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Presence of certain eye disorders linked with poorer survival rates

The JAMA Network Journals

CHICAGO - Individuals with age-related macular degeneration (AMD) and cataract may have a decreased life span compared with those without these eye disorders, suggesting that these conditions may also reflect other underlying processes, according to an article in the May issue of The Archives of Ophthalmology, one of the JAMA/Archives journals.

According to information in the article, various eye disorders have been reported to be significant predictors of a shorter life span, and cataract in particular may be a sign of physiological processes that are associated with aging and death. The reason that eye disorders are associated with decreased survival is unclear, the article states.

Frederick L. Ferris III, M.D., of the National Eye Institute, Bethesda, Md., and colleagues investigated whether various types of visual impairment and eye disorders were associated with death in participants in the Age-Related Eye Disease Study (AREDS), a long-term study of age-related cataract and AMD. AREDS included a subgroup of participants randomly assigned to take high-dose antioxidants, zinc, antioxidants plus zinc, or placebo. A total of 4,753 people aged 55 to 81 years entered AREDS between November 13, 1992 and January 15, 1998. During the median follow up of 6.5 years, 534 (11 percent) of AREDS participants died.

The researchers found that participants with AMD compared with participants with little or no drusen (opaque deposits under the retina associated with AMD) had about a 41 percent higher risk of death, and advanced AMD was associated with cardiovascular deaths. Compared with participants with good vision, those with vision worse than 20/40 (indicative of poor vision) in one eye and those who had cataract surgery had increased risks of death (36 percent and 55 percent, respectively). Patients who had been assigned to receive zinc had lower mortality than those not taking zinc (approximately 27 percent lower).

"The decreased survival of AREDS participants with AMD and cataract suggests that these conditions may reflect systemic rather than only local processes," the authors write. "The improved survival in individuals randomly assigned to receive zinc requires further study."

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(Arch Ophthalmol. 2004;122:716-726. Available post-embargo at archophthalmol.com)

Editor's Note: This study was supported by contracts from the National Eye Institute, National Institutes of Health, Department of Health and Human Services, with additional support from Bausch & Lomb, Inc., Rochester, N.Y.

For more information, contact JAMA/Archives Media Relations at 312/464-JAMA (5262) or e-mail mediarelations@jama-archives.org.

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