Visual impairment and ten-year mortality: the Liwan Eye Study

• Published in: Eye (London) Vol. 35; no. 8; pp. 2173 - 2179
• Main Authors: Wang, Lanhua, Zhu, Zhuoting, Scheetz, Jane, He, Mingguang
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.08.2021; Nature Publishing Group
• Subjects: 692/499; 692/699/3161/3178; Acuity; Adult; Aged; Blindness; Cross-Sectional Studies; Diabetes mellitus; Eye; Female; Humans; Laboratory Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Mortality; Ophthalmology; Pharmaceutical Sciences/Technology; Population studies; Prevalence; Regression analysis; Risk factors; Surgery; Surgical Oncology; Survival; Vision Disorders - epidemiology; Vision, Low - epidemiology; Visual Acuity; Visual impairment; Visually Impaired Persons; China
• ISSN: 0950-222X; 1476-5454; 1476-5454
• DOI: 10.1038/s41433-020-01226-x

Objectives To explore associations between visual impairment (VI) and mortality in an adult population in urban China. Methods The Liwan Eye Study was a population-based prevalence survey conducted in Guangzhou, Southern China. The baseline examination was carried out in 2003. All baseline participants were invited for the 10-year follow-up visit. VI was defined as the visual acuity of 20/40 or worse in the better-seeing eye with habitual correction if worn. Correctable VI was defined as the VI correctable to 20/40 or better by subjective refraction, and non-correctable VI was defined as the VI correctable to worse than 20/40. Mortality rates were compared using the log-rank test and Cox proportional hazards regression models. Results Of the 1399 participants (mean age: 65.3 ± 9.93 years; 56.4% female) with available baseline visual acuity measurement, 320 participants (22.9%) had VI. After 10 years, 314 (22.4%) participants died. Visually impaired participants had a significantly increased 10-year mortality compared with those without VI (40.0% vs. 17.2%, P  < 0.05). After adjusting for age, gender, income, educational attainment, BMI, history of diabetes and hypertension, both VI (HR, 1.55; 95% CI, 1.14–2.11) and non-correctable VI (HR, 2.72; 95% CI, 1.86–3.98) were significantly associated with poorer survival, while correctable VI (HR, 0.99; 95% CI, 0.66–1.49) was not an independent risk factor for 10-year mortality. Conclusions Our findings that VI, particularly non-correctable VI, predicting poorer survival may imply the underlying mechanism behind VI-mortality association and reinforce the importance of preventing and treating disabling ocular diseases to prevent premature mortality in the elderly.