Abstract
Purpose :
Prior studies evaluating risk factors for the development of uveitis and its complications have suggested a potential correlation between sex and race, among other factors. To study the real-world risk factors for development of uveitis, the present study employed analyses of data from a national health insurance claims database.
Methods :
Medical claims and demographic data were obtained from OptumInsight Clinformatics Data Mart, a large, national medical claims database. Inclusion required continuous enrollment for at least 15 months within 2007 to 2015 (n=21,516,133). For inclusion in the uveitis sample, an eye care provider established the index uveitis diagnosis (index date). Patients with an index date within 3 months after incisional intraocular surgery were excluded (n=137,536). For non-uveitis patients, an index date was randomly selected from the individual’s enrollment period. We excluded those with an index date after September 30, 2014 to ensure ICD9 coding throughout the observation period. We compared chronic comorbidities and risk factors for uveitis employing multivariable logistic regression.
Results :
Patients with uveitis were on average older than the full Optum population (52.8 vs. 40.4 years), less likely to be male (42.0% vs. 48.8%), more likely to be black (11.6% vs 8.6%), and less likely to be Hispanic (6.9% vs 10.2%) or Asian (3.6% vs. 4.4%) (p<0.01 for all differences). Logistic regression confirmed the unadjusted findings of higher incidence of uveitis among blacks (odds ratio (OR) compared to white, non-Hispanics: 1.32, p<0.01) and lower among males (OR 0.82, p<0.01) and Hispanics (0.88, p<0.01), but found higher incidence among Asians (OR 1.08, p<0.01). The five co-morbidities most strongly associated with uveitis incidence included rheumatoid arthritis (OR: 2.31, p<0.01), AIDS/HIV (OR: 2.19, p<0.01), hypertension (OR: 1.25, p<0.01), diabetes (OR: 1.16, p<0.01) and valvular disease (OR: 1.16, p<0.01). Income and education were positively associated with uveitis incidence.
Conclusions :
The real-world incidence of uveitis differs according to sex and race, and is higher among individuals with many common chronic illnesses. Patients with higher socioeconomic status have higher diagnosed incidence, potentially reflecting differences in access to healthcare.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.