Latinos have higher rates of developing visual impairment, blindness, diabetic eye disease, and cataracts than non-Hispanic whites, researchers found. These are the first estimates of visual impairment and eye disease development in Latinos, the largest and fastest growing minority population in the United States.
The research was part of the Los Angeles Latino Eye Study (LALES), which was supported by the National Eye Institute (NEI), part of the National Institutes of Health. LALES began in 2000 as the nation's largest and most comprehensive study of vision in Latinos.
"This study showed that Latinos develop certain vision conditions at different rates than other ethnic groups," said Rohit Varma, M.D., M.P.H., principal investigator of LALES and director of the Ocular Epidemiology Center at the Doheny Eye Institute, University of Southern California. "The burden of vision loss and eye disease on the Latino community is increasing as the population ages, and many eye diseases are becoming more common."
Hispanics numbered 45 million in the United States as of 2007, according to the Census Bureau. In the current phase of LALES, researchers examined more than 4,600 Latinos four years after they initially enrolled in the study to determine the development of new eye disease and the progression of existing conditions, including visual impairment, blindness, diabetic eye disease, age-related macular degeneration, and cataracts.
Participants were mainly of Mexican descent, age 40 and older, and living in the city of La Puente, Los Angeles County, Calif. Study results were published in four papers in the May issue of the American Journal of Ophthalmology.
"These data have significant public health implications and present a challenge for eye care providers to develop programs to address the burden of eye disease in Latinos," said NEI Director Paul A. Sieving, M.D., Ph.D. "NEI has a strong record of commitment to educating the Latino community and health care providers about eye diseases through its National Eye Health Education Program, and will continue to make this a priority."
LALES researchers found that over the four-year interval, Latinos developed visual impairment and blindness at the highest rate of any ethnic group in the country, when compared with estimates from other U.S. population-based studies. Overall, nearly 3 percent of Latinos developed visual impairment and 0.3 percent developed blindness in both eyes, with older adults impacted more frequently. Of Latinos age 80 and older, 19.4 percent became visually impaired, and 3.8 percent became blind in both eyes.
U.S. Latinos were also more likely to develop diabetic retinopathy than non-Hispanic whites. Over the four-year period, 34 percent of Latinos who had diabetes developed diabetic retinopathy, with Latinos aged 40 to 59 having the highest rate. Though increasing age did not play a role, Latinos with a longer duration of diabetes were more likely to develop the disease. In fact, 42 percent of Latinos with diabetes for more than 15 years developed diabetic retinopathy. Also, among participants who had diabetic retinopathy at the beginning of the study, 39 percent showed worsening of the disease four years later.
Researchers found that Latinos who already had visual impairment, blindness, or diabetic retinopathy in one eye when they began the study had very high rates of developing the condition in the other eye during the study. More than half of participants who already had diabetic retinopathy in one eye developed it in the other eye.
"These results underscore the importance of Latinos, especially those with diabetes, getting regular, dilated eye exams to monitor their eye health," Varma said. "Eye care professionals should closely monitor Latinos who have eye disease in one eye because their quality of life can be dramatically impacted if they develop the condition in both eyes."
In addition, LALES showed that Latinos were more likely to develop cataracts in the center of the lens (10.2 percent) than the edge of the lens (7.5 percent). Many of these lens changes were age-related, as 50 percent of Latinos age 70 and older developed cataracts in the center of the lens.
However, Latinos in the study had low rates of early and late age-related macular degeneration (AMD) development. Less than 8 percent developed early AMD and less than 1 percent developed late AMD, though the chance of developing AMD did increase with age. Compared with other population-based studies, Latinos in LALES were half as likely to develop early AMD and one-third as likely to develop late AMD as non-Hispanic whites.
Previous results from LALES showed that more than 60 percent of eye disease in Latinos is undiagnosed and undetected -- specifically, 98 percent of AMD, 95 percent of diabetic retinopathy, 82 percent of glaucoma, 57 percent of cataracts, and 19 percent of refractive error. LALES researchers are currently investigating the risk factors for eye disease development in Latinos, and will examine specific genetic risk factors for diabetic retinopathy and AMD.
- Rohit Varma, Jessica Chung, Athena W.P. Foong, Mina Torres, Farzana Choudhury, Stanley P. Azen. Four-Year Incidence and Progression of Visual Impairment in Latinos: The Los Angeles Latino Eye Study. American Journal of Ophthalmology, 2010; 149 (5): 713 DOI: 10.1016/j.ajo.2009.12.011
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