March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Geographic Patterns of Pseudoexfoliative Glaucoma in the United States Medicare Population
Author Affiliations & Notes
  • Victoria L. Tseng
    Division of Ophthalmology, Alpert Medical School of Brown University, Providence, Rhode Island
  • Fei Yu
    Ophthalmology, UCLA Jules Stein Eye Institute, Los Angeles, California
  • Flora Lum
    H. Dunbar Hoskins, Jr, MD Center for Quality Eye Care, American Academy of Ophthalmology, San Francisco, California
  • Anne L. Coleman
    Ophthalmology, UCLA Jules Stein Eye Institute, Los Angeles, California
  • Footnotes
    Commercial Relationships  Victoria L. Tseng, None; Fei Yu, None; Flora Lum, None; Anne L. Coleman, None
  • Footnotes
    Support  Center for Eye Epidemiology/Jules Stein Eye Institute
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 4462. doi:
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    • Get Citation

      Victoria L. Tseng, Fei Yu, Flora Lum, Anne L. Coleman; Geographic Patterns of Pseudoexfoliative Glaucoma in the United States Medicare Population. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4462.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose:
 

To determine whether geographic region of residence is an independent risk factor for pseudoexfoliative glaucoma in the United States (US) Medicare population.

 
Methods:
 

The 2009 Denominator and Physician/Supplier Part B files for a 5% sample of Medicare beneficiaries were used to identify patients with isolated pseudoexfoliation syndrome, pseudoexfoliative glaucoma, primary open angle glaucoma, and any type of glaucoma. The prevalence of each condition in 2009 in the Medicare population was determined for the northern, middle, and southern tiers of the continental US. Baseline characteristics examined included demographics, Charlson Comorbidity Index (CCI) score, risk factors for pseudoexfoliation syndrome, and ocular comorbidities. Adjusted odds ratios (OR) of Medicare patients having isolated pseudoexfoliation syndrome, pseudoexfoliative glaucoma, primary open angle glaucoma, or any type of glaucoma during 2009 were determined for each tier of US residence.

 
Results:
 

In the 5% sample of Medicare beneficiaries in 2009, there were 2,487 patients with isolated pseudoexfoliation syndrome, 2,803 patients with pseudoexfoliative glaucoma, 95,484 patients with primary open angle glaucoma, and 176,353 patients with any type of glaucoma. Using the middle tier of the US as a reference, adjusted OR (95% confidence interval [CI]) of having each condition in in the northern tier was 1.56 (1.43,1.71) for isolated pseudoexfoliation syndrome, 2.00 (1.84,2.17) for pseudoexfoliative glaucoma, 1.04 (1.02,1.06) for primary open angle glaucoma, and 1.11 (1.09,1.12) for any type of glaucoma. Using the middle tier of the US as a reference, adjusted OR (95% CI) of having each condition in the southern tier was 0.62 (0.56,0.69) for isolated pseudoexfoliation syndrome, 0.68 (0.61,0.76) for pseudoexfoliative glaucoma, 0.97 (0.96,0.99) for primary open angle glaucoma, and 0.94 (0.92,0.95) for any type of glaucoma.

 
Conclusions:
 

Consistent with a previous report, this study suggests that northern US residence may be an independent risk factor for the development of pseudoexfoliative glaucoma. Other types of glaucoma are much more weakly associated with region of US residence. Further prospective studies are warranted to investigate the association between region of residence and glaucoma.

 
Keywords: clinical (human) or epidemiologic studies: prevalence/incidence 
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