title: Nine-year refractive changes in the Barbados Eye Studies.
abstract: OBJECTIVE
  To describe 9-year changes in refractive errors and estimate incidence of myopia and hyperopia in adults of African-descent, along with associated risk factors.
  
  
  METHODS
  The 9-year follow-up of the Barbados Eye Studies (1997-2003) reexamined 2793 surviving cohort members (81% participation). Refractive errors were determined by automated refraction. Myopia/hyperopia were defined as spherical equivalent < -0.5 diopters (D)/> +0.5 D, and the cutoff for moderate-high myopia/hyperopia was 3.0 D. Incidence rates of myopia/hyperopia were estimated by the product-limit approach, based on eyes without such conditions at baseline. Risk factors were evaluated by logistic regression in discrete time hazard models.
  
  
  RESULTS
  Nine-year refraction changes varied by age. Persons aged 40 to 49 years experienced hyperopic shifts (median, +0.38 D), whereas persons > or =60 years had myopic shifts (median, -0.75D). Overall 9-year incidence was 12.0% for myopia and 29.5% for hyperopia; rates were 3.6% and 2.0% for moderate-high myopia and hyperopia, respectively. Myopia risk increased with age, baseline nuclear lens opacities (risk ratio [RR] = 1.7; 95% confidence interval [CI]: 1.01-2.9), glaucoma (RR = 6.0, 95% CI: 3.9-9.3), and ocular hypertension (RR = 2.0, 95% CI: 1.3-3.0), while cortical lens opacities decreased risk (RR = 0.6, 95% CI: 0.4-0.9). Incidence of moderate-high myopia was also related to baseline age, nuclear opacities, glaucoma, male gender (RR = 1.7, 95% CI: 1.0-2.8), and diabetes history (RR = 1.9, 95% CI: 1.01-3.5). Hyperopia risk decreased with older age, male gender, and glaucoma diagnosis.
  
  
  CONCLUSIONS
  Refractive errors continue to develop frequently in older adults. Nuclear lens opacities, glaucoma, and diabetes increase the risk of older-onset myopia, a result of public health relevance to this and similar African-origin populations.
authors.affiliation: Department of Preventive Medicine, Stony Brook University, New York, 11794, USA. swu@notes.cc.sunysb.edu
authors.forename: Suh-Yuh
authors.initials: SY
authors.lastname: Wu
authors.forename: Yun Joo
authors.initials: YJ
authors.lastname: Yoo
authors.forename: Barbara
authors.initials: B
authors.lastname: Nemesure
authors.forename: Anselm
authors.initials: A
authors.lastname: Hennis
authors.forename: M Cristina
authors.initials: MC
authors.lastname: Leske
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001460:Barbados / Q000453:epidemiology; D044383:Black People / Q000208:ethnology*; D002386:Cataract / Q000150:complications; D048909:Diabetes Complications / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000150:complications; D006801:Humans; D006956:Hyperopia / Q000208:ethnology* / Q000209:etiology / Q000503:physiopathology; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000208:ethnology* / Q000209:etiology / Q000503:physiopathology; D016016:Proportional Hazards Models; D012029:Refraction, Ocular; D012307:Risk Factors