Purpose:
To estimate mortality risk depending on central retinal volume (CRV) from optical coherence tomography (OCT) in a German cohort of the old-aged population.

Methods:
In the AugUR study, a prospective population-based cohort study in individuals aged 70–95 years at baseline, we conducted multimodal retinal imaging, including spectral-domain OCT. Heidelberg Spectralis-derived CRV measurements from first examinations of 2,166 participants were included in the analyses. Within the observation period (median 5.9-years), 374 participants died. Association between CRV at baseline and mortality was analysed with Kaplan-Meier curves and Cox proportional hazard regression.

Results:
Decrease in CRV was associated with increased all-cause mortality risk. In a full model with age, sex, body weight, body size, OCT scan focus, age-related macular degeneration, smoking, cardiovascular disease, diabetes, and hypertension, hazard ratio per standard deviation lower CRV was 1.17. Cardiovascular death was not associated with CRV in the full model. However, other causes for death except cardiovascular reasons showed association with lower CRV (hazard ratio 1.25). In addition, the association was significant in those who had already exceeded their expected life expectancy (hazard ratio 1.21) but not in women below 83 years and men below 78 years, respectively.

Conclusion:
This study indicates that lower CRV, which can be easily and automatically derived from OCT images, is a potential predictor for mortality in the old-aged population. This effect occurs independently of cardiovascular disease.