BARBADOS INCIDENCE STUDY OF EYE DISEASE (BISED)

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The Barbados Incidence Study of Eye Diseases (BISED) is designed to provide epidemiologic data on open-angle glaucoma (OAG) and other major causes of visual loss in black populations. It aims to determine incidence, progression and risk factors for OAG, age-related cataract, age-related macular degeneration, diabetic retinopathy and visual impairment among the population-based cohort of about 4500 persons, ages 40-86 years, who were examined from 1988-1992 as part of the Barbados Eye Study (BES). The BES was designed to measure prevalence and risk factors for each of the major eye diseases in a black population and to establish a baseline for future incidence measurements. No incidence or progression data have ever been collected on eye diseases in blacks that are based on a nationwide prevalence study with a high (85%) participation, a sufficiently large population to allow both precise estimates and risk factor assessment, and standardized and reproducible clinical and photographic protocols to measure each disease. To achieve these aims, BES participants would be re-examined to obtain ocular data (e.g., intraocular pressure, refraction, visual acuity, visual fields, lens gradings), blood pressure and anthropometric measurements, medical history and other interview data, stereo fundus photographs of the disc and macula and glycated hemoglobin, following the same BES protocol. Comparison of BES and BISED data would not only provide much needed data on incidence and progression, but would also allow risk factor evaluation and determination of relative and population attributable risks. Baseline risk factor data include cardiovascular variables, diabetes and body size, ocular variables, use of nutritional supplements, medication exposures, smoking and alcohol use, pigmentation, familial aggregation, genetic markers, demographic and health care utilization measures. The information will provide data for public health planning, understanding etiology, identifying groups at high risk and developing appropriate strategies to control visual loss. The feasibility of BISED was supported by a pilot study that had a 94% participation rate and a 91% positive response to a response to a return examination.