Abstract
Purpose :
To examine potential risk factors for developing retinal vein occlusion (RVO) in California (CA) Medicare beneficiaries with primary open angle glaucoma (POAG).
Methods :
This was a cross-sectional study using the 2019 CA Master Beneficiary Summary File and Standard Analytic Files for part B carrier claims obtained from the Centers for Medicare and Medicaid Services. Study participants included CA residents 65 years and older, with both Medicare Part A and B coverage and at least one part B claim in 2019, with a diagnosis of POAG, which was defined by the International Classification of Diseases, Tenth Revision (ICD-10) diagnosis codes. The outcome of interest was RVO, which was defined by ICD-10 diagnosis codes. Potential RVO risk factors that were examined included age, sex, race and ethnicity, systemic disease burden defined by Charlson Comorbidity Index (CCI) score, hypertension (HTN) and diabetes mellitus (DM). Univariate logistic regression models were first used to examine the association between each factor and RVO, and a multivariable logistic regression model was then conducted to assess the associations between all factors and RVO jointly.
Results :
The study population included 171,988 CA Medicare beneficiaries with POAG, of whom 5,230 (3.0%) had an RVO diagnosis. In univariate logistic regression models, greater odds for RVO was seen in beneficiaries with HTN (odds ratio [OR]=1.58; 95% confidence interval [CI]=1.47-1.70), and DM (OR=1.15; 95% CI=1.08-1.21), and in Black compared to Non-Hispanic White beneficiaries (OR=1.29; 95% CI=1.16-1.43), while reduced odds for RVO was seen in females compared to males (OR=0.85; 95% CI=0.81-0.90). Greater odds for RVO was also associated with increasing age (OR=2.30; 95% CI=2.05-2.57 for >90 vs. 65-69 years old), and increasing CCI score (OR=1.61; 95% CI=1.48-1.75 for CCI 5+ vs. CCI 0). In the multivariable logistic regression model, all factors remained statistically significant in the same direction except for DM (OR=1.00; 95% CI=0.94-1.07), and CCI scores of 1 to 2 (OR=1.06; 95% CI=0.97-1.15).
Conclusions :
In 2019 CA Medicare beneficiaries with POAG, those who were Black, male, older, with increased systemic disease burden, and with HTN had increased likelihood of RVO. Further investigations are needed to examine potential interventions to reduce RVO risk and sequelae in beneficiaries with POAG.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.