Prevalence and Risk Factors for Refractive Error in Adult Chinese Americans: The Chinese American Eye Study

Abstract

Purpose To estimate the prevalence of refractive errors in adult Chinese Americans, and evaluate factors associated with myopia and high myopia. Design A population-based, cross-sectional study. Methods Chinese Americans 50 years and older residing in Monterey Park, California, were recruited. Noncycloplegic automated refraction with supplemental subjective refraction was performed. Myopia, high myopia, hyperopia, and high hyperopia were defined as a spherical equivalent of < −0.5 diopter (D), < −5.0D, > +0.5D, and ≥ +3.0D, respectively. Astigmatism and high astigmatism were defined as a cylinder of > 0.5D and > 2.25D, respectively. Risk factor assessment was guided by a conceptual model. Results Data from 4144 participants were analyzed. The overall prevalence of myopia, high myopia, hyperopia, high hyperopia, astigmatism, and high astigmatism was 35.1% (95% confidence interval, 33.6%–36.6%), 7.4% (6.6%–8.3%), 40.2% (38.7%–41.8%), 2.7% (2.2%–3.3%), 45.6% (44.1%–47.2%), and 3.7% (3.1%–4.3%), respectively. The prevalence of myopia and high myopia was lower among older individuals (Ps < 0.05). Reversed age trends were observed for the other refractive errors (Ps < 0.05). There was no sex difference in the prevalence of refractive errors, except for a higher prevalence of hyperopia among females (P = 0.010). Age, acculturation, education, income, marital status, birth country, history of ocular disease, non-ocular comorbidities, and recent eye exam were associated with prevalence of myopia. All of these factors, except for acculturation, were also associated with high myopia. Conclusions Our data present the first population-based estimates of the prevalence of refractive errors among adult Chinese Americans. Compared with whites, Hispanics, and blacks, Chinese Americans have a higher burden of myopia, high myopia, and astigmatism.

Global Epidemiology of Myopia

“…From a viewpoint of ethnicity difference, Chinese have a substantially higher prevalence of myopia compared with other racial groups, and a similar pattern of even greater magnitude was seen in HM prevalence. The prevalence of myopia and HM in Chinese ethnicity in western countries is similar to other studies of Chinese in urban Asian countries [80].…”

“…In the USA, the latest report in the Chinese American study showed the relatively high prevalence of myopia and HM, 35.1% and 7.4%, respectively, in 4144 Chinese adults aged 50 years or older [80]. This result is similar to or slightly higher than same Chinese populations from other studies in urban Asian countries (38.7% in the Tanjong Pagar Study, Singapore and 32.3% in the Liwan Eye Study).…”

Prevalence and risk factors of myopia in Han and Yugur older adults in Gansu, China：a cross-sectional study

“…After excluding participants diagnosed with cataracts, the prevalence of hyperopia increased with age in both ethnic groups. The age-related change in prevalence was also concluded in previous studies [26,30,31].…”

“…To eliminate the effects of noncycloplegic refraction, we compared the prevalence of myopia in the Han ethnicity in the 50-59 age group (30.8%) with other studies. We found that the prevalence of myopia in our study was higher than that in He J's study in Shanghai (23.2%) [26] the Handan eye study (18.2%) [25] and the Yunnan minority eye studies (5.0%) [21] in the same age group but lower than that in the Chinese American study (36.1%) [30] the Tajimi study (49.6%) [32], the Hong Kong vision study (40%) [33], the Singapore epidemiology of eye disease study (38.9%) [11], Korea national health and nutrition examination survey (55.2% in 45-49 age group) [34], and close to values from the Liwan study (31.7%) [24,31] and The Kumejima study (29.4%) [35] Table. 5 . The prevalence of high myopia in the Han ethnicity in the 50-59 age group was 5.0%, which was higher than the prevalence in the Handan Eye study (1.8%) [25], the Andhra Pradesh eye disease study (4.8%)[36] and the Kumejima study (0.8%) [35], but lower than that in the Liwan Study (5.3%) [24], The Shanghai Eye study (5.23%) [26] the Chinese American study (7.4%) [30], the Singapore epidemiology of eye disease study (5.1%) [11] and the Tajimi study (8.7%) [32].…”

Axis-free correction of astigmatism using bifocal soft contact lenses

“…The prevalence of regular astigmatism (0.5 DC < Cylinder < 2.00 DC) was published as 45.6% out of 4144 participants from the Chinese American Eye Study [1] and Young et al reported a prevalence of 47.4% in relation to a contact lens wearing population [2]. Ohlendorf et al [3] reported a prevalence of 55% for astigmatism greater 0.5 DC in German study cohort of 655 adults.…”