Visual Impairment in White, Chinese, Black, and Hispanic Participants from the Multi-Ethnic Study of Atherosclerosis Cohort

Diana E. Fishera*, Sandi Shragerb, Steven J. Sheac, Gregory L. Burked, Ronald Kleine, Tien Y. Wongfg, Barbara E. Kleine & Mary Frances Cotchaa Division of Epidemiology and Clinical Applications, Intramural Research Program, National Eye Institute (NEI), National Institutes of Health (NIH), Bethesda, MD, USA, b Department of Biostatistics, University of Washington, Seattle, WA, USA, c Departments of Medicine and Epidemiology, Columbia University, New York, NY, USA, d Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA, e Department of Ophthalmology and Visual Sciences, University of Wisconsin--Madison, Madison, WI, USA, f Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, and g Singapore Eye Research Institute, Singapore National Eye Centre, SingaporeCorrespondence: Diana E. Fisher, Division of Epidemiology and Clinical Applications, Intramural Research Program, National Eye Institute (NEI), National Institutes of Health (NIH), Bethesda, MD 20892, USA. Tel: +1 (301) 496 1331. Fax: +1 (301) 496 7295. E-mail: diana.fisher@nih.govAbstractPurpose: To describe the prevalence of visual impairment and examine its association with demographic, socioeconomic, and health characteristics in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort.Methods: Visual acuity data were obtained from 6134 participants, aged 46–87 years at time of examination between 2002 and 2004 (mean age 64 years, 47.6% male), from six communities in the United States. Visual impairment was defined as presenting visual acuity 20/50 or worse in the better-seeing eye. Risk factors were included in multivariable logistic regression models to determine their impact on visual impairment for men and women in each racial/ethnic group.Results: Among all participants, 6.6% (n = 421) had visual impairment, including 5.6% of men (n = 178) and 7.5% of women (n = 243). Prevalence of impairment ranged from 4.2% (n = 52) and 6.0% (n = 77) in white men and women, respectively, to 7.6% (n = 37) and 11.6% (n = 44) in Chinese men and women, respectively. Older age was significantly associated with visual impairment in both men and women, particularly in those with lower socioeconomic status, but the effects of increasing age were more pronounced in men. Two-thirds of participants already wore distance correction, and not unexpectedly, a lower prevalence of visual impairment was seen in this group; however, 2.4% of men and 3.5% of women with current distance correction had correctable visual impairment, most notably among seniors.Conclusion: Even in the U.S. where prevalence of refractive correction is high, both visual impairment and uncorrected refractive error represent current public health challenges.