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      Age-Related Macular Degeneration and Mortality: The Beijing Eye Study


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          Purpose: To assess the association between age-related macular degeneration (AMD) and mortality in a population-based setting. Procedures: At baseline in 2001, the Beijing Eye Study examined 4,378 subjects for AMD with a detected frequency of 110/4,378 (2.5%) subjects for early AMD and of 12/4,378 (0.3%) subjects for late AMD. In 2006, all study participants were re-invited for a follow-up examination. Results: Out of the 4,378 subjects, 3,218 (73.5%) returned for a follow-up examination while 138 (3.2%) were dead and 1,022 (23.3%) did not agree to be re-examined or had moved away. Early AMD and late AMD were not significantly associated with mortality (p = 0.40 and 0.33, respectively), neither in univariate analysis nor in multivariate analysis. Conclusions: AMD may not be associated with an increased mortality in adult Chinese.

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          Most cited references2

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          Is there a direct association between age-related eye diseases and mortality? The Rotterdam Study.

          To study mortality in subjects with age-related maculopathy (ARM), cataract, or open-angle glaucoma (OAG) in comparison with those without these disorders. Population-based prospective cohort study. Subjects (n = 6339) aged 55 years and older from the population-based Rotterdam Study for whom complete information on eye disease status was present. Vital status continuously monitored from 1990 until January 1, 2000. The diagnosis of ARM was made according to the International Classification System. Cataract, determined on biomicroscopy, was defined as any sign of nuclear or (sub)cortical cataract, or both, in at least one eye with a visual acuity of 20/40 or less. Aphakia and pseudophakia in at least one eye were classified as operated cataract. Definite OAG was defined as a glaucomatous optic neuropathy combined with a glaucomatous visual field defect. Diagnoses were assessed at baseline. Mortality hazard ratios were computed using Cox proportional hazard regression analysis, adjusted for appropriate confounders (age, gender, smoking status, body mass index, cholesterol level, atherosclerosis, hypertension, history of cardiovascular disease, and diabetes mellitus). The adjusted mortality hazard ratio for subjects with AMD (n = 104) was 0.94 (95% confidence interval [CI], 0.52-1.68), with biomicroscopic cataract (n = 951) was 0.94 (95% CI, 0.74-1.21), with surgical cataract (n = 298) was 1.20 (95% CI, 0.86-1.68), and with definite OAG (n = 44) was 0.39 (95% CI, 0.10-1.55). Both ARM and cataract are predictors of shorter survival because they have risk factors that also affect mortality. When adjusted for these factors, ARM, cataract, and OAG were themselves not significantly associated with mortality.
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            Age-related macular degeneration and cancer mortality in the atherosclerosis risk in communities study.

            To examine the prospective association of early age-related macular degeneration (AMD) with cancer mortality. A population-based cohort study of 10 029 persons aged 49 to 73 years free of cancer. The AMD signs were evaluated from retinal photographs taken in 1993 through 1995. Cancer mortality was determined from death records. There were 464 cases of early AMD. Over 10 years, there were 234 cancer deaths (71 lung cancer deaths). After controlling for age, sex, race, field center, education, smoking status, pack-years of smoking, body mass index (calculated as weight in kilograms divided by height in meters squared), and diabetes mellitus, early AMD was associated with cancer mortality (rate ratio [RR], 1.68; 95% confidence interval [CI], 1.03-2.73). This association was overall stronger in African American individuals (RR, 3.93; 95% CI, 1.67-9.22) than white individuals (RR, 1.28; 95% CI, 0.71-2.32) and for lung cancer deaths (RR, 2.14; 95% CI, 0.97-4.72) than non-lung cancer deaths (RR, 1.50; 95% CI, 0.81-2.78). In African American individuals, early AMD was associated with a 5-fold higher risk of lung cancer deaths (RR, 5.28; 95% CI, 1.52-18.40). Middle-aged African American individuals with early AMD may be at increased risk of dying of cancer, particularly lung cancer. This association was not present in white individuals and needs confirmation in other studies.

              Author and article information

              S. Karger AG
              December 2008
              20 August 2008
              : 222
              : 6
              : 378-379
              aBeijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China; bDepartment of Ophthalmology, Medical Faculty Mannheim, Ruprecht Karl University of Heidelberg, Mannheim, Germany
              151468 Ophthalmologica 2008;222:378–379
              © 2008 S. Karger AG, Basel

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              : 13 December 2007
              : 21 December 2007
              Page count
              References: 10, Pages: 2
              Original Paper

              Vision sciences,Ophthalmology & Optometry,Pathology
              Age-related maculopathy,Mortality,Beijing Eye Study


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