Los Angeles Latino Eye Study

Los Angeles Latino Eye Study
Name	Los Angeles Latino Eye Study
Acronym	LALES
Type	Population-based cohort study
Location	Los Angeles County, California
Participants	Latino adults
Start date	2000
Principal investigators	R. Rand Allingham, Anne L. Coleman
Funding	National Eye Institute, National Institutes of Health

Los Angeles Latino Eye Study is a population-based ocular epidemiologic cohort investigating eye disease prevalence, incidence, and risk factors among Latino adults in Los Angeles County, California. Initiated with support from the National Eye Institute and conducted by academic partners including University of Southern California and Doheny Eye Institute, the study provided landmark data on diabetic retinopathy, age-related macular degeneration, glaucoma, and visual impairment in a large community-based Latino sample. LALES findings informed clinical guidelines, public health programs, and subsequent cohort studies.

Overview

LALES enrolled predominantly Mexican-origin and other Latino participants from neighborhoods in Los Angeles County, with baseline examinations performed in the early 2000s and follow-up visits planned to assess incidence and progression. Investigators affiliated with University of Southern California, Doheny Eye Institute, and colleagues at Kaiser Permanente and Children's Hospital Los Angeles coordinated clinical examinations, questionnaire administration, and image grading. The study design drew on methods used in previous cohorts such as the Framingham Heart Study, Beaver Dam Eye Study, and Blue Mountains Eye Study to allow comparative analyses across populations.

Methods

LALES employed standardized protocols for visual acuity testing, stereoscopic fundus photography, intraocular pressure measurement, and visual field testing using instruments from manufacturers represented in studies by National Institutes of Health consortia. Trained examiners and graders from institutions including University of California, Los Angeles and Johns Hopkins University utilized grading scales akin to the Early Treatment Diabetic Retinopathy Study and the International Classification of Diabetic Retinopathy. Data collection incorporated questionnaires on medical history, socioeconomic variables, and acculturation with measures harmonized against surveys conducted by Centers for Disease Control and Prevention and the Hispanic Health and Nutrition Examination Survey. Statistical analyses were performed with methods referenced in works by researchers at Harvard University, Columbia University, and Mayo Clinic to model prevalence, incidence, and associations.

Major Findings

LALES documented a high prevalence of visual impairment and undiagnosed ocular disease among Latino adults, with notable estimates for diabetic retinopathy, open-angle glaucoma, age-related macular degeneration, and cataract burden. Comparative prevalence metrics were contrasted with results from the Beaver Dam Eye Study, Rotterdam Study, and Proyecto VER. The cohort identified substantial unmet need for eye care services documented in reports by California Department of Public Health and informed recommendations similar to those from the American Academy of Ophthalmology and the American Diabetes Association. LALES publications appeared alongside work from investigators at Johns Hopkins University School of Medicine and University of California, San Francisco in highlighting disparities in vision health.

Risk Factors and Associations

LALES analyses linked glycemic status and diabetes duration to diabetic retinopathy risk, echoing findings from the Diabetes Control and Complications Trial and the United Kingdom Prospective Diabetes Study. Associations between intraocular pressure, cup-to-disc ratio, and glaucoma-related outcomes paralleled studies from Baltimore Eye Survey investigators. Socioeconomic indicators, health insurance status, and acculturation measures — variables also examined by researchers at Rutgers University and University of Michigan — were associated with access to eye care and disease detection. Cardiovascular risk factors documented in cohorts like the Framingham Heart Study were evaluated for relationships with ocular outcomes, and genetic predispositions referenced loci investigated by teams at Massachusetts General Hospital and Broad Institute were explored in nested analyses.

Public Health Impact and Interventions

Findings from LALES informed community screening initiatives coordinated with local partners such as Los Angeles County Department of Public Health, Primary Care Coalition of Los Angeles County, and clinics affiliated with Cedars-Sinai Medical Center and Los Angeles County+USC Medical Center. Recommendations influenced outreach programs modeled on interventions from the National Eye Health Education Program and screening strategies advocated by the World Health Organization for avoidable blindness. LALES data supported grant proposals to the National Institutes of Health and policy briefs prepared for stakeholders including the California Medical Association, and guided culturally tailored education campaigns implemented with nonprofits like Molina Healthcare and Clinica Romero.

Criticisms and Limitations

Critiques of LALES have paralleled those of other community cohorts such as the Blue Mountains Eye Study and include concerns about generalizability beyond Los Angeles County and Mexican-origin populations to other Latino subgroups documented in work from Hispanic Community Health Study/Study of Latinos. Potential selection bias, loss to follow-up, and measurement differences compared with population studies like the Rotterdam Study and Beaver Dam Eye Study were noted. Genetic and environmental heterogeneity described in publications from National Human Genome Research Institute consortia indicate limits to extrapolating genetic associations. Despite these caveats, LALES remains a foundational dataset for ocular epidemiology among Latino communities in the United States.

Category:Epidemiological studies