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Cataract prevalence varies substantially with assessment systems: comparison of clinical and photographic grading in a population-based study.

Publication ,  Journal Article
Tan, ACS; Wang, JJ; Lamoureux, EL; Wong, W; Mitchell, P; Li, J; Tan, AG; Wong, TY
Published in: Ophthalmic Epidemiol
August 2011

PURPOSE: Cataract is the major cause of blindness worldwide yet there is no consensus on its assessment and definition. This study compares age-related cataract prevalence derived from two commonly used methods: clinical assessment using the Lens Opacity Classification System (LOCS III) and photographic grading using the Wisconsin Cataract Grading System (Wisconsin System). METHODS: The Singapore Malay Eye Study is a population-based study of 3,280 Singapore Malays aged 40-80 years. Presence of nuclear, cortical and posterior sub-capsular cataract was assessed clinically during slit-lamp examination using LOCS III, and via slit-lamp and retro-illumination photographic grading using the Wisconsin System. Analyses were conducted to determine agreement in cataract prevalence estimates between the two grading Systems and approaches. RESULTS: Poor agreement was found between severity levels of the two grading scales for all three cataract types. Using currently accepted cut-offs to define nuclear (≥ 4 on both LOCS III and Wisconsin System), cortical (≥ 2 in LOCS III, ≥ 25% in Wisconsin) and PSC (≥ 2 in LOCS III, ≥ 5 % in Wisconsin) cataract, the LOCS III overestimated the prevalence of significant cataract as compared to the Wisconsin System, with nuclear cataract prevalence, 27.5% (LOCS III) versus 17.0% (Wisconsin System), cortical cataract prevalence, 27.9% versus 7.0% and posterior sub-capsular cataract prevalence, 7.8% versus 5.1%. CONCLUSION: The prevalence of cataract in a population varies substantially by measurement methods, with systematically different estimates found using the two most frequent cataract grading systems. This study re-emphasizes the need for global standards to assess and define cataract for epidemiologic and clinical studies.

Duke Scholars

Published In

Ophthalmic Epidemiol

DOI

EISSN

1744-5086

Publication Date

August 2011

Volume

18

Issue

4

Start / End Page

164 / 170

Location

England

Related Subject Headings

  • Singapore
  • Prevalence
  • Photography
  • Middle Aged
  • Humans
  • Health Services Research
  • Epidemiology
  • Diagnostic Techniques, Ophthalmological
  • Cataract
  • Asian People
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Tan, A. C. S., Wang, J. J., Lamoureux, E. L., Wong, W., Mitchell, P., Li, J., … Wong, T. Y. (2011). Cataract prevalence varies substantially with assessment systems: comparison of clinical and photographic grading in a population-based study. Ophthalmic Epidemiol, 18(4), 164–170. https://doi.org/10.3109/09286586.2011.594205
Tan, Anna C. S., Jie Jin Wang, Ecosse L. Lamoureux, Wanling Wong, Paul Mitchell, Jialiang Li, Ava Grace Tan, and Tien Y. Wong. “Cataract prevalence varies substantially with assessment systems: comparison of clinical and photographic grading in a population-based study.Ophthalmic Epidemiol 18, no. 4 (August 2011): 164–70. https://doi.org/10.3109/09286586.2011.594205.
Tan ACS, Wang JJ, Lamoureux EL, Wong W, Mitchell P, Li J, et al. Cataract prevalence varies substantially with assessment systems: comparison of clinical and photographic grading in a population-based study. Ophthalmic Epidemiol. 2011 Aug;18(4):164–70.
Tan, Anna C. S., et al. “Cataract prevalence varies substantially with assessment systems: comparison of clinical and photographic grading in a population-based study.Ophthalmic Epidemiol, vol. 18, no. 4, Aug. 2011, pp. 164–70. Pubmed, doi:10.3109/09286586.2011.594205.
Tan ACS, Wang JJ, Lamoureux EL, Wong W, Mitchell P, Li J, Tan AG, Wong TY. Cataract prevalence varies substantially with assessment systems: comparison of clinical and photographic grading in a population-based study. Ophthalmic Epidemiol. 2011 Aug;18(4):164–170.

Published In

Ophthalmic Epidemiol

DOI

EISSN

1744-5086

Publication Date

August 2011

Volume

18

Issue

4

Start / End Page

164 / 170

Location

England

Related Subject Headings

  • Singapore
  • Prevalence
  • Photography
  • Middle Aged
  • Humans
  • Health Services Research
  • Epidemiology
  • Diagnostic Techniques, Ophthalmological
  • Cataract
  • Asian People