Cataract: Health Disparity for Older African-Americans

与高加索人相比，非裔美国人因白内障造成的视力损害更多，而白内障手术更少。虽然已经对白内障的危险因素进行了研究，但尚未对白内障发生和进展的特定决定因素以及白内障手术时间、比较因素及其在种族群体中的重要性进行研究。这项研究的目的是：确定以老年人口为基础的非裔美国人与高加索人相比，白内障的发病率和进展；确定预测因素及其对发病率和进展的相对重要性；以及确定预测每个种族中视力残疾的白内障患者的白内障手术时间的因素。作为NIA资助的SEE项目的一部分，已经收集了预期数据；2520名参与者提供了关于紫外线暴露、酒精和烟草使用、药物、高血压和糖尿病等疾病以及其他关键风险因素的基线、2年、6年和8年数据。在基线时拍摄眼部照片，对皮质型、核型和后囊膜下白内障的存在和严重程度进行分级，并拍摄但尚未分级的随访。在每一轮中都进行了视力和身体功能测量，从而能够分析白内障的功能影响和寻求白内障手术的预测因素。将建立模型以确定白内障发生和进展的风险因素，并测试种族群体的相互作用。由于白内障造成的视力损害程度和种族群体对身体功能的影响将被用来模拟后续白内障手术的触发因素。这些数据将增加对种族群体内白内障发病机制的了解，并提供对寻求白内障手术的不同群体的更多了解。这些数据将推动减少老年非裔美国人因白内障而致视力障碍的健康差距的目标。

African Americans have more visual impairment from cataract, and less cataract surgery, compared to Caucasians. While risk factors for cataract have been studied, specific determinants of cataract incidence and progression, and time to cataract surgery, comparing factors and their importance within racial groups has not been done. The aims of this research are: to determine the incidence and progression of cataract in an older population-based sample of African Americans compared to Caucasians; to determine predictive factors and their relative importance for incidence and progression; and to determine factors predicting time to cataract surgery for those with visually disabling cataract in each racial group. Prospective data have already been collected as part of the NIA funded SEE project; baseline, 2, 6, and 8 year data are available from the 2520 participants on UV exposure, alcohol and tobacco use, medications, diseases such as hypertension and diabetes, and other key risk factors. Ocular photographs were taken at baseline and graded for presence and severity of cortical, nuclear, and posterior sub-capsular cataract, and taken but not yet graded for follow up visits. Vision and physical function measures were taken at each round, enabling analyses of functional impact of cataract and predictors of seeking cataract surgery. Models will be constructed to determine risk factors for cataract incidence and progression, testing for interactions by racial groups. Level of visual impairment due to cataract and effect on physical function within racial groups will be used to model triggers for subsequent cataract surgery. Such data will increase knowledge of cataractogenic mechanisms within racial groups, and provide more understanding of disparites in seeking cataract surgery. These data will advance the goal of reducing health disparity in visual disability from cataract among older African Americans.