Eye disease and mortality, cognition, disease, and modifiable risk factors: an umbrella review of meta-analyses of observational studies

Trott, Mike; Smıth, Lee; Veronese, Nicola; Pizzol, Damiano; Barnett, Yvonne; Gorely, Trish; Pardhan, Shahina

doi:10.1038/s41433-021-01684-x

Cited by 18 publications

(17 citation statements)

References 71 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To address the breadth of the literature of complex conditions and multiple outcomes, an increasing number of studies have used an ‘umbrella review’ approach: a novel method of synthesising existing meta‐analyses to capture the breadth and credibility of outcomes associated with a given exposure 8‐11 …”

Section: Introductionmentioning

confidence: 99%

“…To address the breadth of the literature of complex conditions and multiple outcomes, an increasing number of studies have used an 'umbrella review' approach: a novel method of synthesising existing meta-analyses to capture the breadth and credibility of outcomes associated with a given exposure. [8][9][10][11] Therefore, the aim of the present study was to assess the strength and credibility of the evidence on the associations between DR and any type of modifiable risk factor, derived from published meta-analyses of existing studies using an umbrella review approach. We aimed to answer the following questions:…”

mentioning

confidence: 99%

See 1 more Smart Citation

Associations between diabetic retinopathy and modifiable risk factors: An umbrella review of meta‐analyses

2022

Self Cite

View full text Add to dashboard Cite

Aims Several modifiable risk factors have been meta‐analysed for diabetic retinopathy (DR), such as physical activity and vitamin D status. To date, these factors have not been systematically aggregated and the credibility of evidence assessed. Therefore, the aim of this umbrella review was to aggregate all modifiable risks of DR and assess the credibility of the evidence. Methods An umbrella review of meta‐analyses was undertaken. For each meta‐analytic association, random‐effects effect size, 95% confidence intervals (CIs), heterogeneity, small‐study effects, excess significance bias and 95% prediction intervals were calculated. The credibility of significant evidence (p < 0.05) was graded from I to IV, using pre‐defined criteria. Results After initial searches, 13 studies were included covering 34 independent outcomes (total participants = 824,372). Positive associations were found between insulin usage and diabetic macular oedema (RR = 4.5; 95% CI 3.1–6.6), and DR risk (RR = 2.3; 95% CI 1.4–3.9) in people with type 2 diabetes. Vitamin D deficiency was associated with DR risk (OR = 2.8; 95% CI 1.1–7.1), as was obesity (RR = 1.34; 95% CI 1.06–1.68) and sedentary behaviour (RR = 1.22; 95%CI 1.03–1.44). Intensive blood pressure targets (RR = 0.8 95%CI 0.8–1.0), and moderate physical activity (RR = 0.69; 95%CI 0.53–0.91) yielded significant protective associations with DR. Conclusions People with type 2 diabetes on insulin have a high risk of macular oedema and DR. Vitamin D deficiency yielded almost three times greater odds of DR, while intensive blood pressure control reduces DR risk by 20% and moderate physical activity by 31%. Healthcare professionals should use this evidence to identify those people most at risk to ensure that proper treatment and healthy lifestyles are recommended.

show abstract

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Associations between diabetic retinopathy and modifiable risk factors: An umbrella review of meta‐analyses

2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…The credibility of analyses was assessed according to stringent criteria based on previously published umbrella reviews [11,16,[25][26][27]. In brief, significant pooled effect sizes from the re-performed meta-analysis were graded as Grade I, II, III, or IV based on several stringent criteria, including the strength of the effect size (including the PI excluding the null), the presence of small study effects, and the presence of excess significance bias (full criteria available in Table 1).…”

Section: Assessment Of the Credibility Of The Evidencementioning

confidence: 99%

Associations between diabetic retinopathy, mortality, disease, and mental health: an umbrella review of observational meta-analyses

2022

Self Cite

View full text Add to dashboard Cite

Background Diabetic retinopathy is a complication of diabetes affecting the eyes and can lead to blindless if left untreated. Several significant risk factors have been reported for DR, of which several can be classified as some form of disease. Furthermore, several systematic reviews have reported associations between several types of mortality and DR. Numerous meta-analyses have pooled the data on these factors, however, a systematic evaluation of these meta-analytic relationships is lacking. In this study, therefore, we performed an umbrella review of systematic reviews of meta-analyses for mortality, diseases and DR, grading the credibility of evidence. Methods A comprehensive database search for observational meta-analyses was conducted from inception until 29/04/2022 against pre-published inclusion criteria. For each meta-analytic outcome, a random-effects meta-analysis was re-conducted, stratifying by study design (and type of DR where possible) of included studies. Several statistical variables, including publication bias, heterogeneity, excess significance bias, and prediction intervals were used to grade the credibility of significant evidence from I to IV, using the recommendations from the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria. Results Of the 1,834 initial results, 11 systematic reviews with meta-analyses were included covering 16 independent outcomes (total participants = 299,655; median participants per outcome: 7,266; median individual studies per outcome = 5). Overall, 10/16 outcomes (62.5%) yielded significant results, most of which were graded as ‘highly suggestive’ (Grade II) evidence. DR was associated with all-cause and cardio-vascular mortality, obstructive sleep apnoea, depression eating disorders, and several forms of cognitive impairment. Conclusions Results show highly suggestive evidence for associations between health outcomes and/or conditions and DR. Public health professionals and practitioners should note these findings when developing and/or reviewing public health polices.

show abstract

“…Of those, more than 50% have vision impairment or blindness from potentially preventable or correctable causes [ 1 ]. Aging, lifestyle, genetics, history of infections, and chronic health conditions (e.g., diabetes or hypertension) are the most important factors for eye diseases and vision impairment [ 1 , 2 , 3 , 4 , 5 ]. Currently, most of the major causes of vision impairment and blindness have modifiable risk factors as well as effective therapy [ 1 , 3 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Eye Care Behaviors among Adults in Poland: A Nationwide Cross-Sectional Survey

Kamińska

Pinkas

Tyszko

et al. 2023

IJERPH

View full text Add to dashboard Cite

Implementation of eye care behaviors may reduce the risk of eye symptoms and diseases. This study aimed to assess eye care behaviors and identify factors associated with eye care practices among adults in Poland. This cross-sectional survey was carried out between 9 and 12 December 2022 on a nationwide random quota sample of adults in Poland. The study questionnaire included a set of questions on 10 different eye care behaviors. The study population included 1076 participants with a mean age of 45.7 ± 16.2 years, and 54.2% of participants were females. The most common (30.2%) eye care behavior was the use of good lighting indoors, and 27.3% used sunglasses with a UV filter. More than one-fifth of participants declared taking regular screen breaks and limiting screen time. Less than one-tenth of participants used dietary supplements with lutein, beta-carotene, or zinc. Out of 12 factors assessed in this study, self-reported knowledge of eye diseases was the most important factor associated (p < 0.05) with eye care behaviors. There were no economic or educational gaps (p > 0.05) in the implementation of most of the eye care behaviors among adults in Poland. This study revealed a low level of implementation of eye care behaviors among adults in Poland.

show abstract

Eye disease and mortality, cognition, disease, and modifiable risk factors: an umbrella review of meta-analyses of observational studies

Cited by 18 publications

References 71 publications

Associations between diabetic retinopathy and modifiable risk factors: An umbrella review of meta‐analyses

Associations between diabetic retinopathy and modifiable risk factors: An umbrella review of meta‐analyses

Associations between diabetic retinopathy, mortality, disease, and mental health: an umbrella review of observational meta-analyses

Eye Care Behaviors among Adults in Poland: A Nationwide Cross-Sectional Survey

Contact Info

Product

Resources

About