Mortality and ocular diseases: the Beijing Eye Study.

OBJECTIVE

To examine the relationship between mortality and major ocular diseases.

DESIGN

Population-based study.

PARTICIPANTS

At baseline in 2001, the Beijing Eye Study examined 4439 subjects with an age of 40 years or more. The mean age was 56.2+/-10.6 years (range, 40-101 years). In 2006, all study participants were invited for a follow-up examination.

METHODS

The participants underwent a detailed ophthalmic examination and answered questions regarding their socioeconomic background. Rate of mortality was determined in the follow-up survey of 2006.

MAIN OUTCOME MEASURES: Factors associated with mortality.

RESULTS

Of the 4439 subjects examined in the 2001, 3251 (73.2%) subjects returned for the follow-up examination, whereas 143 (3.2%) subjects had died and 1045 (23.5%) subjects were alive but did not agree to be reexamined. In binary logistic regression analysis, mortality was significantly associated with the systemic parameters of higher age (P<0.001; odds ratio [OR], 1.07), male gender (P = 0.01; OR, 0.55), lower level of education (P<0.001; OR, 0.65), smoking status (P = 0.023; OR, 1.25), and with the ocular parameters of level of diabetic-like retinopathy (P = 0.036; OR, 1.02), presence of angle-closure glaucoma (P = 0.013; OR, 3.74), and presence of nonglaucomatous optic nerve damage (P = 0.027; OR, 3.41). Presence of retinal vein occlusions was associated marginally with mortality (P = 0.059; OR, 2.59). Mortality was not significantly associated with best-corrected visual acuity (P = 0.14) in multivariate analysis, nor with age-related macular degeneration, open-angle glaucoma, trachoma, any type of cataract, visual field defects, intraocular pressure, or refractive error.

CONCLUSIONS

If socioeconomic parameters, age, gender, and smoking status were taken into account, ocular parameters associated with an increased mortality were diabetic-like retinopathy, angle-closure glaucoma, and nonglaucomatous optic nerve damage. Retinal vein occlusions were marginally associated. Other major ocular disorders such as any form of cataract, open-angle glaucoma, age-related macular degeneration, trachoma, pterygia, and high myopia or high hyperopia were not significantly related to mortality.