Background: To assess associations between mortality and major ocular parameters and diseases.

Methods: The population-based Ural Eye and Medical Study (UEMS) and Ural Very Old Study (UVOS) included 5899 individuals (age: 40+ years) and 1526 individuals (age: 85+ years), respectively. Cause-specific mortality was determined using the government regional information and analytical system.

Results: In the UEMS, 689 (11.7%) participants had died during the follow-up of 7.0 ± 0.4 years (median: 6.9 years). Higher death occurrence was associated (multivariable analysis) with lower best corrected visual acuity (OR: 1.86; 95%CI:1.10, 2.68) and higher prevalence of diabetic retinopathy (OR: 2.97; 95%CI: 1.68, 5.26), with adjusting for older age (OR: 1.08), male sex (OR: 4.18), higher waist-hip ratio (OR: 5.53), current smoking (OR: 2.25), history of cancer (OR: 1.93) and dementia (OR: 2.54), higher serum concentration of glucose (OR: 1.13) and lower serum concentration of high-density lipoproteins (OR: 0.89) and haemoglobin (OR: 0.99), higher leucocyte count (OR: 1.07), higher prevalence of chronic obstructive pulmonary disease (OR: 1.67), higher stage of arterial hypertension (OR: 1.15), and higher depression score (OR: 1.04). Death occurrence was not significantly associated with prevalence of age-related macular degeneration (P = 0.90), macular reticular pseudodrusen (P = 0.90), open-angle glaucoma (P = 0.11), angle-closure glaucoma (P = 0.98), nuclear cataract (P = 0.07), cortical cataract (P = 0.46), axial length (P = 0.44) and intraocular pressure (P = 0.87). In the UVOS, 791 (51.9%) participants had died during the follow-up of 4.8 ± 1.0 years (median: 5.2 years). None of the ophthalmological parameters was significantly associated with death occurrence.

Conclusions: Diabetic retinopathy was the only major ophthalmic disease or parameter, in addition to vision impairment, which was associated with an increased death risk.

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http://dx.doi.org/10.1038/s41433-025-03615-6DOI Listing

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