State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Eye (Lond). 2021 Aug;35(8):2173-2179. doi: 10.1038/s41433-020-01226-x. Epub 2020 Oct 19.
To explore associations between visual impairment (VI) and mortality in an adult population in urban China.
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.
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.
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.
探讨中国城市成年人中视力障碍（VI）与死亡率之间的关联。
荔湾区眼病研究是在中国南方广州市进行的一项基于人群的患病率调查。基线检查于 2003 年进行。所有基线参与者均被邀请参加 10 年随访。VI 定义为经习惯性矫正后较好眼的视力为 20/40 或更差。可矫正 VI 定义为经主观折射矫正至 20/40 或更好的 VI，不可矫正 VI 定义为经矫正后仍差于 20/40 的 VI。死亡率使用对数秩检验和 Cox 比例风险回归模型进行比较。
在有基线视力测量值的 1399 名参与者（平均年龄：65.3±9.93 岁；56.4%为女性）中，有 320 名（22.9%）有 VI。10 年后，有 314 名（22.4%）参与者死亡。与无 VI 者相比，视力障碍者的 10 年死亡率显著升高（40.0% vs. 17.2%，P<0.05）。在校正年龄、性别、收入、教育程度、BMI、糖尿病和高血压病史后，VI（HR，1.55；95%CI，1.14-2.11）和不可矫正 VI（HR，2.72；95%CI，1.86-3.98）均与较差的生存率显著相关，而可矫正 VI（HR，0.99；95%CI，0.66-1.49）不是 10 年死亡率的独立危险因素。
我们的研究结果表明，VI，特别是不可矫正 VI，可预测生存率较差，这可能提示 VI 与死亡率之间关联的潜在机制，并强调预防和治疗致盲性眼病对于预防老年人过早死亡的重要性。
