Impact of Visual Impairment and Eye diseases on Mortality: the Singapore Malay Eye Study (SiMES)

Sci Rep. 2015 Nov 9;5:16304. doi: 10.1038/srep16304.


We investigated the relationship of visual impairment (VI) and age-related eye diseases with mortality in a prospective, population-based cohort study of 3,280 Malay adults aged 40-80 years between 2004-2006. Participants underwent a full ophthalmic examination and standardized lens and fundus photographic grading. Visual acuity was measured using logMAR chart. VI was defined as presenting (PVA) and best-corrected (BCVA) visual acuity worse than 0.30 logMAR in the better-seeing eye. Participants were linked with mortality records until 2012. During follow-up (median 7.24 years), 398 (12.2%) persons died. In Cox proportional-hazards models adjusting for relevant factors, participants with VI (PVA) had higher all-cause mortality (hazard ratio[HR], 1.57; 95% confidence interval[CI], 1.25-1.96) and cardiovascular (CVD) mortality (HR 1.75; 95% CI, 1.24-2.49) than participants without. Diabetic retinopathy (DR) was associated with increased all-cause (HR 1.70; 95% CI, 1.25-2.36) and CVD mortality (HR 1.57; 95% CI, 1.05-2.43). Retinal vein occlusion (RVO) was associated with increased CVD mortality (HR 3.14; 95% CI, 1.26-7.73). No significant associations were observed between cataract, glaucoma and age-related macular degeneration with mortality. We conclude that persons with VI were more likely to die than persons without. DR and RVO are markers of CVD mortality.

MeSH terms

  • Age Factors
  • Aged
  • Cause of Death
  • Cohort Studies
  • Comorbidity
  • Eye Diseases / diagnosis
  • Eye Diseases / epidemiology*
  • Eye Diseases / mortality
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mortality
  • Population Surveillance
  • Proportional Hazards Models
  • Risk Factors
  • Singapore / epidemiology
  • Vision Disorders / diagnosis
  • Vision Disorders / epidemiology*
  • Vision Disorders / mortality
  • Visual Acuity