Methodology of the Singapore Indian Chinese Cohort (SICC) Eye Study: Quantifying ethnic variations in the epidemiology of eye diseases in Asians

Lavanya, Raghavan; Jeganathan, V Swetha E; Zheng, Yang; Raju, P. Krishnam; Cheung, Ning; Tai, E. Shyong; Jj, Wang; Lamoureux, Ecosse L.; Mitchell, Paul; Young, TL; Cajucom-Uy, Howard; Foster, Paul J.; Aung, Tin; Sm, Saw; Ty, Wong

doi:10.3109/09286580903144738

Cited by 310 publications

(268 citation statements)

References 66 publications

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“…The study was approved by the SingHealth Institutional Review Board and conducted in accordance to the Declaration of Helsinki, and written informed consent was obtained from all participants. Detailed population selection and methodology have been published previously (30). Briefly, from 2007 to 2009, the study was conducted in the southwestern part of Singapore using an age-stratified random sampling strategy.…”

Section: Sindi Protocolmentioning

confidence: 99%

“…We first conducted a nested population-based case-control study on 40 patients with diabetes with DR and 40 patients with diabetes without DR (discovery set) selected from banked plasma collected as part of the Singapore Indian Eye Study (SINDI) (30). Metabolite markers of DR identified from the discovery set were separately quantified in a separate sample set with 40 patients with diabetes and DR, 40 patients with diabetes and without DR, and 40 participants without diabetes (validation set).…”

Section: Sample Selectionmentioning

confidence: 99%

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Plasma Metabonomic Profiling of Diabetic Retinopathy

et al. 2016

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Diabetic retinopathy (DR) is the most common microvascular complication of diabetes and the leading cause of visual impairment in working-age adults. Patients with diabetes often develop DR despite appropriate control of systemic risk factors, suggesting the involvement of other pathogenic factors. We hypothesize that the plasma metabolic signature of DR is distinct and resolvable from that of diabetes alone. A nested populationbased case-control metabonomic study was first performed on 40 DR cases and 40 control subjects with diabetes using gas chromatography-mass spectrometry. Eleven metabolites were found to be correlated with DR, and the majority were robust when adjusted for metabolic risk factors and confounding kidney disease. The metabolite markers 2-deoxyribonic acid; 3,4-dihydroxybutyric acid; erythritol; gluconic acid; and ribose were validated in an independent sample set with 40 DR cases, 40 control subjects with diabetes, and 40 individuals without diabetes. DR cases and control subjects with diabetes were matched by HbA 1c in the validation set. Activation of the pentose phosphate pathway was identified from the list of DR metabolite markers. The identification of novel metabolite markers for DR provides insights into potential new pathogenic pathways for this microvascular complication and holds translational value in DR risk stratification and the development of new therapeutic measures.Diabetic retinopathy (DR) is the most common microvascular complication of diabetes and the leading cause of visual impairment in working-age adults worldwide (1,2). The global prevalence of diabetes is rising and the number of people with diabetes is projected to increase by 54% in 2030, compared with 2010 (3). The public health burden of diabetes and DR would thus increase correspondingly. The major risk factors of DR are poor glycemic control and hypertension, as well as the duration of diabetes (4,5), but their relative importance varies between studies (2,6). Although the risks of DR progression and vision loss are reduced with intensive control of risk factors (7,8), many patients with diabetes continue to develop complications despite tight glycemic and blood pressure control. There is increasing evidence to suggest that "metabolic memory" is responsible for this observation. The term metabolic memory refers to the persistent epigenetic modifications caused by early exposure to hyperglycemia that, in turn, predispose individuals to the development of diabetes complications even after good glycemic control

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Section: Sindi Protocolmentioning

confidence: 99%

Section: Sample Selectionmentioning

confidence: 99%

Plasma Metabonomic Profiling of Diabetic Retinopathy

et al. 2016

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“…Eligible stroke cases were matched to controls of the same 10-year age group, sex, and race, with no self-reported history of stroke selected from participants of the Singapore Epidemiology of Eye Diseases (SEED) study. 15,16 This study is a population-based study of eye disease in an age-stratified random sample of Chinese, Malay, and Indian residents aged 40 to 80 years living in south western Singapore in the region where Singapore General Hospital provides stroke services. Written informed consent was obtained from each participant or next-of-kin, and previous approval for the project was obtained from the Singapore General Hospital's Institutional Review Board.…”

Section: Study Populationmentioning

confidence: 99%

Microvascular Structure and Network in the Retina of Patients With Ischemic Stroke

Ong

Silva

Cheung

et al. 2013

Stroke

121

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; and neurodegenerative diseases (including cognitive decline, dementia, and cerebral atrophy). [6][7][8] These findings further support the concept that microvascular pathology may play an important role in the development of a wide range of age-related brain diseases, such as stroke, dementia, and Alzheimer disease. These retinal microvascular changes not only may represent cerebral small-vessel damage 9,10 but also may be the result of downstream effects of proximal largeartery disease.11 Retinopathy signs are, however, relatively late indicators of target organ damage in the eye and probably Background and Purpose-Microvascular disease has been implicated in the pathogenesis of stroke. The retina provides a window to assess microcirculation noninvasively. We studied the association between quantitatively measured retinal microvascular characteristics and acute ischemic stroke. Methods-We conducted a case-control study with acute ischemic stroke patients recruited from a tertiary hospital in Singapore and controls from the Singapore Epidemiology of Eye Disease program matched by 10-year age strata, sex, and race. Strokes were classified using modified Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Retinal vascular parameters were measured from retinal fundus photographs using a computer program. Logistic regression models for stroke were constructed adjusting for age, sex, race, and additionally for smoking, hypertension, diabetes mellitus, and hypercholesterolemia.

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“…A detailed description of the population model can be found in the references as cited. [27][28][29] To project the number of people with eye disease, we applied the prevalence of eye diseases from the Singapore Epidemiology of Eye Diseases (SEED) study [30][31][32] for resident Singaporeans 40 years and older to the population model of resident Singaporeans. The prevalence of eye diseases was disaggregated by age, gender, ethnicity and educational attainment.…”

Section: Methodsmentioning

confidence: 99%

“…[33] The population module was calibrated using time series data on the resident Singapore population from SDS. Age-specific prevalence estimates from the SEED study [30][31][32] were used. Administrative data on patient visits were provided by the Ministry of Health (MOH).…”

Section: Datamentioning

confidence: 99%

Comparing health workforce forecasting approaches for healthcare planning: The case for ophthalmologists

Ansah

Koh

Korne

et al. 2017

IJH

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Health workforce planning is essential in the provision of quality healthcare. Several approaches to planning are customarily used and advocated, each with unique underlying assumptions. Thus, a thorough understanding of each assumption is required in order to make an informed decision on the choice of forecasting approach to be used. For illustration, we compare results for eye care requirements in Singapore using three established workforce forecasting approaches -workforce-to-population-ratio, needs based approach, utilization based approach -and a proposed robust integrated approach to discuss the appropriateness of each approach under various scenarios. Four simulation models using the systems modeling methodology of system dynamics were developed for use in each approach. These models were initialized and simulated using the example of eye care workforce planning in Singapore, to project the number of ophthalmologists required up to the year 2040 under the four different approaches. We found that each approach projects a different number of ophthalmologists required over time. The needs based approach tends to project the largest number of required ophthalmologists, followed by integrated, utilization based and workforce-to-population ratio approaches in descending order. The four different approaches vary widely in their forecasted workforce requirements and reinforce the need to be discerning of the fundamental differences of each approach in order to choose the most appropriate one. Further, health workforce planning should also be approached in a comprehensive and integrated manner that accounts for developments in demographic and healthcare systems.

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Methodology of the Singapore Indian Chinese Cohort (SICC) Eye Study: Quantifying ethnic variations in the epidemiology of eye diseases in Asians

Cited by 310 publications

References 66 publications

Plasma Metabonomic Profiling of Diabetic Retinopathy

Plasma Metabonomic Profiling of Diabetic Retinopathy

Microvascular Structure and Network in the Retina of Patients With Ischemic Stroke

Comparing health workforce forecasting approaches for healthcare planning: The case for ophthalmologists

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