나이관련황반변성 관련요인: 국민건강영양조사 2008-2012

Tyler Hyungtaek Rim,Se Woong Kang,Jae Pil Shin,Seung-Young Yu,Su Jeong Song,Christopher Seungkyu Lee,Sung Soo Kim,the Epidemiologic Survey Committee of the Korean Ophthalmological Society 한국망막학회 2018 Journal of Retina Vol.3 No.1

Purpose: To evaluate the associations between early/late age-related macular degeneration (AMD) and systemic and ocular parameters using national population-based data. Methods: From 2008 to 2012, a total of 16,897 participants of the Korea National Health and Nutrition Examination Survey underwent ophthalmologic examinations by the Korean Ophthalmological Society. Cases of early and late (neovascular and geographic atrophy) AMD were identified using digital fundus images. Risk factors were identified using logistic regression. Results: Age-standardized prevalence of early and late AMD among subjects aged 40 years and older was 5.5% and 0.6%, respectively. Increasing age was the most significant risk factor for both early and late AMD (adjusted odds ratio [aOR]: 1.09, 95% confidence interval [CI]; 1.07–1.10; aOR: 1.14, 95% CI: 1.10−1.19, respectively). Patients who slept, on average, more than nine hours per day (aOR: 0.68, 95% CI: 0.47−1.00) and who were in the lowest quintile (≤ 38.21 g/dL) of high-density lipoprotein (HDL) cholesterol (aOR: 0.68, 95% CI: 0.51−0.92) were significantly associated with a lower prevalence of early AMD. Increasing spherical equivalent (SE) [aOR: 0.53 of the first quintile of SE ≤ -1.38 diopters (D), 95% CI: 0.35−0.78; aOR: 1.41 of the fifth quintile of SE ≥ +0.69 D, 95% CI: 1.07−1.86] was associated with a higher prevalence of early AMD. Lower quartile of systolic blood pressure (≤ 110.0 mmHg) was associated with a lower prevalence of neovascular AMD (aOR: 0.25, 95% CI: 0.09−0.67). Conclusions: Aging was the most significant risk factor for both early and late AMD. Lower level of HDL cholesterol, longer duration of sleep, and myopia had protective associations with early AMD, while lower systolic blood pressure had a protective association with neovascular AMD.

Epiretinal Membrane: Prevalence and Risk Factors from the Korea National Health and Nutrition Examination Survey, 2008 through 2012

김종민,이호영,신재필,안지윤,유제문,송수정,김상진,강세웅,Epidemiologic Survey Committee of the Korean Ophthalmologic Society 대한안과학회 2017 Korean Journal of Ophthalmology Vol.31 No.6

Purpose: To investigate the prevalence and risk factors for an epiretinal membrane (ERM) in Korean population. Methods: Using the database of the Korea National Health and Nutrition Examination Survey from 2008through 2012, 14,772 participants 40 years of age or older with gradable fundus photographs were included. The presence of ERM was determined by using fundus photographs. The prevalence of ERM was estimatedand possible risk factors including systemic factors, nutritional status, and blood tests were analyzed viamultiple logistic regression analyses. Results: The prevalence of ERM was 2.9% (95% confidence interval [CI], 2.6% to 3.3%). On multiple logisticregression analysis, the prevalence of ERM was affected by age. The odds ratios (ORs) against the fortieswere 2.70, 5.48, and 5.69 in the fifties, sixties, and seventies, respectively. ERM was also significantly affectedby cataract surgery (OR, 2.82; 95% CI, 2.08 to 3.81) and by the increase in intake of 100-mg calcium (OR,1.05; 95% CI, 1.00 to 1.11). ERM had negative associations with red blood cell count (OR, 0.66; 95% CI, 0.45to 0.95). Conclusions: The estimated nation-wide prevalence of ERM in Korea is 2.9%. The presence of ERM in thegeneral population is associated with age, cataract surgery, increased dietary calcium, and a low red bloodcell count.

포도 섭취와 당뇨망막증의 연관성

이보영(Bo Young Lee),지동현(Donghyun Jee),대한안과학회 역학조사위원회(Epidemiology Survey Committee of the Korean Ophthalmology Society) 대한안과학회 2016 대한안과학회지 Vol.57 No.2

목적: 포도의 섭취와 당뇨망막증의 유병률과의 연관성을 알아보고자 하였다. 대상과 방법: 국민건강영양조사 2008‐2011 중에서 30세 이상이면서 당뇨병을 가지고 있는 1,555명을 대상으로 하였다. 포도 섭취 빈도는 식품 섭취 빈도 조사법을 기준으로 조사하여, 지난 1년간 평균 포도 섭취의 빈도를 10단계로 나누어 평가하였다. 당뇨망막증은산동 후에 7장의 표준망막사진을 얻어 분석하였다. 당뇨망막증을 Airlie House 분류체계에 따라서 전체 당뇨망막증, 증식 당뇨망막증,그리고 실명위험 당뇨망막증으로 나누어 분석하였다. 결과: 당뇨망막증은 16.9 ± 1.2%에서 발견되었다. 포도 섭취 빈도가 1단계 증가함에 따라 전체당뇨망막증은 14% 감소하였고(odds ratio [OR] 0.86, 95% confidence interval [CI] 0.75‐0.98), 증식 당뇨망막증은 35% 감소하였으며(OR 0.65, 95% CI 0.48‐0.88), 실명위험 당뇨망막증은 23% 감소하였다(OR 0.77, 95% CI 0.60‐0.99). 포도 섭취 빈도가 한 달에 1회 미만일 경우에 비하여 한 달에 2‐3회섭취할 경우에, 전체 당뇨망막증은 46% 감소하였고(OR 0.54, 95% CI 0.33‐0.89), 증식 당뇨망막증은 75% 감소하였으며(OR 0.25,95% CI 0.07‐0.81), 실명위험 당뇨망막증은 64% 감소하였다(OR 0.36, 95% CI 0.13‐0.95). 결론: 포도 섭취가 증가할수록 당뇨망막증의 유병률이 감소하였다. Purpose: To evaluate the association between grape intake and diabetic retinopathy. Methods: A population-based cross-sectional study using a nation-wide, stratified, multistage, clustered sampling method included 1,555 subjects aged ≥30 years who participated in the Korean National Health and Nutritional Examination Survey 2008-2011. All participants performed standardized interviews, food frequency questionnaires (FFQ), and comprehensive ophthalmic examinations. Grape intake was evaluated by an FFQ using 10 intervals of average frequency of grape intake during the past year. Diabetic retinopathy (DR) was evaluated by 7 standard retinal fundus photographs after pharmacological pupil dilatation. DR was classified as any DR, proliferative DR, or vision-threatening DR by the modified Air House classification system. Results: The prevalence of diabetes was 16.9 ± 1.2%. As the grape intake frequency increases in FFQ, the odds ratio (OR) for any DR, proliferative DR, and vision-threatening DR were 0.86 (95% confidence interval [CI], 0.75-0.98), 0.65 (95% CI, 0.48-0.88), and 0.77 (95% CI, 0.60-0.99) respectively. Compared to the group with a grape intake of less than once per month, the OR for any DR, proliferative DR, and vision-threatening DR in the group with a grape intake of more than 2-3 times per month were 0.54 (95% CI 0.33-0.89), 0.25 (95% CI 0.07-0.81), 0.36 (95% CI 0.13-0.95), respectively. Conclusions: The intake of grapes was inversely associated with the prevalence of DR.

국내 백내장 수술 현황과 향후 전망: 국민건강 영양 조사자료

임형택,우영제,박현주,김성수,대한안과학회역학조사위원회,Tyler Hyung Taek Rim,Young Jae Woo,Hyun Joo Park,Sung Soo Kim,The Epidemiologic Survey Committee in the Korean Ophthalmological Society 대한안과학회 2014 대한안과학회지 Vol.55 No.12

Purpose: To identify socio-demographic factors in cataract surgery in Korea and expect future effect of the bundle of service system. Methods: We analyzed the number of people undergoing cataract surgery and associated factors such as surgery ratio, region, age, income, and insurance status of 28,980 patients older than 40 years using data from the fifth Korea National Health and Nutrition Examination Survey 2008-2012 (KNHANES). Results: Among total population in 2012, 47.5% of elderly aged 80 years and older have received cataract surgery. According to region in patients older than 40, Jeollanam-do showed the highest proportion of patients undergoing cataract surgery, at 12%, Daejeon showed the lowest proportion of 3.6%, and Seoul showed 6.8%. Regional analysis was also performed by analyzing the number of cataract patients per ophthalmologist. Jeollanam-do showed the highest with 40,115 patients per ophthalmologist, and Seoul showed the least with 1,094 patients per ophthalmologist. The sociodemographic factors such as education or income, were not associated with cataract surgery after adjusting for age and regional difference. On the other hand, subjects with medicaid were associated with 1.6-fold (95% confidence interval, 1.3-2.0) higher rate of cataract surgery than subjects with national health insurance. Conclusions: Regional disparity was found in the cataract surgery rate and surgery rate per an ophthalmologists, whereas sociodemographic factors were not significant in receiving benefits of cataract surgery. Before the amount of bundled payment is changing, down-leveling of quality of care and deepening of disparities among health care provider should be considered.J Korean Ophthalmol Soc 2014;55(12):1772-1778