title: Impact of Visual Impairment and Eye diseases on Mortality: the Singapore Malay Eye Study (SiMES).
abstract: 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.
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore.
authors.forename: Rosalynn Grace
authors.initials: RG
authors.lastname: Siantar
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Graduate Medical School, National University of Singapore, Singapore.|Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Cheng
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Graduate Medical School, National University of Singapore, Singapore.
authors.forename: Chui Ming
authors.initials: CM
authors.lastname: Gemmy Cheung
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Graduate Medical School, National University of Singapore, Singapore.
authors.forename: Ecosse L
authors.initials: EL
authors.lastname: Lamoureux
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
authors.forename: Peng Guan
authors.initials: PG
authors.lastname: Ong
authors.affiliation: National Registry of Diseases Office, Ministry of Health, Singapore.
authors.forename: Khuan Yew
authors.initials: KY
authors.lastname: Chow
authors.affiliation: Center for Vision Research, University of Sydney, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Graduate Medical School, National University of Singapore, Singapore.|Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Tin
authors.initials: T
authors.lastname: Aung
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Graduate Medical School, National University of Singapore, Singapore.|Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Tien-Yin
authors.initials: TY
authors.lastname: Wong
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Graduate Medical School, National University of Singapore, Singapore.|Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.|Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong.
authors.forename: Carol Y
authors.initials: CY
authors.lastname: Cheung
mesh_terms: D000367:Age Factors; D000368:Aged; D002423:Cause of Death; D015331:Cohort Studies; D015897:Comorbidity; D005128:Eye Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011159:Population Surveillance; D016016:Proportional Hazards Models; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D014786:Vision Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D014792:Visual Acuity