Cataract, Visual Impairment and Long-Term Mortality in a Rural Cohort in India: The Andhra Pradesh Eye Disease Study

Khanna, Rohit C; Murthy, Gudlavalleti Venkata Satyanarayana; Giridhar, Pyda; Krishnaiah, Sannapaneni; Pant, Hira; Shantha, Ghanshyam Palamaner Subash; Chakrabarti, Subhabrata; Gilbert, Clare; Rao, Gullapalli N

doi:10.1371/journal.pone.0078002

Cited by 61 publications

(62 citation statements)

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“…Details of the methodology for APEDS, which was conducted between 1996 and 2000, are described elsewhere 3. Data on mortality were obtained during an exercise undertaken between June 2009 and January 2010, the purpose of which was to identify as many participants as possible from the original APEDS, and recruit them for subsequent re-examination.…”

Section: Methodsmentioning

confidence: 99%

“…The associations of mortality and VI, lens status and ARMD have already been published 3. The purpose of this study is to explore whether glaucoma (POAG and angle closure disease), IOP, PXF and CDR are associated with a different mortality risk.…”

Section: Methodsmentioning

confidence: 99%

“…Details of the tracing exercise and assessment of the cause of mortality have already been described 3. In brief, names and addresses of APEDS1 participants were extracted from the APEDS1 database.…”

Section: Methodsmentioning

confidence: 99%

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Glaucoma-associated long-term mortality in a rural cohort from India: the Andhra Pradesh Eye Disease Study

et al. 2018

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AimTo evaluate glaucoma-associated mortality in a rural cohort in India.MethodsThe study cohort comprised individuals aged 40 years and above who took part in the Andhra Pradesh Eye Disease Study (APEDS1) during 1996–2000. All participants underwent detailed comprehensive eye examination. Glaucoma was defined using International Society of Geographic and Epidemiologic Ophthalmology criteria. This cohort was followed up after a decade (June 2009 to January 2010; APEDS2). Mortality HR analysis for ocular risk factors was performed using Cox proportional hazards regression after adjusting for sociodemographic, lifestyle and clinical variables.ResultsIn APEDS1, 2790 individuals aged more than or equal to 40 years were examined. 47.4% were male. Forty-five participants had primary open angle glaucoma (POAG) and 66 had primary angle closure disease (PACD). Ten years later, 1879 (67.3%) were available, 739 (26.5%) had died and 172 (6.2%) had migrated; whereas 22 of the 45 (48.8%) with POAG and 22 of the 66 (33.3%) with PACD had died. In univariate analysis, a higher mortality was associated with POAG (HR 1.9; 95% CI 1.23 to 2.94), pseudoexfoliation (HR 2.79; 95% CI 2.0 to 3.89), myopia (HR 1.78; 95% CI 1.54 to 2.06) and unit increase in cup:disc ratio (HR 4.49; 95% CI 2.64 to 7.64). In multivariable analysis, only cup:disc ratio remained independently associated with mortality (HR 2.5; 95% CI 1.3 to 5.1). The association remained significant when other ocular parameters were included in the model (HR 2.1; 95% CI 1.03 to 4.2).ConclusionsThis is the first longitudinal study to assess the association of glaucoma and mortality in a rural longitudinal cohort in India. Increased cup:disc ratio could be a potential marker for ageing and would need further validation.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Glaucoma-associated long-term mortality in a rural cohort from India: the Andhra Pradesh Eye Disease Study

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“…2 A large body of data from cross-sectional and longitudinal studies report an association between diabetes and cataract. The Beaver Dam Eye Study (BDES), Blue Mountains Eye Study (BMES), and Visual Impairment Project have documented an association between diabetes and incidence of posterior subcapsular cataract (PSC) and, to a lesser extent, incidence of cortical cataract (CC).…”

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Incidence, Progression, and Risk Factors for Cataract in Type 2 Diabetes

Srinivasan¹,

Raman²,

Swaminathan³

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PURPOSE.We report the 4-year incidence, progression, and risk factors of cataract subtypes in type 2 diabetes. METHODS.A total of 779 subjects completed baseline and 4-year follow-up.RESULTS. The incidences of nuclear opalescence (NO), nuclear color (NC), cortical cataract (CC), and posterior subcapsular cataract (PSC) were 70%, 55.2%, 25.7%, and 7.3%, respectively. One-step progressions of NO, NC, CC, and PSC were 14.3%, 16.1%, 8.8%, and 8.1%, respectively, and two-step or more progressions were 5.0%, 6.0%, 0.8%, and 6.0%, respectively. Incident NO was seen in patients 50 to 59 (odds ratio [OR] ¼ 3.3), NC in those 50 to 59 (OR ¼ 2.7) and 60 to 69 (OR ¼ 3.9), and CC in those 60 to 69 (OR ¼ 3.3) years old. A lower hemoglobin A 1c (HbA 1c ; OR ¼ 0.7), longer diabetes duration (OR ¼ 1.1), and hyperopia (OR ¼ 4.0) were associated with incident PSC. Women (OR ¼ 1.7) and patients with higher total cholesterol (OR ¼ 1.3) at baseline showed one-step NO progression. Patients 60 to 69 (OR ¼ 2.8) and ‡70 (OR ¼ 3.8) years old showed one-step NC progression, while those 60 to 69 years old showed one-step CC progression (OR ¼ 6.3). A lower HbA 1c (OR ¼ 0.3) was associated with one-step PSC progression. A higher low-density lipoprotein (OR ¼ 1.6) was associated with two-step or more NO progression. Patients 60 to 69 years old (OR ¼ 6.7) had a greater risk, while those with hyperopia at baseline (OR ¼ 0.2) had lower risk of two-step or more NC progression. Patients 40 to 49 years old constituted the reference group for all.CONCLUSIONS. The 4-year cumulative incidence of cataract is higher than that of progression. Greater age is a risk factor for incidence and progression of most types of cataract.

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“…11 In addition to improving visual function, some evidences suggest that cataract surgery is associated with better chances of survival, although this has yet to be conclusive. [3][4][5][6][7][8][12][13][14][15] The Beaver Dam Eye Study (BDES) 5 found no association between cataract surgery and mortality in participants who did and did not undergo surgery, while in the Bristol Eye Hospital Study, 15 people who had undergone cataract surgery had a significantly lower mortality than the national and regional standardized mortality ratios (SMR ¼ 0.88 vs. 0.87). Although many studies assessed the association of cataract surgery with mortality, they compared operated people with unoperated people with or without cataract, or people in the general population, which complicated the interpretation of the role cataract surgery played in its association with mortality.…”

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confidence: 99%

Cataract-Related Visual Impairment Corrected by Cataract Surgery and 10-Year Mortality: The Liwan Eye Study

Zhu

Wang

Young

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To assess 10-year mortality in people who had undergone cataract surgery with no residual visual impairment (VI) and those who had persistent VI due to cataract using a population-based cohort.METHODS. The Liwan Eye Study is a 10-year longitudinal study commenced in 2003. According to the World Health Organization, presenting VI was defined as visual acuity less than 20/63 in the better-seeing eye. History of cataract surgery was defined as cataract surgery performed on either eye. Information on the date of surgery was recorded. Dates of death occurring between baseline and April 30, 2014 were obtained from the National Death Index data. Information on socioeconomic factors was obtained from questionnaire interviews. Cox proportional hazards regression models were used to assess the hazard ratios (HRs) and 95% confidence intervals (CIs).RESULTS. Fifty-nine participants had undergone cataract surgery without residual VI and 67 participants had persistent cataract-related VI. The 10-year mortality rate for participants who had undergone cataract surgery without residual VI was statistically significant lower than that in participants who had VI due to cataract based on log-rank test (32.2% vs. 64.2%; P ¼ 0.002). This finding remained significant in the unadjusted Cox proportional hazards model (HR, 0.43; 95% CI, 0.25-0.74; P ¼ 0.002). After adjusting for age, sex, history of diabetes, and hypertension, body mass index (BMI), education level, and personal income, participants with cataract surgery and no residual VI did not have a higher chance of survival than participants with persistent VI due to cataract (HR, 0.56; 95% CI, 0.26-1.20; P ¼ 0.136).CONCLUSIONS. Cataract-related VI corrected by cataract surgery was not associated with better survival after adjusting for a number of possible confounders. Given our sample size is relatively small and limited power, further studies with larger sample are needed.

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Cataract, Visual Impairment and Long-Term Mortality in a Rural Cohort in India: The Andhra Pradesh Eye Disease Study

Cited by 61 publications

References 42 publications

Glaucoma-associated long-term mortality in a rural cohort from India: the Andhra Pradesh Eye Disease Study

Glaucoma-associated long-term mortality in a rural cohort from India: the Andhra Pradesh Eye Disease Study

Incidence, Progression, and Risk Factors for Cataract in Type 2 Diabetes

Cataract-Related Visual Impairment Corrected by Cataract Surgery and 10-Year Mortality: The Liwan Eye Study

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