Abstract
Purpose :
Known AMD risks include demographic variables such as age, sex, and race, but the impact of environmental exposures is currently unclear. We investigate associations of environmental exposures with nvAMD development across the US.
Methods :
All patients ≥ 55 years in the IRIS Registry during 2016-2018 (period of interest [POI]) were analyzed. Patients undergoing treatment for nvAMD were identified by nvAMD ICD code and CPT code for anti-VEGF intravitreal injections. Patients without provider-level zip codes matching any zip code tabular area were excluded. Environmental data was obtained from public sources including the US Geological Survey, National Renewable Energy Laboratory, and National Oceanic and Atmospheric Administration. Patients were assigned environmental variables from measurements nearest their zip code. Variable selection was done using elastic-net regularization. Multivariable logistic regression quantified the association of each environmental variable with nvAMD while adjusting for age, sex, race, and phakic status.
Results :
A total of 18,166,512 patients were included. All demographic variables, phakic status, elevation, latitude, solar irradiance measured in global horizontal irradiance (GHI) and direct normal irradiance (DNI), and temperature and precipitation variables were included in our model after regularization. After adjusting for demographic factors and phakic status, the strongest environmental associations were DNI (OR: 0.550, 95%CI: [0.524, 0.578]), GHI (3.874, [3.452, 4.348]), and latitude (1.099, [1.092, 1.106]), while elevation had minimal association (1.000, [1.000, 1.000]) (Figure 1). The risk of nvAMD for a 75-year-old, pseudophakic, Caucasian female was calculated for the US (Figure 2).
Conclusions :
Strongest associations for environmental factors were seen for DNI, GHI, and latitude. Further studies are warranted to investigate the clinical relevance of these associations.
This is a 2021 ARVO Annual Meeting abstract.