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Pterygium in Indonesia: prevalence, severity and risk factors
Aim: To determine prevalence rates, severity, and risk factors for pterygium in adults in provincial Indonesia and to validate a clinical grading scheme in a population based setting. Methods: A population based prevalence survey of 1210 adults aged 21 years and above was conducted in five rural vil...
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| Published in: | British journal of ophthalmology 2002-12, Vol.86 (12), p.1341-1346 |
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| container_title | British journal of ophthalmology |
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| creator | Gazzard, G Saw, S-M Farook, M Koh, D Widjaja, D Chia, S-E Hong, C-Y Tan, D T H |
| description | Aim: To determine prevalence rates, severity, and risk factors for pterygium in adults in provincial Indonesia and to validate a clinical grading scheme in a population based setting. Methods: A population based prevalence survey of 1210 adults aged 21 years and above was conducted in five rural villages and one provincial town in Riau province, Sumatra, Indonesia, an area near to the equator. A one stage household cluster sampling procedure was employed: 100 households were randomly selected from each village or town. Pterygia were graded for severity (T1 to T3, by visibility of episcleral vessels) and the basal and apical extent measured by an ophthalmologist (GG) with a hand held slit lamp. Refraction was measured by hand held autorefractor (Retinomax). Face to face household interviews assessed outdoor activity, occupation, and smoking. The participation rate was 96.7%. Results: The mean age was 36.6 years (SD 13.1), 612 were male. The age adjusted prevalence rate of any pterygium was 10.0% (95% confidence intervals (CI) 8.2 to 11.7) and of bilateral pterygia was 4.1% (95% CI 2.9 to 5.3). There was a significant dose-response relation with age (2.9% (95% CI 0.4 to 5.8) for 21–29 years versus 17.3% (95% CI 10.4 to 24.2) 50 years and above; p for trend |
| doi_str_mv | 10.1136/bjo.86.12.1341 |
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Methods: A population based prevalence survey of 1210 adults aged 21 years and above was conducted in five rural villages and one provincial town in Riau province, Sumatra, Indonesia, an area near to the equator. A one stage household cluster sampling procedure was employed: 100 households were randomly selected from each village or town. Pterygia were graded for severity (T1 to T3, by visibility of episcleral vessels) and the basal and apical extent measured by an ophthalmologist (GG) with a hand held slit lamp. Refraction was measured by hand held autorefractor (Retinomax). Face to face household interviews assessed outdoor activity, occupation, and smoking. The participation rate was 96.7%. Results: The mean age was 36.6 years (SD 13.1), 612 were male. The age adjusted prevalence rate of any pterygium was 10.0% (95% confidence intervals (CI) 8.2 to 11.7) and of bilateral pterygia was 4.1% (95% CI 2.9 to 5.3). There was a significant dose-response relation with age (2.9% (95% CI 0.4 to 5.8) for 21–29 years versus 17.3% (95% CI 10.4 to 24.2) 50 years and above; p for trend <0.001) and occupations with more time outdoors (p for trend = 0.02). This was true for both sexes, all grades of lesion (T1 to T3), and bilateral disease. A multivariate logistic regression model showed pterygium was independently related to increasing age and outdoor activity 10 years earlier. The mean basal diameter = 3.3 mm (SD 1.51, range 0.1–9.5) and extent from limbus = 1.4 mm (SD 1.18, range 0.1–8.0). Higher grade pterygia were larger for basal and apical extent (p for trend <0.001). The presence of pterygium was associated with astigmatism (defined as cylinder at least −0.5 dioptres (D); p <0.001). This association increased with increasing grade of lesion (p for trend <0.001). Median cylinder for those with pterygium (−0.50 D) was greater than for those without (−0.25D), (p <0.001), and increased with higher grade of lesion (p for trend <0.001). For eyes with pterygia, magnitude of astigmatism was associated with greatest extent from the limbus, (p = 0.03), but not basal width (p = 0.99). Conclusions: There is a high prevalence rate of pterygia in provincial Sumatra. The independent increase with age and past outdoor activity (a surrogate for sun exposure) is consistent with previous findings. Clinical grading of pterygium morphology by the opacity of the lesion was a useful additional marker of severity.]]></description><identifier>ISSN: 0007-1161</identifier><identifier>EISSN: 1468-2079</identifier><identifier>DOI: 10.1136/bjo.86.12.1341</identifier><identifier>PMID: 12446360</identifier><identifier>CODEN: BJOPAL</identifier><language>eng</language><publisher>BMA House, Tavistock Square, London, WC1H 9JR: BMJ Publishing Group Ltd</publisher><subject>Adult ; Age Distribution ; Astigmatism ; Astigmatism - complications ; Biological and medical sciences ; Diseases of eyelid, conjunctiva and lacrimal tracts ; epidemiology ; Female ; Households ; Humans ; Indonesia - epidemiology ; Logistic Models ; Male ; Medical personnel ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Ophthalmology ; Participation ; Pathogenesis ; Population ; Prevalence ; pterygium ; Pterygium - complications ; Pterygium - epidemiology ; Risk Factors ; Rural Health ; Sample size ; Socioeconomic Factors ; sun exposure ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the eye and orbit ; Ultraviolet radiation ; Ultraviolet Rays - adverse effects ; Urban Health ; Visual Acuity - physiology ; World Views</subject><ispartof>British journal of ophthalmology, 2002-12, Vol.86 (12), p.1341-1346</ispartof><rights>Copyright 2002 British Journal of Ophthalmology</rights><rights>2003 INIST-CNRS</rights><rights>COPYRIGHT 2002 BMJ Publishing Group Ltd.</rights><rights>Copyright: 2002 Copyright 2002 British Journal of Ophthalmology</rights><rights>Copyright © Copyright 2002 British Journal of Ophthalmology 2002</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b618t-5546939b1bed4a80e25acae021fe42de95377469fe1161360687be4c550e39123</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1771435/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1771435/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14027723$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12446360$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gazzard, G</creatorcontrib><creatorcontrib>Saw, S-M</creatorcontrib><creatorcontrib>Farook, M</creatorcontrib><creatorcontrib>Koh, D</creatorcontrib><creatorcontrib>Widjaja, D</creatorcontrib><creatorcontrib>Chia, S-E</creatorcontrib><creatorcontrib>Hong, C-Y</creatorcontrib><creatorcontrib>Tan, D T H</creatorcontrib><title>Pterygium in Indonesia: prevalence, severity and risk factors</title><title>British journal of ophthalmology</title><addtitle>Br J Ophthalmol</addtitle><description><![CDATA[Aim: To determine prevalence rates, severity, and risk factors for pterygium in adults in provincial Indonesia and to validate a clinical grading scheme in a population based setting. Methods: A population based prevalence survey of 1210 adults aged 21 years and above was conducted in five rural villages and one provincial town in Riau province, Sumatra, Indonesia, an area near to the equator. A one stage household cluster sampling procedure was employed: 100 households were randomly selected from each village or town. Pterygia were graded for severity (T1 to T3, by visibility of episcleral vessels) and the basal and apical extent measured by an ophthalmologist (GG) with a hand held slit lamp. Refraction was measured by hand held autorefractor (Retinomax). Face to face household interviews assessed outdoor activity, occupation, and smoking. The participation rate was 96.7%. Results: The mean age was 36.6 years (SD 13.1), 612 were male. The age adjusted prevalence rate of any pterygium was 10.0% (95% confidence intervals (CI) 8.2 to 11.7) and of bilateral pterygia was 4.1% (95% CI 2.9 to 5.3). There was a significant dose-response relation with age (2.9% (95% CI 0.4 to 5.8) for 21–29 years versus 17.3% (95% CI 10.4 to 24.2) 50 years and above; p for trend <0.001) and occupations with more time outdoors (p for trend = 0.02). This was true for both sexes, all grades of lesion (T1 to T3), and bilateral disease. A multivariate logistic regression model showed pterygium was independently related to increasing age and outdoor activity 10 years earlier. The mean basal diameter = 3.3 mm (SD 1.51, range 0.1–9.5) and extent from limbus = 1.4 mm (SD 1.18, range 0.1–8.0). Higher grade pterygia were larger for basal and apical extent (p for trend <0.001). The presence of pterygium was associated with astigmatism (defined as cylinder at least −0.5 dioptres (D); p <0.001). This association increased with increasing grade of lesion (p for trend <0.001). Median cylinder for those with pterygium (−0.50 D) was greater than for those without (−0.25D), (p <0.001), and increased with higher grade of lesion (p for trend <0.001). For eyes with pterygia, magnitude of astigmatism was associated with greatest extent from the limbus, (p = 0.03), but not basal width (p = 0.99). Conclusions: There is a high prevalence rate of pterygia in provincial Sumatra. The independent increase with age and past outdoor activity (a surrogate for sun exposure) is consistent with previous findings. Clinical grading of pterygium morphology by the opacity of the lesion was a useful additional marker of severity.]]></description><subject>Adult</subject><subject>Age Distribution</subject><subject>Astigmatism</subject><subject>Astigmatism - complications</subject><subject>Biological and medical sciences</subject><subject>Diseases of eyelid, conjunctiva and lacrimal tracts</subject><subject>epidemiology</subject><subject>Female</subject><subject>Households</subject><subject>Humans</subject><subject>Indonesia - epidemiology</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Ophthalmology</subject><subject>Participation</subject><subject>Pathogenesis</subject><subject>Population</subject><subject>Prevalence</subject><subject>pterygium</subject><subject>Pterygium - complications</subject><subject>Pterygium - epidemiology</subject><subject>Risk Factors</subject><subject>Rural Health</subject><subject>Sample size</subject><subject>Socioeconomic Factors</subject><subject>sun exposure</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the eye and orbit</subject><subject>Ultraviolet radiation</subject><subject>Ultraviolet Rays - adverse effects</subject><subject>Urban Health</subject><subject>Visual Acuity - physiology</subject><subject>World Views</subject><issn>0007-1161</issn><issn>1468-2079</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><recordid>eNqFksGL1DAYxYso7rh69ShFURC2NV-aJq2gsAyuruzqHnTxFtL065jZNh2TdnD-e1Nm2FllQHIISX55eXm8KHoKJAXI-Jtq2acFT4GmkDG4F82A8SKhRJT3oxkhRCQAHI6iR94vw5JyEA-jI6CM8YyTWfTuakC3WZixi42Nz23dW_RGvY1XDteqRavxJPa4RmeGTaxsHTvjb-JG6aF3_nH0oFGtxye7-Tj6fvbh2_xTcvH14_n89CKpOBRDkueMl1lZQYU1UwVBmiutkFBokNEayzwTIiANTmaDL16ICpnOc4JZCTQ7jt5vdVdj1WGt0Q5OtXLlTKfcRvbKyL9PrPkpF_1aghDAsjwIvNoJuP7XiH6QnfEa21ZZ7EcvBRWk5PkEvvgHXPajs-Fzk1ZJgBA2-Xm-pRYhImls04dX9SQpT8s8ZFsSHqCTA9ACLQaHIebGhO27eHIAD6PGzuhDfLrlteu9d9jcxgFETt2QoRuy4BKonLoRLjy7G-Ie35UhAC93gPJatY1TVhu_5xihQtBs79T4AX_fnit3I7nIRC6_XM9leX11-eNSfJZngX-95atu-T-TfwClHttb</recordid><startdate>20021201</startdate><enddate>20021201</enddate><creator>Gazzard, G</creator><creator>Saw, S-M</creator><creator>Farook, M</creator><creator>Koh, D</creator><creator>Widjaja, D</creator><creator>Chia, S-E</creator><creator>Hong, C-Y</creator><creator>Tan, D T H</creator><general>BMJ Publishing Group Ltd</general><general>BMJ</general><general>BMJ Publishing Group LTD</general><general>Copyright 2002 British Journal of Ophthalmology</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20021201</creationdate><title>Pterygium in Indonesia: prevalence, severity and risk factors</title><author>Gazzard, G ; Saw, S-M ; Farook, M ; Koh, D ; Widjaja, D ; Chia, S-E ; Hong, C-Y ; Tan, D T H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b618t-5546939b1bed4a80e25acae021fe42de95377469fe1161360687be4c550e39123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adult</topic><topic>Age Distribution</topic><topic>Astigmatism</topic><topic>Astigmatism - complications</topic><topic>Biological and medical sciences</topic><topic>Diseases of eyelid, conjunctiva and lacrimal tracts</topic><topic>epidemiology</topic><topic>Female</topic><topic>Households</topic><topic>Humans</topic><topic>Indonesia - epidemiology</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Ophthalmology</topic><topic>Participation</topic><topic>Pathogenesis</topic><topic>Population</topic><topic>Prevalence</topic><topic>pterygium</topic><topic>Pterygium - complications</topic><topic>Pterygium - epidemiology</topic><topic>Risk Factors</topic><topic>Rural Health</topic><topic>Sample size</topic><topic>Socioeconomic Factors</topic><topic>sun exposure</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the eye and orbit</topic><topic>Ultraviolet radiation</topic><topic>Ultraviolet Rays - adverse effects</topic><topic>Urban Health</topic><topic>Visual Acuity - physiology</topic><topic>World Views</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gazzard, G</creatorcontrib><creatorcontrib>Saw, S-M</creatorcontrib><creatorcontrib>Farook, M</creatorcontrib><creatorcontrib>Koh, D</creatorcontrib><creatorcontrib>Widjaja, D</creatorcontrib><creatorcontrib>Chia, S-E</creatorcontrib><creatorcontrib>Hong, C-Y</creatorcontrib><creatorcontrib>Tan, D T H</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gazzard, G</au><au>Saw, S-M</au><au>Farook, M</au><au>Koh, D</au><au>Widjaja, D</au><au>Chia, S-E</au><au>Hong, C-Y</au><au>Tan, D T H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pterygium in Indonesia: prevalence, severity and risk factors</atitle><jtitle>British journal of ophthalmology</jtitle><addtitle>Br J Ophthalmol</addtitle><date>2002-12-01</date><risdate>2002</risdate><volume>86</volume><issue>12</issue><spage>1341</spage><epage>1346</epage><pages>1341-1346</pages><issn>0007-1161</issn><eissn>1468-2079</eissn><coden>BJOPAL</coden><abstract><![CDATA[Aim: To determine prevalence rates, severity, and risk factors for pterygium in adults in provincial Indonesia and to validate a clinical grading scheme in a population based setting. Methods: A population based prevalence survey of 1210 adults aged 21 years and above was conducted in five rural villages and one provincial town in Riau province, Sumatra, Indonesia, an area near to the equator. A one stage household cluster sampling procedure was employed: 100 households were randomly selected from each village or town. Pterygia were graded for severity (T1 to T3, by visibility of episcleral vessels) and the basal and apical extent measured by an ophthalmologist (GG) with a hand held slit lamp. Refraction was measured by hand held autorefractor (Retinomax). Face to face household interviews assessed outdoor activity, occupation, and smoking. The participation rate was 96.7%. Results: The mean age was 36.6 years (SD 13.1), 612 were male. The age adjusted prevalence rate of any pterygium was 10.0% (95% confidence intervals (CI) 8.2 to 11.7) and of bilateral pterygia was 4.1% (95% CI 2.9 to 5.3). There was a significant dose-response relation with age (2.9% (95% CI 0.4 to 5.8) for 21–29 years versus 17.3% (95% CI 10.4 to 24.2) 50 years and above; p for trend <0.001) and occupations with more time outdoors (p for trend = 0.02). This was true for both sexes, all grades of lesion (T1 to T3), and bilateral disease. A multivariate logistic regression model showed pterygium was independently related to increasing age and outdoor activity 10 years earlier. The mean basal diameter = 3.3 mm (SD 1.51, range 0.1–9.5) and extent from limbus = 1.4 mm (SD 1.18, range 0.1–8.0). Higher grade pterygia were larger for basal and apical extent (p for trend <0.001). The presence of pterygium was associated with astigmatism (defined as cylinder at least −0.5 dioptres (D); p <0.001). This association increased with increasing grade of lesion (p for trend <0.001). Median cylinder for those with pterygium (−0.50 D) was greater than for those without (−0.25D), (p <0.001), and increased with higher grade of lesion (p for trend <0.001). For eyes with pterygia, magnitude of astigmatism was associated with greatest extent from the limbus, (p = 0.03), but not basal width (p = 0.99). Conclusions: There is a high prevalence rate of pterygia in provincial Sumatra. The independent increase with age and past outdoor activity (a surrogate for sun exposure) is consistent with previous findings. Clinical grading of pterygium morphology by the opacity of the lesion was a useful additional marker of severity.]]></abstract><cop>BMA House, Tavistock Square, London, WC1H 9JR</cop><pub>BMJ Publishing Group Ltd</pub><pmid>12446360</pmid><doi>10.1136/bjo.86.12.1341</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | British journal of ophthalmology, 2002-12, Vol.86 (12), p.1341-1346 |
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| subjects | Adult Age Distribution Astigmatism Astigmatism - complications Biological and medical sciences Diseases of eyelid, conjunctiva and lacrimal tracts epidemiology Female Households Humans Indonesia - epidemiology Logistic Models Male Medical personnel Medical sciences Middle Aged Multivariate Analysis Ophthalmology Participation Pathogenesis Population Prevalence pterygium Pterygium - complications Pterygium - epidemiology Risk Factors Rural Health Sample size Socioeconomic Factors sun exposure Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the eye and orbit Ultraviolet radiation Ultraviolet Rays - adverse effects Urban Health Visual Acuity - physiology World Views |
| title | Pterygium in Indonesia: prevalence, severity and risk factors |
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