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Lanhua Wang, Zhuoting Zhu, Billy Heung Wing Chang, Mingguang He; Ten-Year Incidentce Mortality and Visual impairment in Urban Southern China: The Liwan Eye Study. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2103.
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Study findings on the association between visual impairment (VI) and mortality were inconsistent and data were limited on this subject in China. This study explores 10-year incidence of mortality and its association with VI in an adult population in China
A total of 1405 subjects aged 50 years or older were examined at baseline from 2003 to 2004 in the Liwan Eye Study. All subjects were invited to return for the 10 year follow up visit in 2013 to 2014. Detailed data from the Chinese Centre for Disease Control and Prevention were used to confirm persons who died during the 10-year follow-up period. Baseline VI was defined as best-corrected visual acuity (BCVA) less than 20/40 in the better eye. Body mass index (BMI) was calculated with the anthropometry data. A brief questionnaire regarding personal income, education level, medical history of systemic diseases was administered. Association between incident mortality and baseline VI was assessed with the Cox proportional hazards regression model, after adjusting for age, gender, BMI, and medical history
Of the 1405 subjects (mean age:62.3±8.7 years;56.4% female) examined at baseline, 90.5% had BCVA≥20/40 in the better eye, 8.9% had 20/200 ≤ BCVA < 20/40 and 0.6% had BCVA<20/200 in the better eye. The corresponding figures on presenting VA (PVA) were 77.1%, 21.8%, and 1.1%, respectively.<br /> By the end of April 2014, 791 (72.9% of survivors, mean age: 72.3±8.74years) subjects had returned for 10year visit, while 320 (22.8%) had died, 167 had moved away from the study area and 127 refused. The returned participants tended to be younger (p<0.001), more likely to be male (p=0.047), with history of hypertension (p=0.032) and poorer baseline VA for the right eye (p=0.016).<br /> Among the 133 (9.5%) subjects with VI at baseline, the cumulative 10-year incidence of mortality was 65.8%, which was significant higher than participants without VI (21.3%). Age-standardized mortality was higher in persons with vs without VI (54.8%vs22.5%). After adjusting for age, gender, BMI, history of diabetes and hypertension, poorer survival was significantly associated with VI (HR,1.65;95% CI,1.03,2.63). Associations tended to be slightly stronger in male than female
VI may be an independent risk factor for worse survival in older persons, Prevention and treatment of ocular diseases in those living with VI remains an important public health
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