Association of Mortality with Ocular Diseases and Visual Impairment in the Age-Related Eye Disease Study 2

Papudesu, Chandana; Clemons, Traci E; Agrón, Elvira; Chew, Emily Y.

doi:10.1016/j.ophtha.2017.10.028

Cited by 26 publications

(35 citation statements)

References 40 publications

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“…Our association between late AMD and mortality not specific to CVD or cancer is in agreement with several previous studies, 15 , 45 but not others. 12 The reasons underlying the association of AMD with increased risk of mortality not due to CVD or cancer are still unclear.…”

Section: Discussionsupporting

confidence: 94%

“…The findings from previous population-based studies 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 40 , 41 on associations between AMD and mortality are summarized in eTable 4 in the Supplement . Our finding that the presence of late AMD was associated with an increased risk of all-cause mortality is in line with the Age-Related Eye Disease Study (AREDS), 14 AREDS2, 15 and Beaver Dam Eye Study. 16 , 20 Other population-based studies 12 , 13 , 17 , 18 , 19 have reported significant associations between any and mild AMD and all-cause mortality in subpopulations only.…”

Section: Discussionmentioning

confidence: 99%

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Association of Age-Related Macular Degeneration With Risk of All-Cause and Specific-Cause Mortality in the National Health and Nutrition Examination Survey, 2005 to 2008

et al. 2019

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Key Points Question What is the association of age-related macular degeneration with mortality outcomes among older adults? Findings In this cohort study of 5603 participants 40 years or older, only late age-related macular degeneration was associated with more than a doubling of all-cause mortality and more than 3-fold higher risk of mortality not due to cardiovascular disease and cancer. Meaning The association of late age-related macular degeneration and poor survival may shed light on mechanisms underlying the disease, indicating that late age-related macular degeneration may be a marker of frailty and aging or may be due to residual confounding factors indicative of aging.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Association of Age-Related Macular Degeneration With Risk of All-Cause and Specific-Cause Mortality in the National Health and Nutrition Examination Survey, 2005 to 2008

et al. 2019

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“…Anti‐VEGFA therapy in wet AMD is considered to be safe for patients, even although some side‐effects have been reported . Moreover, Papudesu et al showed that AREDS2 participants with wet AMD in one eye at baseline had a statistically significant increased risk for mortality compared with patients having no or only a few drusen . Moreover, a visual acuity less than 20/40 was associated with a reduced survival.…”

Section: Discussionmentioning

confidence: 99%

“…12,57 Moreover, Papudesu et al showed that AREDS2 participants with wet AMD in one eye at baseline had a statistically significant increased risk for mortality compared with patients having no or only a few drusen. 58 between advanced AMD and mortality. 60 Hanhart et al noted an increased mortality in wet AMD patients after myocardial infarction (MI) treated with bevacizumab as compared to non-treated individuals.…”

Section: Discussionmentioning

confidence: 99%

Expression of VEGFA‐regulating miRNAs and mortality in wet AMD

Błasiak

Watała

Tuuminen

et al. 2019

J Cellular Molecular Medi

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MicroRNAs (miRNAs) regulate gene expression; many of them act in the retinal pigment epithelium (RPE), and RPE degeneration is known to be a critical factor in age‐related macular degeneration (AMD). Repeated injections with anti‐VEGFA (vascular endothelial growth factor A) are the only effective therapy in wet AMD. We investigated the correlation between the expression of 18 miRNAs involved in the regulation of the VEGFA gene in serum of 76 wet AMD patients and 70 controls. Efficacy of anti‐VEGFA treatment was evaluated by counting the number of injections delivered up to 12 years. In addition, we compared the relative numbers of deaths in patient with AMD and control groups. We observed a decreased expression of miR‐34‐5p, miR‐126‐3p, miR‐145‐5p and miR‐205‐5p in wet AMD patients as compared with controls. These miRNAs are involved in the regulation of angiogenesis, cytoprotection and protein clearance. No miRNA was significantly correlated with the treatment outcome. Wet AMD patients had greater mortality than controls, and their survival was inversely associated with the number of anti‐VEGFA injections per year. No association was observed between miRNA expression and mortality. Our study emphasizes the need to clarify the role of miRNA regulation in AMD pathogenesis.

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“…For this reason, we used the term "percentage of death" instead of "mortality rate". Second, the presenting visual acuity or the presence of neovascular age-related macular degeneration, which are reported to have relatively superior predictive value for mortality, could not be used in this study because of limitations in the disability registration data regarding visual function 15,21,39 . Additionally, individuals with treatable transient blindness conditions, especially those caused by severe cataracts, could not be included in the blindness group in this study, in contrast with previous papers 15,18,31,40 .…”

Section: Discussionmentioning

confidence: 99%

Mortality and causes of death in a population with blindness in Korea: A longitudinal follow-up study using a national sample cohort

Choi

Lee

2020

Sci Rep

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The influence of visual impairment and blindness on the risk of mortality has been reported in diverse cohort studies. However, the results reported have varied from nonsignificant to significant associations. In the present study, we evaluated the influence of blindness on the risk of mortality from 2002 to 2013 using a longitudinal database with a national sample cohort provided by the Korean National Health Insurance Service. Of a total of 1,125,691 subjects, 1,279 subjects who were registered as blind were enrolled, and 5,116 control participants were matched at a 1:4 ratio for age, sex, income, region of residence, and medical histories of hypertension, diabetes mellitus and dyslipidemia. The life/ death information contained in this dataset was used for the analysis; this information was originally recorded by the medical doctors on the death certificates of the participants. The percentage of total deaths during the mean follow-up period of 111.0 ± 41.6 months was 28.1% in the blindness group and 19.7% in the matched control group. The risk of mortality was significantly higher in the blindness group than in the control group according to the Cox proportional hazards model with additional adjustments for ischemic heart disease, stroke, and depression (adjusted hazard ratio [HR] of mortality = 1.54, 95% confidence interval [CI] = 1.37-1.74, P < 0.001). In the subgroup analyses, the adjusted HRs for mortality were significantly higher in the blindness group than in the control group regardless of age (young defined as <60 years old vs old defined as ≥60 years old) and sex. The percentage of death due to metabolic diseases and genitourinary diseases was higher in the blindness group than in the matched control group. Sensory impairments are common among the elderly population 1-3. In particular, visual impairment, including blindness, negatively impacts functional independence, cognition, and mental health, consequently resulting in reduced quality of life 3-7. According to the criteria of the World Health Organization (WHO), visual impairment is defined as presenting vision worse than 20/60 (or 6/18) in the better seeing eye and blindness as vision worse than 20/400 (or 3/60) in the better seeing eye 1,8. According to population-based studies, the reported prevalence of visual impairment ranges from 0.35% to 2.54%, and that of blindness ranges from 0.1% to 1.02% according to the WHO criteria 9. The influence of visual impairment and blindness on the risk of mortality has been reported in diverse cohort studies, but the results have varied from nonsignificant to significant associations, and the relative risk (RR) has varied from 1.17 to 3.60 8,10-19. The risk of mortality associated with visual impairment was well summarized in a recent meta-analysis including 29 studies with a total of 269,839 participants and 67,061 deaths 8. Of the 29 included studies, 17 studies reported a significant association between visual impairment and the risk of mortality, but the rest of the studies failed to identify a signifi...

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Association of Mortality with Ocular Diseases and Visual Impairment in the Age-Related Eye Disease Study 2

Abstract: In AREDS2, the presence of late AMD, bilateral cataract surgery, and VA less than 20/40 was associated with decreased survival. However, oral supplementation with omega-3 fatty acids, lutein plus zeaxanthin, zinc, or beta-carotene had no statistically significant impact on mortality.

Cited by 26 publications

References 40 publications

Association of Age-Related Macular Degeneration With Risk of All-Cause and Specific-Cause Mortality in the National Health and Nutrition Examination Survey, 2005 to 2008

Association of Age-Related Macular Degeneration With Risk of All-Cause and Specific-Cause Mortality in the National Health and Nutrition Examination Survey, 2005 to 2008

Expression of VEGFA‐regulating miRNAs and mortality in wet AMD

Mortality and causes of death in a population with blindness in Korea: A longitudinal follow-up study using a national sample cohort

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