Author(s):Klein R,Klein BE, Moss SE, Cruickshanks KJ. Association of ocular disease and mortality in a diabetic population. Arch Ophthalmol. 1999 Nov;117(11):1487-95. PMID 10565517
Journal: Archives Of Ophthalmology (Chicago, Ill. : 1960), Volume 117, Issue 11, Nov 1999
OBJECTIVE To investigate the association of ocular disease with all-cause and cause-specific mortality in a diabetic population.
DESIGN Geographically defined population-based cohort study.
SETTING An 11-county area in Wisconsin.
STUDY POPULATION Participants were all younger-onset diabetic persons (diagnosed as having diabetes at or =30 years of age). Diabetic retinopathy, macular edema, visual acuity, and cataract were measured using standardized protocols at baseline examinations from 1980 to 1982, in which 996 younger-onset and 1370 older-onset persons participated. Participants were followed up for 16 years.
MAIN OUTCOME MEASURE All-cause and cause-specific mortality as determined from death certificates.
RESULTS In the younger-onset group, after controlling for age and sex, retinopathy severity, macular edema, cataract, history of cataract surgery, and history of glaucoma at baseline were associated with all-cause and ischemic heart disease mortality. In the older-onset group, after controlling for age and sex, retinopathy and visual impairment were related to all-cause, ischemic heart disease, and stroke mortality. No ocular variable under study was related to cancer mortality in the older-onset group. After controlling for systemic risk factors, visual impairment was associated with all-cause and ischemic heart disease mortality in the younger-onset group. In the older-onset group, retinopathy severity was related to all-cause and stroke mortality, and visual impairment was related to all-cause, ischemic heart disease, and stroke mortality.
CONCLUSIONS Presence of more severe retinopathy or visual impairment in diabetic patients is a risk indicator for increased risk of ischemic heart disease death. Presence of these ocular conditions may identify individuals who should be under care for cardiovascular disease.