Unadjusted hazard ratio of 2.14 for mortality in primary open-angle glaucoma patientsUnderstanding the link between glaucoma and overall health risks for patients

International ophthalmology Published August 7, 2026 Study authors: Shan Shiyi, Luo Zeyu, Feng Yan, Liu Xinyu, Cao Jin, Wu Jing, Zhang Chenhao, Jiang Denan, Song Peige PubMed ↗ DOI ↗ Editorial oversight: Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

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Key Takeaway

Note that while unadjusted data shows increased mortality in POAG, adjusted results are not statistically significant.

This meta-analysis synthesizes data regarding the mortality rates of individuals with primary open-angle glaucoma (POAG), primary angle-closure glaucoma (PACG), and congenital glaucoma. The study aimed to quantify the risk of death associated with these specific ocular conditions across different cohorts.

Key findings include an annual cumulative mortality of 3.42% for POAG (95% CI 1.70%-5.58%) and a mortality rate of 6.1 per 1000 person-years (95% CI 5.5-6.7). While the unadjusted relative mortality risk for POAG showed an increased hazard ratio of 2.14 (95% CI 1.32-3.47), the fully adjusted model yielded a non-significant hazard ratio of 1.13 (95% CI 0.91-1.40). Additionally, cumulative mortality for PACG over ten years was reported at 47.6% (95% CI 25.7%-70.2%), and congenital glaucoma showed a 3.48% cumulative mortality over 15 years.

The authors note that more prospective studies are required to establish a basis for allocating resources toward eye health care. Clinically, these results suggest that while POAG is associated with increased mortality in raw data, the lack of significance in adjusted models indicates potential confounding factors. Integrating glaucoma management into comprehensive systemic health care may improve long-term outcomes.

How this fits prior evidence

This meta-analysis addresses a gap in understanding the systemic impact and mortality risks associated with specific glaucoma subtypes. While prior evidence has focused on diagnostic tools, such as portable visual-field testing devices with 86% sensitivity, and physiological factors like glucocorticoid signaling influencing intraocular pressure, this study specifically quantifies mortality risk. The finding of an unadjusted hazard ratio of 2.14 for POAG provides a specific metric for the severity of the condition's impact on overall survival.

Doctors are looking closer at how eye conditions like glaucoma affect a person's overall health. This study looked at many different types of glaucoma to see if they were linked to a higher risk of death over time.

For people with primary open-angle glaucoma, the data showed an increased risk when only basic factors were looked at. However, when researchers adjusted for other health conditions, that specific link became less clear. This suggests that many factors can influence a patient's health at once.

Other types of glaucoma, such as those found in infants or those caused by blocked drainage, showed different patterns. Because these results are complex, experts suggest that eye doctors and general doctors should work together to provide the best care possible.

By treating the whole person rather than just the eyes, doctors can better manage a patient's long-term health. More studies are needed to help hospitals decide how to best share resources for eye care and general health.

What this means for you:

Patients with glaucoma may face higher health risks, making it important for eye and general doctors to work together.

Common questions

What did the study find about primary open-angle glaucoma?

The study found an unadjusted relative mortality risk of 2.14 for those with primary open-angle glaucoma (POAG). However, when researchers adjusted the data to account for other factors, the result was not statistically significant. The annual cumulative mortality for this group was found to be 3.42%.

How do different types of glaucoma compare in risk?

The study looked at several types. Primary angle-closure glaucoma showed a cumulative mortality rate of 47.6% over ten years. Congenital glaucoma showed a cumulative mortality rate of 3.48% over 15 years.

What does this mean for my treatment?

The findings suggest that managing glaucoma should be part of a complete health plan. Because the data shows different risks for different types of glaucoma, you should talk to your doctor about how these findings relate to your specific condition.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedAug 2026

PMID42565899

View Original Abstract ↓

OBJECTIVES: To quantify the mortality and relative mortality risk of glaucoma and its subtypes through a systematic review and meta-analysis. METHODS: We identified prospective studies reporting glaucoma mortality published from January 1, 1990 to August 9, 2025. Data on absolute mortality and relative mortality risk of primary open-angle glaucoma (POAG), primary angle-closure glaucoma (PACG), and congenital glaucoma were extracted. The absolute mortality was reported either as cumulative mortality or mortality rate, and the relative mortality risk was reported as hazard ratio (HR), risk ratio (RR), or odds ratio (OR). The annual cumulative mortality (ACM) of POAG was transformed from cumulative mortality and pooled using a random-effects meta-analysis. Unadjusted and fully adjusted HRs of mortality risk comparing people with and without POAG were also pooled using random-effects meta-analyses. RESULTS: Seven articles were included. The pooled ACM of POAG was 3.42% (95% confidence interval [CI] 1.70%-5.58%). The mortality rate of POAG was reported in one study as 6.1 (95% CI 5.5-6.7) per 1000 person-years. A significant association between POAG and mortality was observed in the pooled unadjusted relative mortality risk estimates (HR 2.14, 95% CI 1.32-3.47). Fully adjusted relative mortality risk estimates did not show a significant association with mortality (HR 1.13, 95% CI 0.91-1.40). The cumulative mortality of PACG over ten years (47.6%, 95% CI 25.7%-70.2%) and the cumulative mortality of congenital glaucoma over 15 years (3.48%) were reported. CONCLUSION: In the context of global aging, integrating glaucoma care with comprehensive management of systemic health may help improve long-term outcomes among individuals with glaucoma. More prospective studies are needed to provide a basis for allocating resources for eye health care.

Unadjusted hazard ratio of 2.14 for mortality in primary open-angle glaucoma patientsUnderstanding the link between glaucoma and overall health risks for patients

How this fits prior evidence

Common questions

Study Details

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Unadjusted hazard ratio of 2.14 for mortality in primary open-angle glaucoma patientsUnderstanding the link between glaucoma and overall health risks for patients

How this fits prior evidence

Common questions

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Systematic review of extensive macular atrophy with pseudodrusen reports visual acuity decline and atrophy progression

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