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Epidemiology of rhegmatogenous retinal detachment in commercially insured myopes in the United States.

ABSTRACT: Myopia is a known risk factor for rhegmatogenous retinal detachment (RRD). Given global trends of increasing myopia, we aimed to determine the absolute risk (incidence rate) of RRD in non-myopes, myopes and high myopes in the United States over ten years. We performed a retrospective cohort study of 85,476,781 commercially insured patients enrolled in the Merative™ Marketscan^® Research Database. The incidence rate of RRD in phakic patients in the United States was 39-fold higher in high myopes than non-myopes (868.83 per 100,000 person-years versus 22.44 per 100,000 person-years) and three-fold higher in myopes than non-myopes (67.51 per 100,000 person-years versus 22.44 per 100,000 person-years). The incidence rate was significantly higher in males in each category (P < 0.01). Combined, the incidence rate of RRD in phakic patients in the United States from 2007 to 2016 was 25.27 RRDs per 100,000 person-years, a rate higher than those in prior published studies in North America, South America, Europe, Asia, and Australia. The absolute risk of myopia and high myopia increased from 2007 to 2016. The risk of RRD in phakic high myopes rose with increasing age. Notably, the magnitude of increased risk of RRD in myopes varied substantially according to the minimum follow-up period in our models and should be accounted for when interpreting data analyses.

SUBMITTER: Ludwig CA

PROVIDER: S-EPMC10256775 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Epidemiology of rhegmatogenous retinal detachment in commercially insured myopes in the United States.

Ludwig Cassie A CA Vail Daniel D Al-Moujahed Ahmad A Callaway Natalia F NF Saroj Namrata N Moshfeghi Andrew A Moshfeghi Darius M DM

Scientific reports 20230609 1

Myopia is a known risk factor for rhegmatogenous retinal detachment (RRD). Given global trends of increasing myopia, we aimed to determine the absolute risk (incidence rate) of RRD in non-myopes, myopes and high myopes in the United States over ten years. We performed a retrospective cohort study of 85,476,781 commercially insured patients enrolled in the Merative™ Marketscan<sup>®</sup> Research Database. The incidence rate of RRD in phakic patients in the United States was 39-fold higher in hi ...[more]

PMID: 37296124

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Project description:BACKGROUND To reduce postpartum morbidity and mortality, optimizing routine outpatient postpartum care has become a focus of national attention and a healthcare priority. OBJECTIVE This study aimed to examine the timing, content, and predictors of routine outpatient postpartum visit attendance within a large, commercially insured patient population. STUDY DESIGN We performed a retrospective cohort study using a national US database of commercial insurance beneficiaries with a delivery hospitalization between 2011 and 2015. We calculated the proportion of patients who had an outpatient postpartum visit within 8 weeks of hospital discharge. Using a multivariable logistic regression model, we identified independent predictors of an outpatient postpartum visit. To gain insight into the nature and extent of any postpartum medical or surgical morbidity, we also identified the most frequent International Classification of Diseases, Ninth Revision, Clinical Modification codes associated with postpartum visits. RESULTS The study cohort comprised 431,969 patients who underwent delivery hospitalization, of whom 257,727 (59.7%; 95% confidence interval, 59.5–59.8) had at least 1 outpatient postpartum visit within 8 weeks of hospital discharge. The distribution of postpartum visits was bimodal, occurring most frequently in the first week (23.2%) and sixth week (21.7%) after hospital discharge. The median period between hospital discharge and the postpartum visit was 28 days (interquartile range, 8–41 days). In our multivariable model, patient-level factors that were most strongly associated with a postpartum visit were preexisting medical morbidities, which included: thyroid disease (adjusted odds ratio, 1.62; 95% confidence interval, 1.40–1.52), seizure disorder (adjusted odds ratio, 1.50; 95% confidence interval, 1.33–1.70), chronic hypertension (adjusted odds ratio, 1.46; 95% confidence interval, 1.58–1.67), and psychiatric disease (adjusted odds ratio, 1.41; 95% confidence interval, 1.36–1.47). Between 29% and 42% of patients with preexisting medical morbidity and between 35% and 41% of patients who experienced peri- or postpartum complications did not attend a postpartum visit. CONCLUSION Our findings indicate that among a large, commercially-insured patient population, postpartum visit attendance was suboptimal. A high proportion with preexisting medical and peripartum morbidities was not evaluated within 8 weeks of hospital discharge. Multifaceted interventions and healthcare reform are suggested to address patients’ concerns and healthcare needs after delivery.

Project description:PurposeTo investigate the characteristics of silicone oil (SO) emulsification after vitrectomy for rhegmatogenous retinal detachment and their possible correlations with clinical factors.MethodsThe first 2 mL of washing out fluid after SO removal was collected, and used for the measurement of the size and number of SO droplets using a Multisizer® 3 Coulter counter (Beckman Coulter, USA). The correlations between SO droplets and clinical factors were analyzed.ResultsA total of 38 patients (23 males, 15 females) who underwent primary PPV with SO injection for RRD and whose retina stayed attached for ≥3 months after SO removal were included in the study. The average number of oil droplets was 1.96 × 106 ± 3.95 × 106/mL (range 0.17 × 106 to 21.71 × 106/ml), and 80.8% (range 64.23%-99.07%) of the droplets were 1-2 μm in diameter. The total number of emulsified SO droplets was not correlated with any clinical factor (all P > 0.05). When the emulsified SO droplets were divided into groups by their diameter, multiple linear regression revealed that age was negatively correlated with the numbers of 5-7-μm in diameter. The total number of emulsified SO droplets was not correlated with any clinical factor (all μm in diameter. The total number of emulsified SO droplets was not correlated with any clinical factor (all P > 0.05). When the emulsified SO droplets were divided into groups by their diameter, multiple linear regression revealed that age was negatively correlated with the numbers of 5-7-μm in diameter. The total number of emulsified SO droplets was not correlated with any clinical factor (all μm in diameter. The total number of emulsified SO droplets was not correlated with any clinical factor (all P > 0.05). When the emulsified SO droplets were divided into groups by their diameter, multiple linear regression revealed that age was negatively correlated with the numbers of 5-7.ConclusionUsing a Multisizer® Coulter counter, we successfully determined the number and size of SO droplets after emulsification. We found that the number of 5-12-μm-diameter droplets was higher in younger-age patients and was higher in patients using antiglaucoma eyedrops.μm in diameter. The total number of emulsified SO droplets was not correlated with any clinical factor (all.

Dataset Information

Epidemiology of rhegmatogenous retinal detachment in commercially insured myopes in the United States.

Publications

Epidemiology of rhegmatogenous retinal detachment in commercially insured myopes in the United States.

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