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Invited Commentary
October 2017

Epidemiology of a Rare Event: The Singapore Epidemiology of Eye Disease Study

Author Affiliations
  • 1The Kresge Eye Institute, Wayne State University School of Medicine, Detroit, Michigan
JAMA Ophthalmol. 2017;135(10):1029. doi:10.1001/jamaophthalmol.2017.3225

Retinal emboli are rare, with a prevalence in most of the relatively few studies on the subject, to my knowledge, of approximately 1 in 100 adults and an even smaller annual incidence.1,2 The study by Cheung et al in the present issue of JAMA Ophthalmology3 involves the multiethnic population of Singapore and found that retinal emboli were present in only 88 of 9978 individuals who had retinal photographs (0.9%). This randomly selected sample of adults aged 40 to 80 years comprised, in almost equal numbers, of members of the 3 major ethnic groups residing in Singapore: Chinese, Malay, and Indian. Cheung et al3 provided data relevant to factors associated with the cause(s) of retinal emboli and arterial occlusions that are common to all 3 groups and factors that are unique to each group. Most of the associated factors that this study revealed had also been evident from epidemiologic studies of retinal vein occlusions in other populations, including increasing age,4 hypertension,5 history of stroke,6 smoking,7 and renal disease.8 A 2008 US population-based study9 of the prevalence of retinal vein occlusions, written by some of the authors of the present article, found some of the same risk factors for this, presumably largely thrombotic, retinal vascular entity as for retinal arterial embolic occlusions.

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