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The Barbados Eye Studies

Suh-Yuh Wu, MA; Barbara Nemesure, PhD; Anselm Hennis, PhD, FRCP; Andrew P. Schachat, MD; Leslie Hyman, PhD; M. Cristina Leske, MD, MPH; for the Barbados Eye Studies Group

Arch Ophthalmol. 2008;126(3):365-370.

Objective  To evaluate the relationship between open-angle glaucoma (OAG) and mortality in a black population at 9-years' follow-up.

Design  Population-based cohort study of 4092 black participants (aged 40-84 years at baseline) in the Barbados Eye Studies. Open-angle glaucoma was defined by visual field defects and optic disc damage, based on standardized examinations and photograph gradings. Ocular hypertension was defined by an intraocular pressure greater than 21 mm Hg or treatment, without OAG damage. Mortality was ascertained from death certificates. Cox proportional hazards regression analyses determined associations with mortality.

Results  After 9 years, 764 (19%) participants were deceased. Mortality was unrelated to overall OAG at baseline (n = 300) after adjustment for confounders. However, cardiovascular mortality tended to increase in persons with previously diagnosed/treated OAG (n = 141; relative risk [RR], 1.38, P = .07) and was significantly higher with treatment involving timolol maleate (RR, 1.91, P = .04). Cardiovascular deaths also tended to increase in persons with ocular hypertension at baseline (n = 498; RR, 1.28, P = .06).

Conclusions  In this black population, cardiovascular mortality tended to increase in persons with previously diagnosed/treated OAG and ocular hypertension. The excess mortality associated with timolol maleate treatment of OAG, also found in a white population, warrants further investigation.

Author Affiliations: Departments of Preventive Medicine and Ophthalmology, Stony Brook University, Stony Brook, New York (Ms Wu and Drs Nemesure, Hennis, Hyman, and Leske); Ministry of Health, Bridgetown, Barbados; and Chronic Disease Research Centre, Tropical Medicine Research Institute, University of the West Indies, Cave Hill, Barbados (Dr Hennis); and the Cleveland Clinic Foundation, Cleveland, Ohio (Dr Schachat).
Group Information: A list of the Barbados Eye Studies members was published in Arch Ophthalmol. 2006;124(11):1631-1636.

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