OBJECTIVETo explore the relationship between the classification and degree of diabetic macular edema (DME) and the stages of diabetic retinopathy (DR), diabetic duration, classification of diabetes, use of insulin, and visual loss.

METHODSWe retrospectively analyzed the stages of DR, diabetic duration, classification of diabetes, use of insulin, and visual loss in 1 172 DR patients with fundus fluorescein angiography (FFA). The occurrence of DME in DR in each stage and the relationships between its related factors were analyzed.

RESULTSIn 1 172 patients, 633 eyes in 394 patients had DME (33.62%), including 265 (41.86%) with focal DME and 368 (58.14%) with diffuse DME. There were 246 (38.86%) eyes with mild DME, 189 (29.86%) with moderate DME, and 198 (31.28%) with severe DME. Significant correlations exhisted among the classification of DME (r = 0.975, P = 0.025), the degree of DME (r = 1.000, P = 0.000), and the stage of DR. DME deteriorated with the increase of the stages of DR. The visual loss significantly correlated with the degree of DME (r = -0.984, P = 0.003). The visual acuity was lower in patients with diffuse DME than those with focal DME. The diabetic duration significantly correlated with the classification and degree of DME (r = 0.962, P = 0.009). DME was mostly seen in patients with a disease course of six years or longer, and its severity and incidence increased along with the prolonged period. Also, The incidence of DME increased in patients with type 2 diabetes and patients who used insulin.

CONCLUSIONThe classification and degree of DME correlates with the stages of DR, diabetic duration, the classification of diabetes, the use of insulin, and visual loss.

Diabetic Retinopathy ; classification ; complications ; epidemiology ; Humans ; Insulin ; therapeutic use ; Macular Edema ; classification ; epidemiology ; etiology ; Retrospective Studies ; Vision Disorders ; complications ; epidemiology

INTRODUCTIONThe visual status of children with learning disabilities has not been extensively studied. This study aimed to compare vision disorders between children in mainstream classes and those with learning disabilities attending special education classes in government primary schools in Malaysia.

METHODSIn this cross-sectional comparative study, 60 school children (30 from mainstream classes and 30 from special education classes) who were matched in age (6-12 years old) and ethnicity (Malay, Chinese and Indian) were examined. The subjects were recruited using non-probability convenience sampling. A complete eye examination was performed to detect three major vision disorders, namely refractive error, lag of accommodation and convergence insufficiency.

RESULTSThe overall prevalence of refractive error, lag of accommodation and convergence insufficiency was found to be 65.0%, 43.3% and 35.2%, respectively. Convergence insufficiency (χ² = 24.073, p < 0.001) was found to be associated with children in special education classes. No association was found between refractive error and lag of accommodation (p > 0.05) with the type of classes.

CONCLUSIONChildren in special education classes are more likely to have convergence insufficiency compared to children in mainstream classes. Thus, vision screening programmes for children in special education classes may need to be modified.

Child ; Cross-Sectional Studies ; Education, Special ; Female ; Humans ; Learning Disorders ; complications ; epidemiology ; Mainstreaming (Education) ; Malaysia ; epidemiology ; Male ; Prevalence ; Schools ; Vision Disorders ; epidemiology ; Vision Screening ; methods ; Visual Acuity

Cerebral Palsy ; classification ; complications ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Developmental Disabilities ; complications ; Female ; Humans ; Infant ; Language Disorders ; complications ; Male ; Seizures ; complications ; Sex Factors ; Vision Disorders ; complications

INTRODUCTIONTo assess the association between sensory and cognitive function, and the potential influence of visual function on cognitive function assessment, in a sample of clients accessing aged care services.

MATERIALS AND METHODSWe recruited 260 non-institutionalised, frail, older individuals who sought aged care services. Visual acuity was assessed using a LogMAR chart and hearing function was measured using a portable pure-tone air conduction audiometer. Visual impairment was defined as visual acuity (VA) <6/12 (<39 letters read correctly in the better eye), moderate-to-severe hearing impairment as hearing thresholds >40 decibels (better ear) and cognitive impairment as Mini-Mental State Examination (MMSE) score <24.

RESULTSVision and hearing assessments were randomly performed in 168 and 164 aged care clients, respectively. Visual acuity correlated weakly with MMSE scores, either including (r = 0.27, P <0.001) or excluding (r = 0.21, P = 0.006) vision-related MMSE items. After partialling out the effect of age, the association remained (r = 0.23, P = 0.013 including, or r = 0.18, P = 0.044 excluding vision-related items). No correlation was found between MMSE scores and hearing thresholds (r = -0.07, P = 0.375). After adjusting for age, sex and stroke, mean MMSE scores were lower in persons with visual impairment than those with normal vision (25.2 + 0.5 versus 26.8 + 0.4 including, or 18.2 + 0.5 versus 19.2 + 0.3 excluding vision-related items), but were similar between subjects with none or mild and those with moderate-to-severe hearing loss (26.3 + 0.4 versus 26.0 + 0.4).

CONCLUSIONSIn this study sample, visual and cognitive functions were modestly associated, after excluding the influence of visual impairment on the MMSE assessment and adjusting for age. Hearing thresholds were not found to be associated with cognitive function.

Age Factors ; Aged ; Aged, 80 and over ; Australia ; epidemiology ; Cognition ; Cognition Disorders ; complications ; epidemiology ; Female ; Frail Elderly ; Geriatric Assessment ; Health Services for the Aged ; utilization ; Hearing Loss ; complications ; epidemiology ; Humans ; Male ; Pilot Projects ; Risk Assessment ; Sensation ; Surveys and Questionnaires ; Vision Disorders ; complications ; epidemiology

Community-based centres were surveyed to determine the frequency of and risk factors for falls among elderly Koreans. We examined fall-related risk factors, including physiological and physical health, psychosocial functions, self-reported physical capacity and activity, vision, and the use of medication, among 351 elderly people aged 65 years or older, with ambulatory. Forty-two per cent of elderly Korean subjects reported at least one episode of falling in the previous 12 months, 38% of whom had consequences that required either the attention of a physician or hospitalization. Factors significantly associated with an increased risk of falling were a restricted activity during the previous five years (adjusted OR 1.3), use of alternative therapy (adjusted OR 2.7), low knee flexor and extensor-muscle strength (adjusted OR 1.21 and 1.20), and poor balance with closed eyes (adjusted OR 8.32). We conclude that falls among older persons living in the community are common in Korea and that indicator of bad health and frailty or variables directly related to neuromuscular impairment are significant predictors of the risk of falling.
Accidental Falls/prevention & control/*statistics & numerical data ; Accidents, Home/prevention & control/*statistics & numerical data ; Activities of Daily Living ; Aged/physiology/psychology/*statistics & numerical data ; Aged, 80 and over ; Drug Utilization ; Female ; Gait ; Geriatric Assessment ; Health Status ; Housing/statistics & numerical data ; Humans ; Incidence ; Korea/epidemiology ; Male ; Mental Health ; Population Surveillance ; Prevalence ; Questionnaires ; Residence Characteristics/statistics & numerical data ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Socioeconomic Factors ; Vision Disorders/complications/epidemiology