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Refractive, corneal and ocular residual astigmatism: distribution in a German population and age-dependency - the Gutenberg health study

  • Refractive Surgery
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Abstract

Purpose

Worldwide, the most frequent cause of visual impairment is uncorrected refractive error. This analysis focused on the distribution and associations of refractive, corneal and ocular residual astigmatism.

Methods

As part of the Gutenberg Health study, a population-based cross-sectional study was conducted in the general population of Germany. A comprehensive ophthalmological examination including refraction, tonometry, and Scheimpflug imaging of the anterior cornea (Pachycam) was performed. In addition to the magnitude and type (with-the-rule, against-the-rule, oblique) of the refractive or corneal astigmatism, we calculated the vector components (J0, J45) of both astigmatisms and calculated the ocular residual astigmatism. We performed multiple quantile regression analysis to evaluate the factors associated with refractive, corneal and ocular residual astigmatisms.

Results

A total of 13,558 subjects (49% female) with a mean age of 54.0 years (range 35–74 years) were included in this study. The prevalence of refractive astigmatism (>1.0D) was 13.0% in right eyes and 12.0% in left eyes, and 85% of these subjects wore spectacles. The distribution of refractive astigmatism showed a two-peak distribution with high astigmatism for with-the-rule and against-the-rule astigmatism. The associated factors were corneal curvature, age and sex for the different astigmatisms (p < 0.001).

Conclusions

We analyzed the prevalence of different astigmatisms within a European population. We confirmed a shift with aging from with-the-rule to against-the-rule astigmatism to refractive and corneal astigmatism. Astigmatism has a large impact on visual perception; more than 85% of people with astigmatism over one diopter wore glasses for distance vision.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany

    Alexander Karl-Georg Schuster, Norbert Pfeiffer, René Hoehn, Katharina A. Ponto & Alireza Mirshahi

  2. Preventive Cardiology and Preventive Medicine / Center for Cardiology, University Medical Center Mainz, Mainz, Germany

    Andreas Schulz & Philipp S. Wild

  3. Department of Ophthalmology, Inselspital, University Hospital of Bern, Bern, Switzerland

    René Hoehn

  4. Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Mainz, Germany

    Katharina A. Ponto & Philipp S. Wild

  5. German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany

    Philipp S. Wild

  6. Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz, Germany

    Maria Blettner

  7. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany

    Manfred E. Beutel

  8. Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Mainz, Germany

    Karl J. Lackner

  9. Center for Cardiology I, University Medical Center Mainz, Mainz, Germany

    Thomas Münzel

  10. Dardenne Eye Hospital, Bonn-Bad Godesberg, Germany

    Alireza Mirshahi

Authors
  1. Alexander Karl-Georg Schuster
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  2. Norbert Pfeiffer
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  3. Andreas Schulz
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  4. René Hoehn
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  5. Katharina A. Ponto
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  6. Philipp S. Wild
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  7. Maria Blettner
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  8. Manfred E. Beutel
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  9. Karl J. Lackner
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  10. Thomas Münzel
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  11. Alireza Mirshahi
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Corresponding author

Correspondence to Alexander Karl-Georg Schuster.

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Conflict of interest

None of the authors has a conflict of interest with the study.

Financial support

“The Gutenberg Health Study is funded through the government of Rheinland-Pfalz („Stiftung Rheinland-Pfalz für Innovation“, contract AZ 961-386261/733), the research programs “Wissen schafft Zukunft” and “Center for Translational Vascular Biology (CTVB)” of the Johannes Gutenberg-University of Mainz, and its contract with Boehringer Ingelheim, PHILIPS Medical Systems and Novartis Pharma, including an unrestricted grant for the Gutenberg Health Study. PSW and KAP are funded by the Federal Ministry of Education and Research (BMBF 01EO1003). Funders were involved in the development of the study design as scientific consultants. However, they played no role in data collection, analysis, decision to publish, or preparation of the manuscript.

Informed consent

This study was approved by the Ethics Committee of the state chamber of physicians of Rhineland-Palatinate and by local and federal data safety commissioners. In accord with the tenets of the Declaration of Helsinki, written informed consent was obtained from all participants prior to entering the study.

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Schuster, A.KG., Pfeiffer, N., Schulz, A. et al. Refractive, corneal and ocular residual astigmatism: distribution in a German population and age-dependency - the Gutenberg health study. Graefes Arch Clin Exp Ophthalmol 255, 2493–2501 (2017). https://doi.org/10.1007/s00417-017-3775-x

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  • DOI: https://doi.org/10.1007/s00417-017-3775-x

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