Publications (2)7.38 Total impact
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ABSTRACT: OBJECTIVE To investigate whether Fuchs endothelial corneal dystrophy (FECD) severity is associated with glaucoma and/or ocular hypertension (G/OHTN). METHODS A subset of eyes (n = 1610) from the FECD Genetics Multi-Center Study were examined to estimate the association between FECD severity (grades 0-6 based on guttae confluence) and G/OHTN. Logistic regression models that accounted for the correlation between eyes and adjusted for age, sex, central corneal thickness, intraocular pressure, presence of diabetes, and time of day of the initial evaluation were fit. RESULTS A total of 107 eyes (6.6%) had G/OHTN based on the study definition. The prevalence of G/OHTN in the control group was 6.0%. The prevalence was lower in index cases with an FECD grade of 1 through 3 and family members with a grade of 0 or 1 through 3 (0.0% and 2.1%, respectively) but higher in index cases and family members with a grade of 4 through 6 (11.2% and 8.5%, respectively). Adjusting for covariates, eyes with a grade of 4 through 6 were more likely to have concurrent G/OHTN than eyes with no FECD (index cases vs controls: odds ratio [OR] = 2.10, P = .04; affected vs unaffected family members: OR = 7.06, P = .07). Age (OR = 1.06 per 1-year increase, P < .001) and intraocular pressure (OR = 1.15 per 1-mm Hg increase, P < .001) were also associated with an increased prevalence of G/OHTN. Sex, diabetes, time of day of evaluation, and central corneal thickness were not associated with the prevalence of G/OHTN (P ≥ .15). CONCLUSIONS Glaucoma and/or ocular hypertension occurs more often in eyes with severe FECD compared with unaffected eyes. Therefore, it may be beneficial to monitor for the development of glaucoma in these patients.
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ABSTRACT: To assess the potential association between vision and cognition in an ambulatory older population. A sample of 84 adults aged 65 and older seeking non-emergent ophthalmic care. Participants were interviewed with the Mini-Mental State Examination (MMSE) during their regular scheduled visit. The average individual was a 78-year-old female, with at least a high school diploma and mildly affected vision (logMAR 0.27). Vision and cognition scores were unrelated (Pearson=-0.09, p=0.41). An MMSE<24 (out of 30) was found in 19% of individuals. A score of 16 in the MMSE(blind) (out of 22) identified 14 (88%) of them. Memory was the most frequently affected component (13 patients, 81%), and recall the most frequently involved item (nine patients, 56%). More individuals (16-26%) with moderate to severe vision impairment (logMAR 0.6 to 1.3) tended to have psychomotor and concentration deficiencies and fewer (14%) memory problems compared with those with normal vision or mild impairment (logMAR -0.3 to 0.5). Language was uniformly affected across levels of vision impairment. An absent relationship between cognition and vision based on overall scores of standard instruments does not preclude the existence of such association as characterised by more comprehensive measures, and thus greater vision impairment may confer some cognitive ageing in specific abilities.
Case Western Reserve University
Cleveland, Ohio, United States
- Department of Epidemiology and Biostatistics