6-Year Incidence of Visual Impairment in a Multi-Ethnic Asian Population: the Singapore Epidemiology of Eye Diseases (SEED) Study

Objective/ PurposeTo examine the 6-year incidence of VI and identify risk factors associated with VI in a multi-ethnic Asian population.DesignProspective, population-based, cohort studySubjects, Participants, and/or ControlsAdults aged ≥40 years were recruited from the Singapore Epidemiology of Eye Diseases (SEED) cohort study at baseline. Eligible subjects were re-examined after 6 years. Subjects included in the final analysis had mean age of 56.1±8.9 years and 2,801 (50.5%) were female.Methods, Intervention, or TestingAll participants underwent standardized examination and interviewer-administered questionnaire at baseline. Incidence were standardized to the Singapore Population Census 2010. Poisson binomial regression model was used to evaluate the associations between baseline factors with incident presenting VI.Main Outcome MeasuresIncident presenting VI was assessed at 6-year follow-up visit. VI (presenting visual acuity [PVA]<20/40), low vision (PVA<20/40 but ≥20/200), and blindness (PVA<20/200) were defined based on US definition.ResultsA total of 5,551 subjects (2,750 male; 2,188 Chinese, 1,837 Indians, 1,526 Malays) were evaluated, of whom 514 developed incident presenting VI over 6 years. Malays had higher incidence of low vision and blindness (13.0%; 0.6%) than Indians (7.0%; 0.1%), and Chinese (7.7%; 0.2%). Amongst Malay individuals with VI at baseline, 52.8% remained visually impaired after 6 years, considerably higher than Chinese (32.4%) and Indians (37.2%). Older age (per decade; relative risk [RR]=1.59), history of cardiovascular disease (RR=1.38), current smoking (RR=1.31), smaller housing type (1-2 room public flat; RR=2.01), and no formal education (RR=1.63) at baseline, were associated with higher risk of incident VI (all P≤0.027). Older age (>60 years) contributed the highest population attributable risk to incident VI (27.1%), followed by lower monthly income (更多