Age-Related Macular Degeneration and the Incidence of Cardiovascular Disease: A Systematic Review and Meta-Analysis

Importance Research has indicated some shared pathogenic mechanisms between age-related macular degeneration (AMD) and cardiovascular disease (CVD). However, results from prior epidemiologic studies have been inconsistent as to whether AMD is predictive of future CVD risk. Objective: To systematically review population-based cohort studies of the association between AMD and risk of total CVD and CVD subtypes, coronary heart disease (CHD) and stroke. Data Sources A systematic search of the PubMed and EMBASE databases and reference lists of key retrieved articles up to December 20, 2012 without language restriction. Data Extraction Two reviewers independently extracted data on baseline AMD status, risk estimates of CVD and methods used to assess AMD and CVD. We pooled relative risks using random or fixed effects models as appropriate. Results: Thirteen cohort studies (8 prospective and 5 retrospective studies) with a total of 1,593,390 participants with 155,500 CVD events (92,039 stroke and 62,737 CHD) were included in this meta-analysis. Among all studies, early AMD was associated with a 15% (95% CI, 1.08–1.22) increased risk of total CVD. The relative risk was similar but not significant for late AMD (RR, 1.17; 95% CI, 0.98–1.40). In analyses restricted to the subset of prospective studies, the risk associated with early AMD did not appreciably change; however, there was a marked 66% (95% CI, 1.31–2.10) increased risk of CVD among those with late AMD. Conclusion: Whereas the results from all cohort studies suggest that both early and late AMD are predictive of a small increase in risk of future CVD, subgroup analyses limited to prospective studies demonstrate a markedly increased risk of CVD among people with late AMD. Retrospective studies using healthcare databases may have inherent methodological limitations that obscure such association. Additional prospective studies are needed to further elucidate the associations between AMD and specific CVD outcomes

Association between tear film break up time and blink interval in visual display terminal users

AIM: To investigate the association between tear film break up time (TBUT) and blinking interval in visual display terminal (VDT) users. METHODS: Nine hundred and thirty VDT users underwent dry eye testing, and functional visual acuity (FVA) test. The blinking interval during FVA was compared with TBUT. Subjects with longer blinking interval than TBUT were considered as unstable tear film. Logistic regression analysis revealed the risk factors for unstable tear group. RESULTS: Among 930 workers, 858 subjects (92.3%) participated in this study. Almost 80% of the subjects were categorized into the unstable tear group. Unstable tear group has significantly lower Schirmer values and TBUT (17.5±11.6 vs 21.1±11.5 mm, 3.7±2.6 vs 5.7±2.7s, both P<0.001). There were no significant differences in epithelial staining or severity of symptoms. Logistic regression showed that over 40y was a risk for being unstable tear group [odds ratio (OR)=1.53; 95% confidence interval (CI)=1.06-2.20]. Contact lens use was protective factor for being in the unstable tear group (OR=0.37; 95%CI= 0.26-0.53). CONCLUSION: Subjects with shorter TBUT than blinking interval are prevalent among VDT users. Subjects over the age of 40 shows an increased risk for unstable tear film

Patient Reported Differences in Dry Eye Disease between Men and Women: Impact, Management, and Patient Satisfaction

Purpose Dry eye disease affects women twice as often as men, but there is little information on whether dry eye treatments, treatment satisfaction, or the impact of dry eye disease on patients’ lives and vision might differ by sex. Design: Questionnaire survey of 4000 participants in the Women’s Health Study and the Physicians’ Health Studies I and II with a prior report of a diagnosis of DED. Methods: Among participants who re-confirmed a diagnosis of dry eye disease, we assessed symptoms, treatments, patient satisfaction and impact of dry eye disease, and analyzed differences between men and women using regression models. Results: The final study population consisted of 1,518 women (mean age 70.7 years) and 581 men (mean age 76.7 years), with a mean reported duration of dry eye disease of 10.5 years and 10.1 years, respectively. The frequency and severity of dry eye disease symptoms were higher among women (each P<0.0001), and women reported a greater impact on everyday activities (P<0.0001). Women were more likely to use artificial tears (P<0.0001) use them more often (P<0.0001), and to use Restasis® (P<0.0001), omega-3 fatty acids (P=0.0006), and have punctal occlusion (P=0.005). Women spent more money per month on dry eye treatments (P<0.0001), but reported greater dissatisfaction with treatment side effects (P=0.001), and the amount of time before treatments started working (P=0.03). Conclusions: These data show that dry eye disease is generally experienced as being more severe among women, having a greater impact on their self-assessed well-being

High Myopia and Its Associated Factors in JPHC-NEXT Eye Study: A Cross-Sectional Observational Study

The increasing prevalence of high myopia has been noted. We investigated the epidemiological characteristics and the related factors of high myopia in a Japanese adult population. Japan Public Health Center-Based Prospective Study for the Next Generation (JPHC-NEXT) Eye Study was performed in Chikusei-city, a rural area in mid-east Japan, between 2013 and 2015. A cross-sectional observational analysis was conducted to investigate prevalence and related factors of high myopia. A total of 6101 participants aged ≥40 years without a history of ocular surgeries was included. High myopia was defined as a spherical equivalent refraction of ≤-6.00 diopters according to the American Academy of Ophthalmology. Potential high myopia-related factors included intraocular pressure (IOP), corneal structure, corneal endothelial cell density, age, height, body mass index, heart rate, blood pressure, biochemical profile, and current history of systemic and ocular disorders. The odds ratios of high myopia were estimated using the logistic regression models adjusted for the associated factors. The prevalence of high myopia was 3.8% in males and 5.9% in females with a significant difference. Age was inversely associated, IOP was positively associated, and none of other factors were associated with high myopia in both sexes. In conclusion, only age and IOP were associated with high myopia in this community-based sample

Glaucomatous Visual Field Defect Severity and the Prevalence of Motor Vehicle Collisions in Japanese: A Hospital/Clinic-Based Cross-Sectional Study

Purpose. This study examined the association between the severity of visual field defects and the prevalence of motor vehicle collisions (MVCs) in subjects with primary open-angle glaucoma (POAG). Methods. This is a cross-sectional study. Japanese patients who have had driver’s licence between 40 and 85 years of age were screened for eligibility. Participants answered a questionnaire about MVCs experienced during the previous 5 years. Subjects with POAG were classified as having mild, moderate, or severe visual field defect. We evaluated associations between the severity of POAG and the prevalence of MVCs by logistic regression models. Results. The prevalence of MVCs was significantly associated with the severity of POAG categorized by worse eye MD (control: 30/187 = 16.0%; mild POAG: 17/92 = 18.5%; moderate POAG: 14/60 = 23.3%; severe POAG: 14/47 = 29.8%; P=0.025, Cochran-Armitage trend test). Compared to the control group, the adjusted OR for MVC prevalence in subjects with mild, moderate, or severe POAG in the worse eye was 1.07 (95% CI: 0.55 to 2.10), 1.44 (95% CI: 0.68 to 3.08), and 2.28 (95% CI: 1.07 to 4.88). Conclusions. There is a significant association between the severity of glaucoma in the worse eye MD and the prevalence of MVCs

健康への配慮とﾒﾀﾎﾞﾘｯｸｼﾝﾄﾞﾛｰﾑ対策状況について -佐世保市民の健康に関する実態調査報告-

本研究では､健康への意識の有無とﾒﾀﾎﾞﾘｯｸｼﾝﾄﾞﾛｰﾑ(以下､MetS)予防および改善行動の実践の有無から分析を行い､意識や行動の違いが健康に関する項目にどのような影響を与えるのか検討を行った｡その結果､健康への意識を持つことにより日常的に健康の維持増進に向けた生活習慣を送り､健康診断やがん検診の受診など健康に向けた望ましい行動や､共食日数の増加や余暇活動の増加など QOL の向上にもつながることが示唆された｡また､健康を意識することに加えて MetS 予防を行っているものでは､さらに望ましい生活習慣状況となっており､MetS 予防といった明確な目的およびその対策を実践しているという自覚によってより一層健康的な日常生活の実践に結びついていることが考えられた｡In the present study, we analyzed the data from the presence or absence of the awareness of health and from the presence or absence of the practice for prevention of metabolic syndrome(hereinafter called“MetS”)and the behavior for improvement, and examined what effect the differences in the awareness and behavior might influence on the items on health. As a result, it was suggested that, by having an awareness of health, it would be possible to establish a life-style enabling the maintenance and promotion of health, and to be linked to the desirable behavior for health such as having regularly a health check-up and a cancer examination, and to go far towards the advancement of QOL such as the increased number of days of‘eating in company\u27and the increased level of activity for leisure. In addition to having an awareness of health, those who were conducting the preventive measure against MetS were found to lead a more, desirable life-style, and to be related to the practice of a healthier daily life by becoming self-conscious of having a definite objective of preventing MetS and practicing its measure

休養状況から見た健康に向けた実践状況 -佐世保市民の健康に関する実態調査報告-

健康づくりの要素として｢栄養･食生活｣｢身体活動･運動｣｢休養･こころの健康づくり｣の3本柱があげられるが､本報告では佐世保市において平成24年1月～2月に行われた｢佐世保市民の健康に関する実態調査｣の調査結果のうち､休養状況を示す｢休養･こころの健康づくり｣に着目をし､休養と健康についての分析を行った｡その結果､日常的に健康に配慮しているもの及び配慮している生活習慣として｢栄養･食生活｣を挙げた者が最も多く､｢休養｣をあげた者の割合は､｢栄養･食生活｣｢運動｣に対して少なかった｡｢運動｣を挙げた者は休養がとれている者ととれていない者との差が大きく､また､休養がとれている者は､積極的に身体を動かしていたことを示した｡休養を適切にとることは､日常生活が健康的な生活につながることを示唆した｡しかし､休養が健康の3本柱でありながら､健康のために配慮することとして休養は考えられにくい状況であったことから､休養と健康とのつながりについて周知していくことが必要となると考える｡It is thought that“nutrition and dietary life”,“physical activity and exercise”and“rest and mental health promotion”are the most important factors for health promotion. Previously, we made a survey on actual conditions of health for people living in Sasebo in a period from January to February of 2012. Based on results of the survey, an analysis was made on a rest and health paying attention to the results of“rest and mental health promotion”, which indicates the situation of people\u27s rest. The number of people usually paying attention to own health and those who chose the item“nutrition and dietary life”as their important life habit was the most. Whereas the number of subjects who chose the item“rest”was less than the number of subjects who chose the item“nutrition and dietary life”or“exercise”. Regarding the subjects who chose the item of exercise, there was a large difference between the numbers of subjects taking a rest enough and those who were not. Moreover, the present findings suggested that physical activity of people taking a rest enough is mostly high. These results suggest that to take an appropriate rest would lead to healthy life. “Rest”is one of three indispensable factors to keep health and so it is important to be concerned about“rest”for health maintenance. However, such idea was not so widely received until recently and“rest”was apt to be disregarded. Therefore, it is thought necessary to widely spread the idea about close correlation between rest and health

Treatment Trends in Dry Eye Disease and Factors Associated with Ophthalmic Follow-up Discontinuation in Japan

Despite the importance of dry eye disease (DED) treatment, the rate of DED treatment discontinuation, especially discontinuation of ophthalmic follow-up, remains unknown. This study aimed to assess the prevalence and risk factors of ophthalmic follow-up discontinuation for DED. A cross-sectional survey of 1030 participants was conducted using a self-administered web-survey instrument. We collected lifestyle information, history of DED diagnosis, types of treatment, frequency of eye-drop usage, symptoms, and the reasons for discontinuing treatment. Statistical analyses including logistic regression were used to evaluate the risk factors of discontinuing ophthalmic follow-up for DED. A past history of clinical DED diagnosis was reported by 155 (15.0%) subjects. Of those, 130 had persistent DED, and 88 (67.7%) of the subjects reported discontinuation of ophthalmic follow-up for DED. The most prevalent reasons for ophthalmic follow-up discontinuation were time restrictions, followed by dissatisfaction with the DED treatment. Duration after DED diagnosis was the only significant risk factor for discontinuing ophthalmic follow-up after adjusting for age and sex (odds ratio = 1.09, 95% confidence interval = 1.02&ndash;1.17, p = 0.009). In conclusion, longer DED duration after diagnosis was a significant risk factor for discontinuing ophthalmic follow-up for DED. This study showed that DED ophthalmic follow-up discontinuation involves both medical and non-medical reasons. Clinicians need to be aware of them, and preventative effort is needed to avoid discontinuation