Visual acuity and risk of overall, injury-related, and cardiovascular mortality: the Kangbuk Samsung Health Study

Abstract

Aims The associations of visual impairment (VI) with cardio-metabolic risk factors have been reported but its association with cardiovascular mortality remains uncertain. Therefore, we evaluated the association of visual acuity (VA) with overall, injury-related, and cardiovascular mortality. Methods and results A cohort study was performed in 580 746 Korean adults (average age, 39.7 years) who were followed for a median of 8.1 years (maximum, 16 years). Presenting VA was measured by the Early Treatment Diabetic Retinopathy Study (ETDRS) chart. Visual acuity in the better vision eye was categorized as normal vision (≥0.8), lowered vision (0.5–0.8), mild visual impairment (VI) (0.3–0.5), or moderate to severe VI (<0.3). Vital status and cause of death were ascertained through linkage to national death records. During 4 632 892.2 person-years of follow-up, 6585 overall deaths, 974 cardiovascular deaths, and 1163 injury-related deaths were identified. After adjustment for possible confounders, the multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for overall mortality among participants with lowered vision, minimal VI, and moderate to severe VI were 1.21 (1.13–1.29), 1.26 (1.15–1.37), and 1.54 (1.40–1.68), respectively, compared with those with normal vision. The corresponding HRs (95% CIs) for injury-related mortality were 1.12 (0.96–1.32), 0.98 (0.76–1.26), and 1.36 (1.04–1.79), respectively, and the corresponding HRs (95% CIs) for cardiovascular mortality were 1.32 (1.12–1.57), 1.43 (1.15–1.77), and 2.41 (1.94–2.99). Conclusion In this large cohort of young and middle-aged individuals, VI was associated with increased risk of mortality especially due to cardiovascular disease.

Impact of vision correction on the visual impairment status and quality of life score in patients with type II diabetes mellitus

“…VI may result in reduced mobility and communication skills [58], twice the risk of falls [59], and high risks of hip fractures [60], depression [61,62], and emotional distress [63,64]. Furthermore, high mortality and injury rates correlated in a population with VI [65,66]. Thus, VI limits one's independence, lowers QOL, shortens one's life in terms of physical and mental health, and has a socioeconomic impact by lowering employment rates, possible social isolation, and higher use of medical expenses [67].…”

Hubungan Antara Tekanan Intraokular, Diabetes Mellitus, dan Hipertensi dengan Visus Setelah Operasi Fakoemulsifikasi

“…Several other studies have shown that exposure to beta-blockers can also increase cataract formation because it can increase intracellular levels of cyclic adenosine monophosphate, resulting in the modification of lens proteins. 18,19,20 A study by Bautista et al has found that elevated plasma levels of IL-6 and TNF-a occur in patients with hypertension, which is closely associated with an intense systemic inflammation resulting in elevated levels of C-reactive protein, hence triggering cataract development. Hypertension has also been reported to cause a conformational change in the lens capsule, thereby interfering with potassium ion transport in the lens epithelial cells.…”

A Dose–Response Relationship of Alcohol Consumption with Risk of Visual Impairment in Korean Adults: The Kangbuk Samsung Health Study

“…The participants presenting VA while wearing their own spectacles was measured for each eye using Early Treatment Diabetic Retinopathy Study (ETDRS) scales placed at a distance of 3 m [30]. The presenting VA (either VA with naked eye vision or with own spectacle) was evaluated because it reflects real-world VA [31].…”