Abstract
Purpose :
Pterygium is a common fibrovascular growth extending from the conjunctiva to the corneal surface that ranges in severity from mild and painless to moderate eye irritation and redness to severe presentations with decreased vision. The United States (US) prevalence of pterygium is estimated at 10–15 million persons (Lucas R et al 2006; Modenese A et al 2018), but this condition is likely underdiagnosed. Here we present a claims analysis to characterize the diagnosed pterygium patient population in the US.
Methods :
Medical claims data were collected from 2016 through 2021 from the Komodo database and from 2018 and 2019 from the Compile database to determine pterygium prevalence and principal care providers for the condition, respectively. Electronic medical record (EMR) data from 2016 through 2021 were collected from the TriNetX database to analyze treatment regimens. Pterygium was defined as ICD-10 code 11.00 and all variations.
Results :
Analysis of insurance claims between 2016 and 2021 identified ~830,000 patients with pterygium among 110 million unique lives in the Komodo database, which represents ~33% of the US population. When extrapolated, the estimate of pterygium prevalence is 2.5 million diagnosed patients between 2016 and 2021. Ophthalmologists were the most common healthcare providers for this condition (Figure). Per EMR data, topical eyedrops to manage pterygium symptoms were the most frequent treatment, used in 79% of patients. Surgical excision was performed in ~12% of patients.
Conclusions :
In an analysis of closed insurance claims in the US, approximately 2.5 million individuals with pterygium sought care between 2016 and 2021. These data are in contrast to the projected prevalence of up to 15 million persons in the US with pterygium, which indicates that pterygium is underdiagnosed, potentially due to a lack of available treatments. Eye care professionals are the principal healthcare providers for pterygium. Topical agents (eyedrops) for symptom management are the most common treatments for pterygium, but they do not address the underlying cause of the disease. For advanced pterygium affecting vision, surgery is a treatment option, but this approach is not preferred by patients because of the perception of morbidity and pain. There is an unmet medical need for the development of an effective topical therapy for this condition.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.