美国的视力丧失和失明：按性别和相关疾病类别进行年龄调整的比较

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-02-07 DOI:10.1016/j.xops.2025.100735

Victoria A. Bugg MD , Kaleb Eppich MS , Macey S. Blakley BA , Flora Lum MD , Tom Greene PhD , M. Elizabeth Hartnett MD

{"title":"美国的视力丧失和失明：按性别和相关疾病类别进行年龄调整的比较","authors":"Victoria A. Bugg MD , Kaleb Eppich MS , Macey S. Blakley BA , Flora Lum MD , Tom Greene PhD , M. Elizabeth Hartnett MD","doi":"10.1016/j.xops.2025.100735","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate differences in vision loss and blindness by disease category between men and women in the the United States (US).</div></div><div><h3>Design</h3><div>Retrospective observational study.</div></div><div><h3>Participants</h3><div>Patients (14 549 105) >50 years old with eye examination data recorded in the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) between January 1, 2018, and December 31, 2018.</div></div><div><h3>Methods</h3><div>Patients were assigned to the vision loss cohort and categorized (mild, moderate, severe, blindness) based on the best-corrected visual acuity in the better-seeing eye. The cause of vision loss was assumed using the International Classification of Diseases, 10th Revision codes for cataract, diabetic retinopathy, age-related macular degeneration (AMD), glaucoma, retinal detachment, retinal vein occlusion, corneal opacity, or amblyopia documented in the electronic health record. The no vision loss cohort was created by subtracting the vision loss cohort from the 2018 total IRIS Registry database.</div></div><div><h3>Main Outcome Measures</h3><div>Primary analyses provided age-adjusted prevalence ratios (PRs) for vision loss conditions for women and men within the vision loss cohort relative to the 2018 US census. Secondary analyses computed age-adjusted PRs for women and men for the same conditions relative to the IRIS Registry.</div></div><div><h3>Results</h3><div>The age-adjusted PR of vision loss in women versus men when comparing our vision loss cohort relative to the US census was 1.28 (95% confidence interval, 1.27, 1.29) for mild vision loss, 1.29 (1.28, 1.30) for moderate vision loss, 1.35 (1.32, 1.38) for severe vision loss, and 1.54 (1.49, 1.59) for blindness. However, these differences were attenuated when age-adjusted prevalences were computed relative to those who were seen in 2018 in the IRIS Registry database. In women, the prevalence of vision loss associated with cataract and AMD was increased in both analyses, while men had a higher prevalence of vision loss associated with retinal detachment in both analyses.</div></div><div><h3>Conclusions</h3><div>Women in the US are more likely to be diagnosed with vision loss at an IRIS Registry practice compared with men, based on clinical presentations relative to the US census. However, this finding is partly driven by the higher rates at which women presented to ophthalmic practices in both the vision loss cohort and no vision loss cohort. The age-adjusted prevalence for vision loss associated with cataract and AMD was higher in women when utilizing both the US census and the 2018 IRIS Registry database as the denominator, which suggests that a true difference in prevalence is present. The same is true for an increase in the age-adjusted relative risk for vision loss associated with retinal detachment in men. These findings warrant further study.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 4","pages":"Article 100735"},"PeriodicalIF":3.2000,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Vision Loss and Blindness in the United States: An Age-Adjusted Comparison by Sex and Associated Disease Category\",\"authors\":\"Victoria A. Bugg MD , Kaleb Eppich MS , Macey S. Blakley BA , Flora Lum MD , Tom Greene PhD , M. Elizabeth Hartnett MD\",\"doi\":\"10.1016/j.xops.2025.100735\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>To evaluate differences in vision loss and blindness by disease category between men and women in the the United States (US).</div></div><div><h3>Design</h3><div>Retrospective observational study.</div></div><div><h3>Participants</h3><div>Patients (14 549 105) >50 years old with eye examination data recorded in the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) between January 1, 2018, and December 31, 2018.</div></div><div><h3>Methods</h3><div>Patients were assigned to the vision loss cohort and categorized (mild, moderate, severe, blindness) based on the best-corrected visual acuity in the better-seeing eye. The cause of vision loss was assumed using the International Classification of Diseases, 10th Revision codes for cataract, diabetic retinopathy, age-related macular degeneration (AMD), glaucoma, retinal detachment, retinal vein occlusion, corneal opacity, or amblyopia documented in the electronic health record. The no vision loss cohort was created by subtracting the vision loss cohort from the 2018 total IRIS Registry database.</div></div><div><h3>Main Outcome Measures</h3><div>Primary analyses provided age-adjusted prevalence ratios (PRs) for vision loss conditions for women and men within the vision loss cohort relative to the 2018 US census. Secondary analyses computed age-adjusted PRs for women and men for the same conditions relative to the IRIS Registry.</div></div><div><h3>Results</h3><div>The age-adjusted PR of vision loss in women versus men when comparing our vision loss cohort relative to the US census was 1.28 (95% confidence interval, 1.27, 1.29) for mild vision loss, 1.29 (1.28, 1.30) for moderate vision loss, 1.35 (1.32, 1.38) for severe vision loss, and 1.54 (1.49, 1.59) for blindness. However, these differences were attenuated when age-adjusted prevalences were computed relative to those who were seen in 2018 in the IRIS Registry database. In women, the prevalence of vision loss associated with cataract and AMD was increased in both analyses, while men had a higher prevalence of vision loss associated with retinal detachment in both analyses.</div></div><div><h3>Conclusions</h3><div>Women in the US are more likely to be diagnosed with vision loss at an IRIS Registry practice compared with men, based on clinical presentations relative to the US census. However, this finding is partly driven by the higher rates at which women presented to ophthalmic practices in both the vision loss cohort and no vision loss cohort. The age-adjusted prevalence for vision loss associated with cataract and AMD was higher in women when utilizing both the US census and the 2018 IRIS Registry database as the denominator, which suggests that a true difference in prevalence is present. The same is true for an increase in the age-adjusted relative risk for vision loss associated with retinal detachment in men. These findings warrant further study.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>\",\"PeriodicalId\":74363,\"journal\":{\"name\":\"Ophthalmology science\",\"volume\":\"5 4\",\"pages\":\"Article 100735\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-02-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ophthalmology science\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666914525000338\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmology science","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666914525000338","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目的评价美国男性和女性因疾病类别导致的视力丧失和失明的差异。设计回顾性观察性研究。参与者（14 549 105），年龄50岁，于2018年1月1日至2018年12月31日期间在美国眼科学会IRIS®注册表（视力智能研究）中记录眼科检查数据。方法根据视力较好的眼的最佳矫正视力，将患者分为轻度、中度、重度失明组。视力丧失的原因是使用国际疾病分类第十次修订代码来假设的，这些代码包括白内障、糖尿病性视网膜病变、年龄相关性黄斑变性（AMD）、青光眼、视网膜脱离、视网膜静脉闭塞、角膜混浊或电子健康记录中的弱视。通过从2018年IRIS Registry总数据库中减去视力丧失队列，创建无视力丧失队列。初步分析提供了与2018年美国人口普查相比，视力丧失队列中女性和男性视力丧失状况的年龄调整患病率（pr）。第二项分析计算了相同条件下女性和男性经年龄调整后的平均寿命。结果与美国人口普查相比，我们的视力丧失队列中男女视力丧失的年龄调整PR为：轻度视力丧失1.28(95%可信区间1.27,1.29)，中度视力丧失1.29(95%可信区间1.28,1.30)，重度视力丧失1.35(95%可信区间1.32,1.38)，失明1.54（95%可信区间1.49,1.59）。然而，当计算年龄调整后的患病率与2018年在IRIS Registry数据库中看到的患病率相比时，这些差异就减弱了。在女性中，与白内障和AMD相关的视力丧失的患病率在两项分析中都有所增加，而男性与视网膜脱离相关的视力丧失的患病率在两项分析中都有所增加。结论：根据与美国人口普查相关的临床表现，美国女性比男性更有可能在IRIS登记处被诊断为视力丧失。然而，这一发现的部分原因是，在视力丧失组和非视力丧失组中，接受眼科治疗的女性比例都较高。当使用美国人口普查和2018年IRIS注册数据库作为分母时，与白内障和AMD相关的视力丧失的年龄调整患病率在女性中更高，这表明患病率存在真正的差异。男性视网膜脱离导致视力丧失的年龄调整相对风险增加也是如此。这些发现值得进一步研究。财务披露专有或商业披露可在本文末尾的脚注和披露中找到。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Vision Loss and Blindness in the United States: An Age-Adjusted Comparison by Sex and Associated Disease Category

Purpose

To evaluate differences in vision loss and blindness by disease category between men and women in the the United States (US).

Design

Retrospective observational study.

Participants

Patients (14 549 105) >50 years old with eye examination data recorded in the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) between January 1, 2018, and December 31, 2018.

Methods

Patients were assigned to the vision loss cohort and categorized (mild, moderate, severe, blindness) based on the best-corrected visual acuity in the better-seeing eye. The cause of vision loss was assumed using the International Classification of Diseases, 10th Revision codes for cataract, diabetic retinopathy, age-related macular degeneration (AMD), glaucoma, retinal detachment, retinal vein occlusion, corneal opacity, or amblyopia documented in the electronic health record. The no vision loss cohort was created by subtracting the vision loss cohort from the 2018 total IRIS Registry database.

Main Outcome Measures

Primary analyses provided age-adjusted prevalence ratios (PRs) for vision loss conditions for women and men within the vision loss cohort relative to the 2018 US census. Secondary analyses computed age-adjusted PRs for women and men for the same conditions relative to the IRIS Registry.

Results

The age-adjusted PR of vision loss in women versus men when comparing our vision loss cohort relative to the US census was 1.28 (95% confidence interval, 1.27, 1.29) for mild vision loss, 1.29 (1.28, 1.30) for moderate vision loss, 1.35 (1.32, 1.38) for severe vision loss, and 1.54 (1.49, 1.59) for blindness. However, these differences were attenuated when age-adjusted prevalences were computed relative to those who were seen in 2018 in the IRIS Registry database. In women, the prevalence of vision loss associated with cataract and AMD was increased in both analyses, while men had a higher prevalence of vision loss associated with retinal detachment in both analyses.

Conclusions

Women in the US are more likely to be diagnosed with vision loss at an IRIS Registry practice compared with men, based on clinical presentations relative to the US census. However, this finding is partly driven by the higher rates at which women presented to ophthalmic practices in both the vision loss cohort and no vision loss cohort. The age-adjusted prevalence for vision loss associated with cataract and AMD was higher in women when utilizing both the US census and the 2018 IRIS Registry database as the denominator, which suggests that a true difference in prevalence is present. The same is true for an increase in the age-adjusted relative risk for vision loss associated with retinal detachment in men. These findings warrant further study.