Elsevier

Ophthalmology

Volume 116, Issue 4, April 2009, Pages 732-738
Ophthalmology

Original article
Mortality and Ocular Diseases: The Beijing Eye Study

https://doi.org/10.1016/j.ophtha.2008.11.003Get rights and content

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.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Section snippets

Patients and Methods

The Beijing Eye Study is a population-based study in northern China. It was carried out in 4 communities in the urban district of Haidian in the north of central Beijing and in 3 communities in the village area of Yufa of the Daxing District south of Beijing. The study has been described in detail recently.40, 41 The Medical Ethics Committee of the Beijing Tongren Hospital approved the study protocol and all participants gave informed consent, according to the Declaration of Helsinki. At the

Results

Of the 4439 subjects examined in 2001 and invited for reexamination in 2006, 3251 (73.2%) subjects returned for the follow-up examination, whereas 143 (3.2%) subjects were dead and 1045 (23.5%) subjects were alive but did not agree to be reexamined. Cerebrovascular events were the most common cause of death (n = 41; 29%), followed by malignancies (n = 37; 26%), heart disorders (n = 31; 22%), and other causes (n = 34; 24%) such as nonmalignant lung diseases (n = 6), and liver (n = 3) and kidney

Discussion

In the adult Chinese population with an age of 40 years or more and living in the Greater Beijing area, 3.2% of subjects died during a follow-up period of 5 years. Besides the systemic parameters of higher age (P<0.001), male gender (P = 0.01), lower level of education (P<0.001), and smoking (P = 0.02), ocular parameters with a significant association with mortality were level of diabetic-like retinopathy (P = 0.036), presence of angle-closure glaucoma (P = 0.013), and presence of

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    Manuscript no. 2008-898.

    Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

    Supported by the Beijing Natural Science Foundation, Beijing, China.

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