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M.D. Knudtson, R. Klein, B.E. K. Klein; Age–Related Eye Disease, Visual Impairment and Survival: The Beaver Dam Eye Study . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1905.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To investigate the relationship of age–related maculopathy (ARM), cataract, glaucoma, and visual impairment to survival over a 14–year period in the population–based Beaver Dam Eye Study. Methods:Persons ranging in age from 43 to 84 years and living in Beaver Dam, Wisconsin, at the time of a census (1987–1988) were examined (n=4926). Stereoscopic color fundus photographs and color slit–lamp and retroillumination photographs were graded to determine the presence of ARM and cataract, respectively. Glaucoma was defined based on measurement of intraocular pressure, optic cup and disc diameters and visual field. Best–corrected visual acuity was measured using a modified ETDRS protocol to determine visual impairment (visual acuity ≥ 20/40 in the better eye). Vital status has been monitored by yearly telephone contact, daily review of obituaries and use of state and national vital status records. Results:As of December 31, 2002, we have confirmed that 32% (1576/4926) of the baseline population has died (median follow–up of 13.2 years). After adjusting for age and gender, poorer survival was associated with nuclear sclerosis (hazard ratio [HR], 95% confidence interval [CI]: 1.12 (1.03,1.21) per 1 step increase in 5–level severity), cortical cataract (HR, 95% CI: 1.21 (1.06,1.37)) and visual impairment (HR, 95% CI: 1.42 (1.19, 1.70)). After further controlling for systemic and lifestyle factors (e.g. blood pressure, diabetes, smoking), cortical cataract (HR=1.20) and visual impairment (HR=1.25) remained significantly associated with poorer survival. ARM (HR=0.98 per 1 step increase in a 3–level severity) and presence of glaucoma (HR=1.09) were not associated with poorer survival. Results were similar for men and women (data not shown). Conclusions:Age–related cortical cataract and visual impairment may be associated with poorer survival. These relationships were not explained by traditional risk factors for mortality. ARM and glaucoma do not appear to increase mortality risk.
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