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      Mortality in Blind Subjects

      a , b , c , a
      S. Karger AG
      Blindness, Mortality, Multiple morbidity

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          Background: Previous studies indicated that mortality is increased in blind subjects. However, no detailed analysis with respect to causes of blindness and the effect of additional diseases has been performed. The present study was undertaken to examine these questions. Materials and Methods: The investigation is based on social security files from the Württemberg-Hohenzollern region (population 5.5 millions) in Germany. In total, 571 files of blind subjects whose blindness benefits terminated (mostly due to death) in 1994 were included. Medical opinions on ophthalmological status and general health were extracted from the files. Standardised mortality ratios (SMRs) on the basis of life tables of former West Germany were calculated using maximum likelihood methods taking into account censoring. Results: Most subjects in our study had one or more additional diseases at onset of blindness (74%). The SMR in all blind is 1.41 [95% CI (confidence interval) = 1.28–1.54; n= 571]. Mortality of blind subjects is increased if subjects suffer from multiple disease at onset of blindness: the SMR in blind with multiple diseases is 1.76 (95% CI = 1.58–1.94; n = 421) versus 0.85 (CI = 0.70–1.0; n = 150) in otherwise healthy blind subjects. In cases where specifically ocular diseases were responsible for the visual loss, the symbol [M] indicates that the blind subject suffered from multiple disease at onset of blindness and [E] denotes that this was not the case. The SMRs for main causes of blindness are: macular degeneration [M] 1.5 (CI = 1.3–1.8; n = 123), [E] 1.1 (CI = 0.8–1.5; n = 43); glaucoma [M] 1.6 (CI = 1.3–2.1; n = 65), [E] 1.0 (CI = 0.6–1.5; n = 26); high myopia [M] 1.2 (CI = 0.8–1.7; n = 32), [E] 0.8 (CI = 0.5–1.2; n = 21); optic atrophy [M] 1.1 (CI = 0.6–1.8; n = 19), [E] 1.4 (CI = 0.4–3.2; n = 4), and tapetoretinal degeneration [M] 2.3 (CI = 1.1– 4.2; n = 10), [E] 0.9 (CI = 0.4–1.8; n = 12). The SMR of cases of blindness in conjunction with other diseases was fairly high for diabetic retinopathy: 5.5 (CI = 4.4–6.8; n = 81). Central-nervous-system-triggered blindness led to an SMR of 1.5 (CI = 1.0–2.2; n = 37). Discussion: According to the results of the present study mortality is significantly increased in blind subjects. However, increased mortality in cases of blindness due to specifically ocular disease (e.g. macular degeneration) is associated with the presence of multiple (extra-ocular) diseases at onset of blindness.

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          Author and article information

          S. Karger AG
          February 1999
          11 December 1998
          : 213
          : 1
          : 48-53
          Departments of aMedical Information Processing and bMedical Biometry, University of Tübingen, and cLandessozialamt (Social Services) Württemberg-Hohenzollern, Stuttgart, Germany
          27393 Ophthalmologica 1999;213:48–53
          © 1998 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Figures: 1, Tables: 6, References: 10, Pages: 6
          Original Paper · Travail original · Originalarbeit

          Vision sciences,Ophthalmology & Optometry,Pathology
          Multiple morbidity,Blindness,Mortality
          Vision sciences, Ophthalmology & Optometry, Pathology
          Multiple morbidity, Blindness, Mortality


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