Visual Impairment Risk With Chronic Conditions

Individuals with multiple chronic conditions, including hypertension, respiratory conditions, and heart disease, have elevated risk of visual impairment compared with healthy individuals, according to the results of a study published in JAMA Ophthalmology.

The researchers conducted a cross-sectional study using data from the National Health Interview Survey, including 387,780 individuals aged 18 years and older. The participants were classified into subgroups based on their patterns of chronic conditions: healthy, hypertensive, respiratory conditions, heart disease, and severely impaired.

Overall, the researchers found that individuals in the 4 disease groups had elevated risk of visual impairment.

Consultant360 reached out to study author Diane Zheng, PhD, from the Center for Cognitive Neurosciences & Aging at the University of Miami, to discuss the findings.

Consultant360: How did you decide on the relationship between chronic conditions and visual impairment for your research?

Diane Zheng, PhD: We classified the study participants into subgroups with different combinations of self-reported chronic conditions; we then examined the relationship between the chronic condition grouping and rate of reporting visual impairment while taking into account socio-economic and health behavior factors.

C360: How did you decide on the 4 subgroups chosen to represent chronic conditions (hypertensive, respiratory conditions, heart disease, severely impaired)?

DDZ: We used a data-driven method, latent class analysis, to classify the population. Models with different numbers of subgroups were compared through model fit indices, and the model that fits the actual data the best was the one selected.  The 5-class model (4 multi-morbidity groups and a healthy group) was the model that fits the data the best. The groups were named based on their main characteristic for the chronic conditions.

C360: You found that individuals from all 4 groups had elevated risk of visual impairment. How could this finding affect clinical practice?

DDZ: Our study results remind the clinicians that patients with multiple chronic conditions have elevated risks of visual impairment.   Clinicians should coordinate health care to avert more severe consequence of multi-morbidity, prevent visual impairment, and improve health.

C360: What knowledge gaps still exist in this area of study?

DDZ: The chronic conditions and visual impairment were self-reported in our study, which may be influenced by psychological factors. It would be great to examine if such a relationship holds when data are clinically objectively measured.

—Michael Potts

Zheng DD, Christ SL, Lam BL, et al. Patterns of chronic conditions and their association with visual impairment and health care use. JAMA Ophthalmol. 2020;138(4):387-394. doi:10.1001/jamaophthalmol.2020.0052