Descriptive Assessment of Eye Cataracts in the Jirel Population, Nepal, March 2015

Jose Escarcega

Mentor: Matthew P. Johnson, Ph.D.Associate ProfessorSouth Texas Diabetes and Obesity InstituteSchool of MedicineUniversity of Texas Rio Grande Valley

Introduction

Visual Impairment•Defined as blindness and/or poor vision•Approximately 11% of the world’s

population is visually impaired•Important public health issue•Burdens health care systems

Cataracts•Defined as clouding of the lens

▫This results from proteins ‘clumping’ together

•Leading cause of visual impairment, globally

•Higher prevalence in developing countries

•Risk factors include: age, UV exposure, and smoking

The Jirel people of Dolakha District, eastern Nepal

Purpose•To perform descriptive statistics of self-

and clinician-reported data from the Jirel population, focusing on cataract disease.

•To determine if there were any

correlations between variables studied that could help explain ocular-related pathology in this population, specifically cataract disease.

Methods

Overview of Methods: Study Design

Data were provided to J. Escarcega for analysis regarding cataract disease

Investigators enter data into an Excel database

First data collection session by Dr. Johnson and his colleagues

Variables Analyzed•Demographic

▫Gender, age•Social

▫Smoking, alcohol, tobacco chewing•Clinical

▫Systemic illness, hypertension, diabetes, asthma, cerebrovascular accident

Results

Demographic Analyses

Gender Distribution

39%

61%

Gender Distribution of the Jirel Eye Cataract Study Population

MaleFemale

N=229

Age Distribution by Gender Male Female Total

Age <49 47 90 137Age >50 42 50 92Total 89 140 229

Age Distribution

0-19 20-39 40-59 60-79 80-990

10

20

30

40

50

60

70

80

90

100

11

76

91

43

8

Age groups

Num

ber

of p

atie

nts

Social DeterminantsBehavior Use Don’t UseSmoking 26% 74%

Alcohol Use 56% 44%Tobacco Chewing 13% 87%

N=229

Clinical FindingsDisease Yes No Data not

Available

Systemic Illness 56% 44% 0%Hypertension 12% 85% 3%

Diabetes 5% 92% 3%Asthma 5% 92% 3%

Cerebrovascular Accident 0% 97% 3%

Association between selected variables and cataract disease

Variable P-ValueAge 2.38e-13

Gender 0.674Smoking 0.01645Alcohol 0.8052Tobacco 0.6305

Systemic Illness 0.00155Hypertension 0.001881

Diabetes 0.05916Asthma 0.01398

Conclusions

Conclusions:•Demographics: >60% female

•Social Determinants: 56% alcohol use, 26% smoking

•Clinical Findings: 56% systemic illness, 12% hypertension

Association of Variables with Cataract Disease•Age> Hypertension> Systemic Illness>

Asthma> Smoking

•These associations make sense biologically

Limitations•Small sample size

•Categorized cataract types into one group to maximize study power

•Only able to analyze selected variables▫As a result, not able to study all the

possible associations between variables and cataract disease

Future Studies•Study more variables related to cataracts

and other eye diseases

•Determine additional risk factors

Acknowledgements• Research funding

▫ NIH/NEI grant number EY024384 (Johnson/Williams-Blangero)

• Personnel▫ South Texas Diabetes & Obesity Institute, UTRGV, Brownsville, TX: Matthew

P. Johnson, Ph.D.; Sarah Williams-Blangero, Ph.D.; John Blangero, Ph.D.; Sandy Laston, R.N., Ph.D.

• Tilganga Institute of Ophthalmology, Kathmandu, Nepal:▫ Suman S. Thapa, M.D., Ph.D.; Mohan K. Shrestha, M.P.H. 

• Miami University, Oxford, OH: ▫ Janardan Subedi, Ph.D.

• Wright State University, Kettering, OH: ▫ Bradford Towne, Ph.D.

Thank you!•The University of Texas School of Public

Health, Brownsville Regional Campus▫Matthew P. Johnson, PhD

•The University of Texas at Austin▫Leanne Field, PhD

Questions?