June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Characterization of prevalence of ocular comorbidities and risk of legal blindness across the United States
Author Affiliations & Notes
  • Jeffrey Chu
    Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
  • Jacqueline K. Shaia
    Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
    Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Neha Sharma
    Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
    Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Matthew W Russell
    Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
    Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, United States
  • Aleksandra V. Rachitskaya
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Katherine Talcott
    Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Rishi Singh
    Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
    Cleveland Clinic Martin North Hospital, Stuart, Florida, United States
  • Footnotes
    Commercial Relationships   Jeffrey Chu None; Jacqueline Shaia None; Neha Sharma None; Matthew Russell None; Aleksandra Rachitskaya None; Katherine Talcott Zeiss, Regenxbio, Code F (Financial Support), Genentech/Roche, Apellis, Eyepoint, Code I (Personal Financial Interest); Rishi Singh Genentech/Roche, Alcon, Novartis, Regeneron, Asclepix, Gyroscope, Bausch and Lomb, Apellis, Code I (Personal Financial Interest)
  • Footnotes
    Support  P30EY025585(BA-A), Research to Prevent Blindness (RPB) Challenge Grant, Cleveland Eye Bank Foundation Grant. This project was supported by the Clinical and Translational Science Collaborative (CTSC) of Cleveland which is funded by the National Institutes of Health (NIH), National Center for Advancing Translational Science (NCATS), Clinical and Translational Science Award (CTSA) grant, UL1TR002548. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 4217. doi:
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      Jeffrey Chu, Jacqueline K. Shaia, Neha Sharma, Matthew W Russell, Aleksandra V. Rachitskaya, Katherine Talcott, Rishi Singh; Characterization of prevalence of ocular comorbidities and risk of legal blindness across the United States. Invest. Ophthalmol. Vis. Sci. 2023;64(8):4217.

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

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Abstract

Purpose : Patients who suffer from visual impairment often present with multiple blinding ocular diseases. Among the most visually impairing conditions, it is poorly understood which ocular comorbidities pose the greatest risk for visual impairment and whether there are differences across sex and racial demographics. This study evaluated which ocular comorbidities and demographics are at highest risk for visual impairment.

Methods : A cross-sectional study was conducted through the TriNetX Analytics Network, a United States database that is comprised of over 87 million patients. Patients were identified for diabetic retinopathy (DR), age-related macular degeneration (AMD), retinal vein occlusion (RVO), glaucoma, uveitis, and visual impairment by ICD-10 codes and the prevalence of a visual impairment was calculated. Prevalence odds were stratified by sex and racial demographics. Statistical analyses were completed using RStudio and Excel and utilized 95% confidence intervals.

Results : The prevalence of visual impairment was higher for every comorbidity compared to a single ocular condition. The single ocular condition with the highest prevalence of low vision was RVO (11.38%) while the highest prevalence of blindness was AMD (6.39%). The combination of comorbidities with the highest prevalence of visual impairment were uveitis and RVO (56.4%), uveitis and DR (39.2%), and uveitis and AMD (26.9%). The comorbidities with the highest odds for low vision were DR and AMD (POR 12.33; 95% CI 11.75, 12.93), while the comorbidities with the highest odds for blindness were RVO and uveitis (4.84; 4.33, 5.41). Compared to the white male, black males had the highest prevalence odds for blindness in glaucoma and AMD (2.86; 2.58, 3.16), RVO and AMD (2.18; 1.57, 3.03), and DR and AMD (2.13; 1.81, 2.50).

Conclusions : The addition of a comorbid ocular disease results in increased prevalence and prevalence odds of low vision and blindness across all ocular conditions. Specifically, the addition of uveitis as a comorbidity appears to cause the greatest increase in visual impairment within comorbidities. Black males are also disproportionately affected by blindness compared to white males. These findings demonstrate which ocular conditions most threaten patient vision and the increased need to monitor minority patients, especially Black males, who have increased prevalence odds for vision loss.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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