Mortality Rate in Ocular Ischemic Syndrome
Ocular ischemic syndrome carries a 5-year mortality rate of approximately 40%, which is nearly four times higher than age- and sex-matched controls (11% in the Framingham study), with cardiac disease being the leading cause of death. 1
Mortality Statistics
- The 5-year mortality rate is 40% in patients diagnosed with ocular ischemic syndrome, compared to 11% in age- and sex-matched controls from the general population 1
- Cardiac disease accounts for 63% of deaths in these patients, making it the predominant cause of mortality 1
- Stroke represents 19% of deaths, making it the second leading cause of mortality in this population 1
Why Mortality is So High
The elevated mortality reflects the systemic nature of the underlying vascular disease:
- Ocular ischemic syndrome is a manifestation of severe atherosclerotic disease, typically involving 80-99% stenosis or complete occlusion of the internal carotid artery in 74% of cases 2
- The condition serves as a sentinel marker for widespread cardiovascular disease, indicating that patients have advanced systemic atherosclerosis affecting multiple vascular beds 2, 3
Associated Systemic Comorbidities
Patients with ocular ischemic syndrome have exceptionally high rates of life-threatening comorbidities:
- Diabetes mellitus is present in 56% of patients, which is significantly higher than the comparable general population 1, 2
- Systemic arterial hypertension affects 50-73% of patients with ocular ischemic syndrome 1, 2
- Coronary artery disease is present in 38%, with incidence much higher than in the general population 2
- Previous stroke or transient ischemic attack occurs in 31% of these patients 2
- Peripheral vascular disease affects 19% of patients 1
Clinical Implications
The diagnosis of ocular ischemic syndrome by an ophthalmologist may be crucial to the patient's survival, as it can be the presenting sign of serious cerebrovascular and ischemic heart disease that requires immediate systemic evaluation and management 2, 3
- Patients require urgent multidisciplinary referral to neurology, vascular surgery, and cardiology for comprehensive cardiovascular risk assessment and intervention 3
- The poor visual prognosis is secondary to the more critical systemic mortality risk, emphasizing that ocular findings should prompt aggressive systemic workup 2