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The Singapore Malay Eye Study (SiMES)

Nishani Amerasinghe, MBBS, MRCOphth; Tien Y. Wong, FRCSE, PhD; Wan-Ling Wong, BSc; Paul Mitchell, FRACO, PhD; Sunny Y. Shen, MRCS, MMED; Seng-Chee Loon, MRCS, MMED; Seang-Mei Saw, MPH, PhD; Paul J. Foster, PhD, FRCS; Tin Aung, FRCS, PhD; for the SiMES Study Group

Arch Ophthalmol. 2008;126(8):1101-1108.

Objective  To describe the distribution and determinants of the optic cup to disc ratio (CDR) in Malay adults in Singapore.

Methods  This population-based, age-stratified study examined 3280 Malay people aged 40 to 80 years in Singapore. Participants underwent a standardized interview and an ocular examination. A slitlamp examination measured the vertical dimensions of the disc and cup, excluding areas of peripapillary atrophy and the Elschnig scleral ring.

Results  Vertical CDR was recorded for 3228 right eyes and 3237 left eyes. The mean (SD) CDR was 0.40 (0.15) in both eyes. The CDR in the right eye increased with age (P < .001) and was greater in men vs women (age-adjusted CDR, 0.42 vs 0.39; P < .001). In multiple linear regression, significant determinants of greater CDR were increasing age, male sex, higher intraocular pressure (IOP), lower diastolic blood pressure, lower body mass index, and previous cataract surgery. Of these, higher IOP was the most important determinant of the CDR. After excluding 149 persons with glaucoma, male sex, higher IOP, lower diastolic blood pressure, lower body mass index, and diabetes mellitus were significant predictors of greater CDR.

Conclusion  Greater vertical CDR was related to male sex, higher IOP, lower diastolic blood pressure, and lower body mass index.

Author Affiliations: Glaucoma Service (Drs Amerasinghe, Shen, and Aung), Retinal Service (Dr Wong), and Division of Epidemiology (Dr Saw), Singapore National Eye Centre, Singapore; Singapore Eye Research Institute (Drs Amerasinghe, Wong, Saw, and Aung and Ms Wong) and Department of Community, Occupational, and Family Medicine (Dr Saw), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria (Dr Wong); Centre for Vision Research, Department of Ophthalmology, University of Sydney, Sydney, Australia (Dr Mitchell); National University Hospital, Singapore (Dr Loon); and National Institute for Health Research Biomedical Research Center, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, England (Dr Foster).

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