Abstract
Purpose :
To elucidate demographic and ocular risk factors on developing corneal ulcers in the geriatric population.
Methods :
Data was collected from a 5% nationwide sample of Medicare beneficiaries aged 65 and above from 2011-2015. Diagnosis of corneal ulcer and ophthalmic disease was defined as having 2 or more claims of each diagnosis. Patients with prior history corneal disorders due to contact lenses, cataract surgery, keratoplasty, or pterygium surgery were excluded. Demographical characteristics including age, gender, race/ethnicity, and climate region were collected. Odds ratios between corneal ulcer and each ocular disease, controlling for demographical covariates, were generated using logistic regression models.
Results :
A total of 2,793 patients with corneal ulcers were identified. Patients of Asian (OR 0.64, 95% CI [0.43, 0.91]), Black (OR 0.47, 95% CI [0.39, 0.56]), and Hispanic race (OR 0.63, 95% CI [0.44, 0.86]) had lower odds of being diagnosed with a corneal ulcer compared to White patients. Moreover, compared to patients residing in the Northeast, patients in the Northwest were less likely to have a corneal ulcer (OR 0.70, 95% CI [0.56, 0.85]). There was no observed pattern between age and corneal ulcer. Having dry eye (OR 5.01, 95% CI [4.60, 5.46]), open-angle glaucoma (OR 2.84, 95% CI [2.56, 3.15]), and cicatrizing disease, including ocular cicatricial pemphigoid, graft vs host disease, and Stevens-Johnson syndrome (OR 10.18, 95% CI [4.98, 18.47]), was associated with associated with higher odds of corneal ulcer diagnosis. After controlling for the presence of dry eye and other ophthalmic disease, Sjogren’s syndrome continued to be an independent risk factor for corneal ulceration (OR 2.57, 95% CI [1.85, 3.47]).
Conclusions :
Race and geography influence the prevalence of corneal ulcers. Controlling for these covariates, there is a significant association between corneal ulcers and dry eye, Sjogren’s syndrome, open-angle glaucoma, and cicatrizing disease in the geriatric population. These associations underscore the importance of close monitoring in patients with the observed risk factors to prevent sight-threatening progression of corneal ulcers.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.