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Prevalence of visual impairment/blindness in elderly adults from East Zone districts of São Paulo city

Grant number: 06/01354-7
Support type:Scholarships in Brazil - Doctorate (Direct)
Effective date (Start): August 01, 2006
Effective date (End): June 30, 2007
Field of knowledge:Health Sciences - Collective Health - Epidemiology
Principal researcher:Solange Rios Salomão
Grantee:Rafael Werneck Cinoto
Home Institution: Departamento de Oftalmologia. Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil


The overall objective of this project is to assess the burden of visual impairment/blindness in adults 50 years and older in São Paulo city. The project will be based in the study: "Evaluation of eye care services and the burden of visual impairment/blindness in São Paulo, Brazil" implemented by the Federal University of Sao Paulo (UNIFESP) with partial support from WHO using a standardized protocol. This study was carried out in a population-based sample of households randomly drawn from three districts of São Paulo. A member of each identified household was interviewed and adults 50 years of age or older in each identified household was invited to an examination site for visual acuity (VA) measurement and a basic ocular examination. The clinical information obtained will provide the basis upon which the prevalence of visual impairment/blindness in older adults, by cause, can be estimated. The findings of this project will, undoubtedly, be relevant to Government health policy planners. Through the use of the protocol and methods used for the previous surveys in India, Nepal, and China, cross-country comparisons will be straightforward. Population-based, samples of households were selected through random cluster sampling. Clusters were defined geographically based on census sectors in such a way that they had 200 adults 50 years of age or older. The cluster listing from the three identified study districts represents the sampling frame. The sample size for this study component was based on estimating the prevalence of cataract blindness (VA < 20/200) in persons of age 50 years and over. The calculation is based on estimating an anticipated 4. 0% prevalence within an error bound (precision) of 20% with 95% confidence and also adjusting the sample size for an anticipated 15% absenteeism and nonparticipation rate, and allowing for an arbitrary 50% increase in sample size to accommodate possible inefficiencies associated with the cluster sampling design. All households within the selected cluster were visited by the enumeration team. All persons were enumerated (by name, gender, and age) and all those  50 years were requested to come to the central site for ocular examination. For those who didn´t show up at the central site, even after multiple efforts to persuade him, a home exam was offered after the field work was completed. Informed consent was obtained for all examined persons. The examination procedures were: VA assessment, cataract surgery history, refraction, anterior segment examination, dilation and fundus examination. The following primary analysis will be conducted: - Prevalence rates with confidence intervals will be calculated for presenting and best corrected VA in the better eye and worst eye using the following categories: > 20/63, < 20/63 to > 20/200, < 20/200 to > 20/400 and < 20/400. - Multiple logistic regression will be used to investigate association of age, gender and education with visual impairment/blindness. Vision impairment/blindness will be analyzed as to the principal cause in each eye. - The prevalence of cataract blindness will be estimated and multiple logistic regression will be used to investigate association of age, gender and education with cataract vision impairment/blindness. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
SALOMAO‚ S.; CINOTO‚ R.; BEREZOVSKY‚ A.; ARAUJO-FILHO‚ A.; MITSUHIRO‚ M.; MENDIETA‚ L.; MORALES‚ P.; POKHAREL‚ G.; BELFORT‚ R.; ELLWEIN‚ L. Prevalence and causes of vision impairment and blindness in older adults in Brazil: the Sao Paulo Eye Study. OPHTHALMIC EPIDEMIOLOGY, v. 15, n. 3, p. 167-175, 2008.

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