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Marc Schargus, Daniel Pauleikhoff, Gisela Haeusser-Fruh, Mathias Maier; German Health Services Research Study: Estimated Prevalence and Incidence of Pathologic Myopia and Lack of Classification of different Stages of Pathologic Myopia. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1559.
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Currently, there are no data available in Germany on prevalence, incidence and treatment of pathologic myopia (PM)/high myopia and its complications. Additionally, there are different definitions of PM and its classification of severity and complications in the literature. Hence, the purpose of this study was to estimate the number of patients with different severity stages of PM in a clearly categorized scheme.
Health services survey with randomly selected ophthalmologists throughout Germany. Physicians were asked about diagnosis, monitoring of PM and health care situation. They were further asked to categorize myopic eyes into: 1. PM without macular degeneration (MD) and choroidal neovascularisation (CNV), 2. PM with MD and without CNV, or 3. CNV secondary to PM. Calculated prevalence/incidence were based on the number of patients reported by the participating ophthalmologists.
340 ophthalmologists took part (84.4% practice-based ophthalmologists, 11.8% retina specialists, 2.6% others) This reflects the real distribution of ophthalmologists throughout Germany. Overall patient number throughout these ophthalmologists was estimated at 2,146.398 patients per year. Based on the total number of patients per year and practice, the estimated prevalence of patients with myopia was calculated at 26.5% and with high myopia (>6D) at 3.4%. Of those, the prevalence/incidence of patients with PM (without MD and CNV) was calculated at 1.9%/0.6%, with PM and MD at 0.6%/0.2%, and with CNV secondary to PM at 0.2%/0.08%. The vast majority of physicians (93%) cited anti-VEGF injection as their most preferred treatment option for patients with CNV secondary to PM.
Estimated patient numbers were much higher than expected and varied considerably between physicians. This may be explained by double counting of patients by the different physicians to which patients had been referred to, the unequal grades of physician specialisation as well as by possibly underlying uncertainties regarding definitions, nomenclature and staging of PM/high myopia. Harmonised definitions, recommendation on diagnosis, disease information and continuous training on PM are required, as well as detailed epidemiological data from other countries for international comparisons.
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