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Jeffrey Ryuta Willis, Susan Vitale, Lawrence S Morse, David W Parke, William L Rich, Flora Lum, Ronald Cantrell; The Burden of High Myopia and Pathological Myopia in the United States. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2467.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the prevalence and factors associated with high myopia (HM) and pathological myopia (PM) in the United States (US).
Cross-Sectional Study. Study participants included individuals 18 years and older, participating in the National Health and Nutrition Examination Survey (NHANES) and patients 18 years and older seen in clinics participating in the American Academy of Ophthalmology’s IRIS® Registry (Intelligent Research in Sight ). We analyzed NHANES data from 2005-2008 to determine the prevalence of HM. HM was defined as myopic refractive error of ≥-6.0 Diopters in the right eye. This prevalence was then applied to estimates from the US Population Census to arrive at a diopter-adjusted population burden of HM. Data from the IRIS Registry were used to calculate the real-world rates of PM among patients with HM at the diopter level. PM was defined as HM with the ICD-9-CM code of “360.21: Progressive High (Degenerative) Myopia.” This was subsequently applied to the above reference population with HM to calculate the diopter-adjusted prevalence and population burden of PM.
In the NHANES, 8,865 individuals (78.3%) had sufficient vision and lensometry/auto-refraction data to classify their degree of myopia. In the IRIS Registry, 2,622,400 individuals (80.5%) seen across 259 clinics had sufficient refraction data to classify their degree of myopia. The estimated diopter-adjusted prevalence of HM and PM were 3.92% (95% CI, 2.82 – 5.60%) and 0.33% (95% CI, 0.21-0.55%), respectively, among US adults aged 18 and older. This translated into an annual population burden of approximately 9,614,719 persons with HM and 817,829 persons with PM. The prevalence of HM in females and males was 4.88% and 2.99%, respectively [Adjusted Odds Ratio (OR) 1.66; 95% CI 1.24-2.24]. The diopter-adjusted prevalence of PM in females and males was 0.418% and 0.245%, respectively [Unadjusted OR 1.072; 95% CI 1.067- 1.077]. The prevalence of PM increased with worsening myopic refraction across both sexes.
HM and PM impose a large burden in the US and these individuals are at risk for experiencing vision-threatening conditions such as myopic choroidal neovascularization. Females appear to be at greater risk for developing HM and PM in the US. Relating data from IRIS Registry and NHANES is a novel method for determining ophthalmic disease prevalence in the US.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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