Mortality in primary open-angle glaucoma: ‘two cupped discs and a funeral’

Purpose: The aim of this study was to investigate the causes of mortality in individuals with open-angle glaucoma (OAG).

Methods: All-cause mortality data from the Registry of Births, Deaths and Marriages for the Australian state of Tasmania, for all people who were at least 40 years of age at the time of death, were classified using International Classification of Diseases-10 guidelines. This information was cross-referenced to identify participants in the Glaucoma Inheritance Study in Tasmania (GIST) who had died. Contingency tables were used for crude analysis and then models were constructed, adjusting for age at death as well as gender.

Results: Between 1996 and 2005, a total of 33 879 deaths were recorded. Data were unavailable for 4868 (14.4%) people. The mean age at death for the study sample was 78.4+/-11.5 (range 41-109) years. Of those cases known to have OAG by their participation in GIST (n = 2409), full mortality data were available for 741 (92.0%). Following adjustment for the age at death and male gender, the odds ratio for death due to ischaemic heart disease in people with OAG compared to the general population not known to have OAG was significant (OR = 1.30, 95% CI: 1.08-1.56; P = 0.006). Crude analysis revealed that there were significantly fewer people with OAG who died due to metastatic cancer (P < 0.001); however, this did not remain significant following adjustment for age and gender.

Conclusion: The pathoaetiological relationship between OAG and ischaemic heart disease is unclear and requires further investigation. Increased awareness of the association between cardiovascular disease and OAG is warranted.