July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Identification of risk factors influencing primary open-angle glaucoma incidence - a longitudinal cohort study based on health claims data
Author Affiliations & Notes
  • Stefanie Frech
    Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany
  • Daniel Kreft
    Institute for Sociology and Demography, University of Rostock, Rostock, Germany
    Rostock Center for the Study of Demographic Change, Rostock, Germany
  • Rudolf F Guthoff
    Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany
  • Gabriele Doblhammer
    Institute for Sociology and Demography, University of Rostock, Rostock, Germany
    Rostock Center for the Study of Demographic Change, Rostock, Germany
  • Footnotes
    Commercial Relationships   Stefanie Frech, None; Daniel Kreft, None; Rudolf Guthoff, None; Gabriele Doblhammer, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2727. doi:
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      Stefanie Frech, Daniel Kreft, Rudolf F Guthoff, Gabriele Doblhammer; Identification of risk factors influencing primary open-angle glaucoma incidence - a longitudinal cohort study based on health claims data. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2727.

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

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Abstract

Purpose :
Primary open-angle glaucoma (POAG) is a chronic and initially asymptomatic disease which causes irreversible nerve fiber damage. It progresses slowly without any notable sign of vision loss until it is very advanced. The study was performed to simultaneously investigate the influence of multiple risk factors influencing POAG incidence based on a large administrative dataset of individual-level health records over the time period 2011-2013.

Methods :
A random sample of 250,000 persons age 50+ of the largest German public health insurer, the Allgemeine Ortskrankenkasse (AOK), was used. The quarter-specific data covered general demographic information, inpatient and outpatient ICD-10 diagnoses, medical treatments, and medication. POAG was defined by using the ICD-10 classification H-40.1. Selected risk factors of POAG incidence were analyzed by applying a multivariate Cox proportional hazard model.

Results :
The incidence rate was 0.38 (95% CI: 0.36-0.39) per 100 person-years for the total population with a rate of 0.32 (95% CI: 0.29-0.34) for men and a rate of 0.43 (95% CI: 0.40-0.45) for women. The hazard model revealed a significant age effect with an increase up to the age of 85-89 (202%, p<0.001, compared to the age of 50-54) followed by a decrease at the highest ages. Furthermore, there was a significant 16% (p=0.001) higher incidence for women compared to men and a higher incidence for persons with myopia (163%, p<0.001), an injury of the eye and orbit (146%, p=0.002), hyperopia (128%, p<0.001), and diabetes mellitus (20%, p<0.001). Hypotension, hypertension, migraine, sleep apnea, and vasospasm revealed insignificant effects.

Conclusions :
To know the predictors responsible for an increased risk to develop POAG is of importance for all persons involved in health care management. Especially the general practitioner might profit from this knowledge, as a patient having known risk factors can be referred to an ophthalmologist for possible glaucoma identification to prevent progression of the disease by an immediate treatment. The lower incidence rates of people aged 90+ may be due to health selection, describing that healthy old-aged people develop fewer diseases. Due to the large sample size and the wide range of diagnoses, health claims data are a valuable source for the identification of risk factors.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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