The Prevalence of Myopic Choroidal Neovascularization in the United States: Analysis of the IRIS^® Data Registry and NHANES

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• 作者：Jeffrey R. Willis ; MD ; PhD¹ ; ² ; Susan Vitale ; MHS ; PhD³ ; Lawrence Morse ; MD ; PhD¹ ; David W. Parke II ; MD⁴ ; William L. Rich ; MD⁴ ; Flora Lum ; MD⁴ ; ^{flum@aao.org" class="auth_mail" title="E-mail the corresponding author} ; Ronald A. Cantrell ; PhD²
• 关键词：AAO ; American Academy of Ophthalmology ; AMD ; age-related macular degeneration ; CI ; confidence interval ; D ; diopter ; EHR ; electronic health record ; HM ; high myopia ; ICD-9-CM ; International Classification of Diseases ; 9th Revision ; Clinical Modification ; IRIS ; Intelligent Research in Sight ; LL ; lower limit ; mCNV ; myopic choroidal neovascularization ; NHANES ; National Health and Nutrition Examination Survey ; NOS ; not otherwise specified ; OR ; odds ratio ; PHM ; progressive high myopia ; UL ; upper limit
• 刊名：Ophthalmology
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：123
• 期：8
• 页码：1771-1782
• 全文大小：974 K

文摘

To determine the prevalence of high myopia (HM), progressive high (degenerative) myopia (PHM), and myopic choroidal neovascularization (mCNV) in the United States.

Design

Cross-sectional study.

Participants

Individuals aged 18 years and older participating in the National Health and Nutrition Examination Survey (NHANES) and patients aged 18 years and older seen in clinics participating in the American Academy of Ophthalmology's Intelligent Research in Sight (IRIS^®) Registry.

Methods

We analyzed NHANES data from 2005 to 2008 to determine the prevalence of HM in the United States. This prevalence was then applied to estimates from the US Population Census (2014) to arrive at a population burden of HM at the diopter level in the United States. Data from the IRIS Registry were used to calculate the real-world prevalence rates of PHM and mCNV among patients with HM at the diopter level. This was subsequently applied to this reference population with HM to calculate the diopter-adjusted prevalence and population burden of PHM and mCNV in the United States in 2014.

Main Outcome Measures

High myopia was defined as myopic refractive error of ≤6.0 diopters in the right eye. Progressive HM was defined as HM with the International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) code of “360.21: Progressive High (Degenerative) Myopia.” Myopic CNV was defined as HM with the presence of subretinal/choroidal neovascularization indicated by the ICD-9-CM diagnosis of “362.16: Retinal Neovascularization NOS.”

Results

The estimated diopter-adjusted prevalence of HM, PHM, and mCNV was 3.92% (95% confidence interval [CI], 2.82–5.60), 0.33% (95% CI, 0.21–0.55), and 0.017% (95% CI, 0.010–0.030), respectively, among adults in the United States aged 18 years and older in 2014. This translated into a population burden of approximately 9 614 719 adults with HM, 817 829 adults with PHM, and 41 111 adults with mCNV in the United States in 2014.

Conclusions

Although HM and PHM impose a relatively large burden among adults in the United States, mCNV seems to be a rare disease. Relating data from the IRIS Registry and NHANES could be a novel method for assessing ophthalmic disease prevalence in the United States. Future studies should aim to better assess current treatment patterns and optimal management strategies of this condition.