May 2007
Volume 48, Issue 13
ARVO Annual Meeting Abstract  |   May 2007
Association Between Age-Related Macular Degeneration and Five-Year Mortality Among Medicare Patients
Author Affiliations & Notes
  • F. Yu
    Ophthalmology, JSEI, UCLA, Los Angeles, California
    UCLA School of Public Health, Los Angeles, California
  • E. Anastasopoulos
    Ophthalmology, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • A. L. Coleman
    Ophthalmology, JSEI, UCLA, Los Angeles, California
    UCLA School of Public Health, Los Angeles, California
  • Footnotes
    Commercial Relationships F. Yu, None; E. Anastasopoulos, None; A.L. Coleman, None.
  • Footnotes
    Support by the Center for Eye Epidemiology, Jules Stein Eye Institute, University of California Los Angeles, CA, and by an unrestricted grant from Research to Prevent Blindness, New York, NY.
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 2094. doi:
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      F. Yu, E. Anastasopoulos, A. L. Coleman; Association Between Age-Related Macular Degeneration and Five-Year Mortality Among Medicare Patients. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2094.

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

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Methods:: Medicare beneficiaries with AMD in 1995 were identified by International Classification of Diseases, Ninth Revision (ICD-9) diagnoses codes from a 5% random sample of Medicare databases (Centers for Medicare and Medicaid Services (CMS) 5% Physician/Supplier Part B Files), including neovascular AMD (ICD-9: 362.42, 362.43, 362.52), non-neovascular AMD (ICD-9: 362.51) and early AMD (ICD-9: 362.50, 362.57). Patients were excluded if they were under 65 years of age, did not reside in the 50 United States or the District of Columbia, did not have Part-B coverage, had HMO coverage that was not processed by CMS, or lacked follow-up information. Five-year mortality rate from 1995 to 1999 was then determined by the death code in the CMS 5% Denominator files. Multiple logistic regression models were applied to estimate the effects of AMD on the five-year mortality rate, adjusted for potential baseline risk factors, including demographic factors (age, gender, race/ethnicity, CMS region of residence, and length of follow-up) and clinical factors (the indicators for the presence of primary open-angle glaucoma, cataract, hypertension, cardiovascular disease, cerebrovascular disease, diabetes, and hyperlipidemia).

Results:: Among 1,223,796 eligible Medicare patients in the 5% sample, a total of 82,017 (6.7%) AMD patients were identified in 1995, including 9,224 (0.8%) neovascular AMD patients, 29,267 (2.4%) non-neovascular AMD patients, and 43,526 (3.6%) early AMD patients. The overall five-year mortality rate was 26%. There was no relationship between any AMD and five-year mortality rate in the adjusted model (OR=0.98; 95% CI: 0.96, 1.00). Compared with patients without any AMD, there was a significantly lower mortality rate in neovascular AMD patients (OR=0.87; 95% CI: 0.82, 0.92) and a slightly higher mortality rate in non-neovascular AMD patients (OR=1.03; 95% CI: 1.00, 1.07).

Conclusions:: Although there was no association between any AMD and the 5-year mortality rate in the fully-adjusted model, which is consistent with the results from the Beaver Dam Eye Study and the Blue Mountain Eye Study, neovascular AMD patients have significantly lower mortality rates and non-neovascular AMD patients have slightly higher mortality rates. These findings warrant further exploration.

Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: outcomes/complications 

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