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Multicenter Study
. 2017 Mar:175:201-212.
doi: 10.1016/j.ajo.2016.10.002. Epub 2016 Oct 18.

Prevalence and Risk Factors for Refractive Error in Adult Chinese Americans: The Chinese American Eye Study

Rohit Varma  1 , Mina Torres  2 , Roberta McKean-Cowdin  3 , Fen Rong  4 , Chunyi Hsu  2 , Xuejuan Jiang  5 ; Chinese American Eye Study Group
Collaborators, Affiliations
Multicenter Study

Prevalence and Risk Factors for Refractive Error in Adult Chinese Americans: The Chinese American Eye Study

Rohit Varma et al. Am J Ophthalmol. 2017 Mar.

Abstract

Purpose: To estimate the prevalence of refractive errors in adult Chinese Americans, and to evaluate factors associated with myopia and high myopia.

Design: A population-based, cross-sectional study.

Methods: Chinese Americans 50 years and older residing in Monterey Park, California, were recruited. Noncycloplegic automated refraction with supplemental subjective refraction was performed. Myopia, high myopia, hyperopia, and high hyperopia were defined as a spherical equivalent of <-0.5 diopter (D), <-5.0 D, >+0.5 D, and ≥+3.0 D, respectively. Astigmatism and high astigmatism were defined as a cylinder of >0.5 D and >2.25 D, respectively. Risk factor assessment was guided by a conceptual model.

Results: Data from 4144 participants were analyzed. The overall prevalence of myopia, high myopia, hyperopia, high hyperopia, astigmatism, and high astigmatism in the right eye was 35.1% (95% confidence interval, 33.6%-36.6%), 7.4% (6.6%-8.3%), 40.2% (38.7%-41.8%), 2.7% (2.2%-3.3%), 45.6% (44.1%-47.2%), and 3.7% (3.1%-4.3%), respectively. The prevalence of myopia and high myopia was lower among older individuals (P < .05). Reversed age trends were observed for the other refractive errors (P < .05). There was no sex difference in the prevalence of refractive errors, except for a higher prevalence of hyperopia among female subjects (P = .010). Age, acculturation, education, income, marital status, birth country, history of ocular disease, nonocular comorbidities, and recent eye examination were associated with prevalence of myopia. All of these factors, except for acculturation, were also associated with high myopia.

Conclusions: Our data present the first population-based estimates of the prevalence of refractive errors among adult Chinese Americans. Compared with whites, Hispanics, and blacks, Chinese Americans have a higher burden of myopia, high myopia, and astigmatism.

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Figures

Figure 1
Figure 1
Distribution of Mean Spherical Equivalent Refractive Error (±Standard Error) in the Right Eye by Age in the Chinese American Eye Study (CHES). Abbreviations: CHES = Chinese American Eye Study; RE = refractive error; SE = spherical equivalent
Figure 2
Figure 2
Age-specific Prevalence of Myopia (< −0.5D) and High Myopia (< −5.0D) and 95% Confidence Intervals in the Right Eye Among All Participants and Participants without Any Nuclear Opacification in the Chinese American Eye Study (CHES). Abbreviations: CHES = Chinese American Eye Study; NO = nuclear opacification
Figure 3
Figure 3
Comparison of the Prevalence of Myopia in the Chinese American Eye Study (CHES) with Estimates from (top) Other Studies of Chinese and (bottom) Studies of Other Racial/ethnic Groups. Abbreviations: BES = Baltimore Eye Survey; CHES = Chinese American Eye Study; LALES = Los Angeles Latino Eye Study; Proyecto VER = Proyecto Vision Evaluation and Research Study; US = United States
Figure 3
Figure 3
Comparison of the Prevalence of Myopia in the Chinese American Eye Study (CHES) with Estimates from (top) Other Studies of Chinese and (bottom) Studies of Other Racial/ethnic Groups. Abbreviations: BES = Baltimore Eye Survey; CHES = Chinese American Eye Study; LALES = Los Angeles Latino Eye Study; Proyecto VER = Proyecto Vision Evaluation and Research Study; US = United States
Figure 4
Figure 4
Comparison of the Prevalence of High Myopia in the Chinese American Eye Study (CHES) with Estimates from (top) Other Studies of Chinese and (bottom) Studies of Other Racial/ethnic Groups Abbreviations: BES = Baltimore Eye Survey; CHES = Chinese American Eye Study; LALES = Los Angeles Latino Eye Study; Proyecto VER = Proyecto Vision Evaluation and Research Study; US = United States
Figure 4
Figure 4
Comparison of the Prevalence of High Myopia in the Chinese American Eye Study (CHES) with Estimates from (top) Other Studies of Chinese and (bottom) Studies of Other Racial/ethnic Groups Abbreviations: BES = Baltimore Eye Survey; CHES = Chinese American Eye Study; LALES = Los Angeles Latino Eye Study; Proyecto VER = Proyecto Vision Evaluation and Research Study; US = United States
Figure 5
Figure 5
Comparison of (top) the Prevalence of Hyperopia in the Chinese American Eye Study (CHES) with Estimates from Other Studies of Chinese and (bottom) the Prevalence of High Hyperopia with Estimates from Studies of Other Racial/ethnic Groups. Abbreviations: BES = Baltimore Eye Survey; CHES = Chinese American Eye Study; LALES = Los Angeles Latino Eye Study; Proyecto VER = Proyecto Vision Evaluation and Research Study; US = United States
Figure 5
Figure 5
Comparison of (top) the Prevalence of Hyperopia in the Chinese American Eye Study (CHES) with Estimates from Other Studies of Chinese and (bottom) the Prevalence of High Hyperopia with Estimates from Studies of Other Racial/ethnic Groups. Abbreviations: BES = Baltimore Eye Survey; CHES = Chinese American Eye Study; LALES = Los Angeles Latino Eye Study; Proyecto VER = Proyecto Vision Evaluation and Research Study; US = United States
Figure 6
Figure 6
Comparison of the Prevalence of Astigmatism (> 0.5D) In the Right Eye in the Chinese American Eye Study (CHES) with Estimates from Other Studies. Abbreviations: BES = Baltimore Eye Survey; CHES = Chinese American Eye Study; LALES = Los Angeles Latino Eye Study
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