61; 95%CI 1.13, 2.29; P = 0.009), and lower prevalence of vigorous leisure activities (OR 0.84; 95%CI 0.72, 0.99; P = 0.04). In the UVOS, NAFLD prevalence (mean: 789/1130; 69.8%; 95%CI 67.1, 72.3) was associated with female sex (OR 2.24; 95%CI 1.66, 3.01; P < 0.001), higher serum concentrations of low-density lipoproteins (OR 1.34; 95%CI 1.17, 1.55; P < 0.001), lower prothrombin index (OR 0.98; 95%CI 0.96, 0.99; P = 0.002), and lower ankle-brachial index (OR 0.03; 95%CI 0.02, 0.29; P = 0.003). The NAFLD prevalence of 40% in the UEMS and 69.8% in the UVOS corresponds to findings obtained in other world regions and shows the importance of NAFLD, including its determinants such as age, sex, waist-hip ratio, serum creatinine concentration, prothrombin index, ankle-brachial index, and lower physical activity.

Результаты популяционного исследования распространенности хирургии катаракты и причин низких послеоперационных зрительных функций

Purpose. Тo study the prevalence of cataract surgery, its effectiveness and factors that reduce visual results in a population of the population of the Republic of Bashkortostan. Material and methods. The Ural Eye and Medical Study population study, based on the Ufa Research Institute of Eye Diseases, was attended by 5885 people aged 40 years and older. A low visual result after cataract surgery was determined with visual acuity without correction below 0.3. Statistical data analysis was performed using the IBM SPSS Statistic application package. Results. The prevalence of cataract surgery was 6.1% (95% confidence interval (95% CI) 4.0–9.3%). A higher frequency of operations was associated with an age factor (odds ratio (OR) 1.13, 95% CI 1.11–1.15%; p&lt;0.001), male gender (OR 1.67, 95% CI 1.19–2.37%; p=0.003), living in a city (OS 1.54, 95% CI 1.06–2.23%; p=0.02), single living (OR 1.46, 95% CI 1.01– 2.11%; p=0.04) and the presence of diabetes mellitus (OR 1.33, 95% CI 0.78–2.20%; p=0.02). Low visual results after cataract surgery, given the maximum postoperative correction, were detected in 11.5% of cases (58 eyes). The main reasons for the low postoperative result are refractive error (40%), macular degeneration (19.0%), glaucoma (15.5%), clouding of the posterior capsule (13.8%) and diabetic retinopathy (12.1%). Conclusion. The obtained results of good postoperative uncorrected visual acuity amounted to 73.1% and turned out to be quite close to international standards (80%). The main reasons for the low visual results of cataract surgery were refractive error and age-related macular degeneration. Key words: population study, cataract surgery, the prevalence of cataract surgery