Association of Ocular Disease and Mortality in a Diabetic Population

Abstract

Objective To investigate the association of ocular disease with all-cause and cause-specific mortality in a diabetic population. Design Geographically defined population-based cohort study. Setting An 11-county area in Wisconsin. Study Population Participants were all younger-onset diabetic persons (diagnosed as having diabetes at Main Outcome Measure All-cause and cause-specific mortality as determined from death certificates. Results In the younger-onset group, after controlling for age and sex, retinopathy severity, macular edema, cataract, history of cataract surgery, and history of glaucoma at baseline were associated with all-cause and ischemic heart disease mortality. In the older-onset group, after controlling for age and sex, retinopathy and visual impairment were related to all-cause, ischemic heart disease, and stroke mortality. No ocular variable under study was related to cancer mortality in the older-onset group. After controlling for systemic risk factors, visual impairment was associated with all-cause and ischemic heart disease mortality in the younger-onset group. In the older-onset group, retinopathy severity was related to all-cause and stroke mortality, and visual impairment was related to all-cause, ischemic heart disease, and stroke mortality. Conclusions Presence of more severe retinopathy or visual impairment in diabetic patients is a risk indicator for increased risk of ischemic heart disease death. Presence of these ocular conditions may identify individuals who should be under care for cardiovascular disease.