Ocular pseudoexfoliation syndrome and life span.

BACKGROUND: To compare life span of persons with and without ocular pseudoexfoliation syndrome (PES). METHODS: The study is based on an epidemiological survey conducted in Sør-Trøndelag county, Norway, in 1985-86. All inhabitants over 64 years of age (2109 individuals) were invited. Mortality information was obtained from The Norwegian Institute of Public Health in 2014, by which time 99% of the participants were deceased. RESULTS: When adjusting for age and gender, life span was not statistically different in persons with and without PES. Following the diagnosis of PES, patients' survival was up to, and beyond, 30 years. CONCLUSIONS: Our observations suggest that, despite all the systemic aberrations reported in persons with ocular PES, none or only marginal functional changes are caused in extraocular organs and tissues. The present study supports the notion that systemic PES is not a life-threatening condition.

Pseudoexfoliation and mortality: a population-based 30-year follow-up study.

PURPOSE: To study the relationship between pseudoexfoliation (PEX) and all-cause mortality in a population in which PEX is a common finding. METHODS: Survival analyses were performed in a cohort of 760 residents 65-74 years of age, examined in a population survey in the municipality of Tierp, Sweden, 1984-86. To expand the cohort, participants in other studies in Tierp were enrolled. Additionally, people were recruited by means of glaucoma case records established at the Eye Department in Tierp in 1978-2007. In this way, the cohort comprised 1524 subjects, representing more than 21,100 person-years at risk. Information on deaths was obtained from the local population register. RESULTS: By the conclusion of the study, in August 2013, 1280 deaths had been reported. Of these cases, 350 were affected by PEX at baseline. No association between PEX and mortality was found (hazard ratio 1.00; 95% confidence interval 0.88-1.14). CONCLUSION: The results strongly suggest that PEX had no effect on all-cause mortality in the population under study.

Mortality in primary open-angle glaucoma and exfoliative glaucoma.

PURPOSE: To study mortality among unselected Finnish patients with either primary open-angle glaucoma (POAG) or exfoliative glaucoma (EG) after a minimum follow-up of 7 years after enrollment. METHODS: A total of 344 patients with POAG and 155 patients with EG had received free medication for the treatment of glaucoma from the Finnish National Social Insurance Institution (FSII). The FSII operates national health insurance, which is compulsory for all Finnish citizens. To be granted free medication, the patient has to file an application with a certificate from an ophthalmologist. If the predefined criteria for glaucoma specified by the Finnish Parliament are met, full reimbursement for glaucoma medications is granted and the patient is listed in the registry of FSII. We reviewed the records of 519 consecutive patients who had been diagnosed with glaucoma and to whom free medication had been granted between June 2004 and December 2005. Patients with acute glaucoma or secondary glaucoma were excluded. Those with open angles were classified into POAG or EG. The quality of the ophthalmologists' records was high. The Finnish Population Registry, a governmental institute, provided information on those patients who had died before January 2013. RESULTS: At enrollment, the groups with POAG and EG were comparable as regards sex: 66% female with POAG and 68% with EG. The patients with POAG were younger (median 68 years) than those with EG (median 74 years). By January 2013, 59 patients with POAG and 48 with EG had died. At death, the patients with POAG were younger (median 81.8 years) than those with EG (87.9 years). In both groups, the women lived longer than the men, but among patients with POAG, women and men died at a younger age than those with EG. CONCLUSIONS: As has been reported previously, life expectancy of patients with EG was longer when compared to those with POAG. Higher death rate among patients with EG is explained by higher median age at baseline.

Exfoliative glaucoma and primary open-angle glaucoma: associations with death causes and comorbidity.

PURPOSE: To investigate whether type of glaucoma or use of acetazolamide are associated with main cause of death and comorbidity. MATERIAL AND METHODS: The survival data, including date and cause of death, for 1147 patients with capsular or simple glaucoma who were ultimately hospitalized at the Eye Department, National Hospital, Oslo, between 1961 and 1970, were analysed. Binary logistic regression was carried out to investigate the patterns of death causes and comorbidity in subgroup analyses. RESULTS: Patients with exfoliative glaucoma (XFG) and those with primary open-angle glaucoma (POAG) showed no significant differences in rates of death caused by acute cerebrovascular diseases, cardiac diseases and cancer. Interestingly, we found that chronic cerebral diseases such as senile dementia, cerebral atrophy and chronic cerebral ischaemia (n = 81) were more common in patients with XFG than in those with POAG (p = 0.01) and in the group of acetazolamide users (p = 0.03). Patients with XFG had a higher probability of developing an acute cerebrovascular disease than patients with POAG (n = 228, p = 0.03). CONCLUSION: In this retrospective study, we found that comorbidity with acute cerebrovascular disease and chronic cerebral diseases (senile dementia, cerebral atrophy and chronic cerebral ischaemia) were more common in patients with XFG than in patients with POAG. Prospective data are needed in order to conclude upon the associations found in this study.

Comparison of survival of exfoliative glaucoma patients and primary open-angle glaucoma patients: impact of acetazolamide use.

PURPOSE: To compare the survival rates of patients with exfoliative glaucoma (XFG) and those with primary open-angle glaucoma (POAG), and to establish whether the use of acetazolamide has any influence on survival. METHODS: The survival data, including date and cause of death, for 1147 patients with XFG or POAG who were ultimately hospitalized at the Eye Department, National Hospital, Oslo, between 1961 and 1970, were analysed retrospectively. The Cox proportional hazard model was used in the survival analyses. RESULTS: No statistically significant differences in survival were found between patients with XFG and those with POAG (p = 0.85). As expected, female gender and younger age at diagnosis were associated with longer survival periods. Surprisingly, we found that patients with more recent birth dates had relatively lower survival rates than patients with earlier birth dates; when this was included in the analyses, the use of acetazolamide was found to be associated with reduced survival (n = 492, p = 0.02).

Pseudo-exfoliation and mortality.

The hypothesis that ocular pseudo-exfoliation syndrome is part of a generalized disorder has been tested by suggesting that subjects having this syndrome would have increased mortality. However, no association was found between presence of ocular pseudo-exfoliation syndrome and mortality.