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

Jeffrey R. Willis, Susan Vitale, Lawrence S Morse, David W. Parke, William L. Rich, Flora Lum, Ronald A. Cantrell

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Purpose 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.

Original languageEnglish (US)
Pages (from-to)1771-1782
Number of pages12
JournalOphthalmology
Volume123
Issue number8
DOIs
StatePublished - Aug 1 2016

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Degenerative Myopia
Choroidal Neovascularization
Nutrition Surveys
Registries
Myopia
Research
Population
International Classification of Diseases
Confidence Intervals
Retinal Neovascularization
Refractive Errors
Eye Diseases
Censuses
Ophthalmology
Rare Diseases

ASJC Scopus subject areas

  • Ophthalmology

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The Prevalence of Myopic Choroidal Neovascularization in the United States : Analysis of the IRIS® Data Registry and NHANES. / Willis, Jeffrey R.; Vitale, Susan; Morse, Lawrence S; Parke, David W.; Rich, William L.; Lum, Flora; Cantrell, Ronald A.

In: Ophthalmology, Vol. 123, No. 8, 01.08.2016, p. 1771-1782.

Research output: Contribution to journalArticle

Willis, Jeffrey R. ; Vitale, Susan ; Morse, Lawrence S ; Parke, David W. ; Rich, William L. ; Lum, Flora ; Cantrell, Ronald A. / The Prevalence of Myopic Choroidal Neovascularization in the United States : Analysis of the IRIS® Data Registry and NHANES. In: Ophthalmology. 2016 ; Vol. 123, No. 8. pp. 1771-1782.
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abstract = "Purpose 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{\circledR}) 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.",
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AU - Willis, Jeffrey R.

AU - Vitale, Susan

AU - Morse, Lawrence S

AU - Parke, David W.

AU - Rich, William L.

AU - Lum, Flora

AU - Cantrell, Ronald A.

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N2 - Purpose 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.

AB - Purpose 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.

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