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Nāgpur, India

Nangia V.,Suraj Eye Institute
PloS one | Year: 2011

Visual acuity is a major parameter for quality of vision and quality of life. Information on visual acuity and its associated factors in rural societies almost untouched by any industrialization is mostly non-available. It was, therefore, the purpose of our study to determine the distribution of visual acuity and its associated factors in a rural population not marked influenced by modern lifestyle. The population-based Central India Eye and Medical Study included 4711 subjects (aged 30+ years), who underwent a detailed ophthalmologic examination including visual acuity measurement. Visual acuity measurements were available for 4706 subjects with a mean age of 49.5±13.4 years (range: 30-100 years). BCVA decreased significantly (P<0.001) from the moderately hyperopic group (0.08±0.15 logMAR) to the emmetropic group (0.16±0.52 logMAR), the moderately myopic group (0.28±0.33 logMAR), the highly hyperopic group (0.66±0.62 logMAR) and finally the highly myopic group (1.32±0.92 logMAR). In multivariate analysis, BCVA was significantly associated with the systemic parameters of lower age (P<0.001), higher level of education (P<0.001), higher body stature (P<0.001) and higher body mass index (P<0.001), and with the ophthalmic parameters of more hyperopic refractive error (spherical equivalent) (P<0.001), shorter axial length (P<0.001), lower degree of nuclear cataract (P<0.001), and lower intraocular pressure (P = 0.006). The results suggest that in the rural population of Central India, major determinants of visual acuity were socioeconomic background, body stature and body mass index, age, refractive error, cataract and intraocular pressure.


Iribarren R.,San Luis Medical Center | Morgan I.G.,Australian National University | Nangia V.,Suraj Eye Institute | Jonas J.B.,University of Heidelberg
Investigative Ophthalmology and Visual Science | Year: 2012

Purpose. To study the relationships between the refractive power of the crystalline lens, overall refractive error of the eye, and degree of nuclear cataract.Methods. All phakic participants of the population-based Central India Eye and Medical Study with an age of 50+ years were included. Calculation of the refractive lens power was based on distance noncycloplegic refractive error, corneal refractive power, anterior chamber depth, lens thickness, and axial length according to Bennett's formula.Results. The study included 1885 subjects. Mean refractive lens power was 25.5 ± 3.0 D (range, 139-36.6). After adjustment for age and sex, the standardized correlation coefficients (β) of the association with the ocular refractive error were highest for crystalline lens power (β = -0.41; P < 0.001) and nuclear lens opacity grade (j3 = -0.42; P < 0.001), followed by axial length (β = -0.35; P < 0.001). They were lowest for corneal refractive power (β = -0.08; P = 0.001) and anterior chamber depth (β = -0.05; P = 0.04). In multivariate analysis, refractive error was significantly (P < 0.001) associated with shorter axial length (β = -1.26), lower refractive lens power (β = -0.95), lower corneal refractive power (β = -0.76), higher lens thickness (β = 0.30), deeper anterior chamber (β = 0.28), and less marked nuclear lens opacity β= -0.05). Lens thickness was significantly lower in eyes with greater nuclear opacity.Conclusions. Variations in refractive error in adults aged 50 + years were mostly influenced by variations in axial length and in crystalline lens refractive power, followed by variations in corneal refractive power, and, to a minor degree, by variations in lens thickness and anterior chamber depth.© 2012 The Association for Research in Vision and Ophthalmology, Inc.


Jonas J.B.,Suraj Eye Institute | Jonas J.B.,University of Heidelberg | Nangia V.,Suraj Eye Institute | Matin A.,Suraj Eye Institute | And 2 more authors.
American Journal of Hypertension | Year: 2010

Background: Because relatively little has been known about the actual prevalence of hypertension in India, particularly for its rural population, we investigated the prevalence of arterial hypertension in a rural Indian population.MethodsThe Central India Eye and Medical Study is a population-based study in a rural Central Indian region. It included 4,711 subjects (ages 30 years) undergoing an ophthalmic and medical examination. Hypertension was defined as systolic blood pressure 140mmHg and/or diastolic blood pressure ≥90mmHg, and/or self-reported current treatment for hypertension. ResultsArterial hypertension was found in 1,041 (22.1%) subjects. Its prevalence was associated with higher age (P <0.001), higher body mass index (P <0.001), body height (P = 0.001), higher blood hemoglobin levels (P <0.001), and elevated blood urea concentration (P = 0.008). It was not significantly associated with gender, level of education, family income, kind of daily physical activities, type of diet, and serum concentrations of cholesterol and creatinine. Among the hypertensive study participants (n = 1,041), 208 (20.0%) subjects were aware of their disease. A current antihypertensive treatment was reported by 84 subjects of the 1,041 arterial hypertensive subjects (8.1 ±0.9%). Out of the treated subjects, 24 (29%) had abnormally high diastolic blood pressure measurements and 44 (52%) participants had abnormally high systolic blood pressure measurements. ConclusionsIn a rural Central Indian population of ages 30 years, the prevalence of arterial hypertension was 22.1 0.6% with an awareness rate of 20% and a treatment rate of 8%. The low awareness and treatment rate may demand increasing public health efforts. © 2010 American Journal of Hypertension, Ltd.


Nangia V.,Suraj Eye Institute | Jonas J.B.,University of Heidelberg | Sinha A.,Suraj Eye Institute | Matin A.,Suraj Eye Institute | Kulkarni M.,Suraj Eye Institute
Ophthalmology | Year: 2010

Objective: To evaluate the refractive error and its associations in the adult population of rural Central India. Design: Population-based study. Participants: The Central India Eye and Medical Study is a population-based study performed in a markedly rural region in Central India. It included 4711 subjects (aged 30 years or older) of 5885 eligible subjects (response rate, 80.1%). Methods: The participants underwent a detailed ophthalmic and medical examination, including standardized questions on the socioeconomic background, lifestyle, and social relations. This study was focused on the refractive error, the prevalence of hyperopia and myopia, and its factors. Main Outcome Measures: Refractive error. Results: After exclusion of pseudophakic or aphakic eyes, 9076 (96.3%) eyes of 4619 (98.0%) subjects (2472 females) were included into the study. The mean refractive error was -0.20±1.51 diopters (D). Myopia of more than -0.50 D, -1.0 D, more than -6.0 D, and more than -8 D occurred in 17.0±0.6%, 13.0±0.5%, 0.9±1.4%, and 0.4±0.1% of the subjects, respectively. Hyperopia of more than 0.50 D was detected in 18.0±0.6% of the subjects. Refractive error was associated significantly (i.e., became more hyperopic) with lower age (P<0.001), lower best-corrected visual acuity (P<0.001), lower corneal refractive power (P<0.001), and shorter axial length (P<0.001). In multivariate analysis, refractive error was not significantly associated with the level of education (P = 0.56). High myopia (>-8 D) was associated significantly with male gender (P = 0.03) and lower best-corrected visual acuity (P<0.001). Mean anisometropia was 0.41±1.02 D. It was associated significantly with age (P<0.001), myopic refractive error (P<0.001), and lower best-corrected visual acuity (P<0.001). The mean astigmatic error was 0.29±0.60 D and was associated significantly with higher age (P<0.001), level of education (P = 0.01), lower best-corrected visual acuity (P<0.001), and higher corneal refractive power (P<0.001). Conclusions: The rural population of Central India has not experienced a myopic shift as described for many urban populations at the Pacific Rim. Correspondingly, the relatively low level of education was not associated with myopia. Urbanization may be a major factor for myopization. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. © 2010 American Academy of Ophthalmology.


Nangia V.,Suraj Eye Institute | Jonas J.B.,University of Heidelberg | Sinha A.,Suraj Eye Institute | Matin A.,Suraj Eye Institute | Kulkarni M.,Suraj Eye Institute
Ophthalmology | Year: 2010

Purpose: To evaluate the distribution of central corneal thickness (CCT) and its associations in an adult Indian population. Design: Population-based study. Participants: The Central India Eye and Medical Study is a population-based study performed in a rural region close to Nagpur in Central India; it included 4711 subjects (ages 30+ years) of 5885 eligible subjects (response rate, 80.1%). Methods: The participants underwent a detailed ophthalmic and medical examination, including 200 standardized questions on socioeconomic background, lifestyle, social relations, and psychiatric depression. This study was focused on CCT as measured by sonography and its associations. Intraocular pressure was measured by applanation tonometry. Main Outcome Measures: Central corneal thickness and intraocular pressure. Results: Central corneal thickness measurement data were available on 9370 (99.4%) eyes. Mean CCT was 514±33 μm (median, 517 μm; range, 290-696 μm). By multiple regression analysis, CCT was associated significantly with younger age (P<0.001), male gender (P<0.001), higher body mass index (P = 0.006), lower corneal refractive power (P<0.001), deeper anterior chamber (P = 0.02), thicker lens (P = 0.02), and shorter axial length (P = 0.006). Central corneal thickness was not associated significantly with refractive error (P = 0.54) or cylindrical refractive error (P = 0.20). If eyes with a corneal refractive power of 45 or more diopters were excluded, the relationship between CCT and axial length was no longer statistically significant (P>0.05), whereas all other relationships remained significant. Intraocular pressure readings increased significantly (P<0.001) with both higher CCT and higher corneal refractive power. Conclusions: Indians from rural Central India have markedly thinner corneas than do Caucasians or Chinese, and, as in other populations, CCT is greater in men. CCT was associated with younger age, higher body mass index, lower corneal refractive power, deeper anterior chamber, thicker lens, and shorter axial length. Intraocular pressure readings were associated with CCT, with high readings in those eyes that had thick corneas or steep corneas. Central corneal thickness and steepness of the anterior corneal surface may thus both have to be taken into account when applanation tonometry is performed. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2010 American Academy of Ophthalmology.

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