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Increased Nonexudative Age-Related Macular Degeneration Diagnosis Among Medicare Beneficiaries With Rheumatoid
Gloriane Schnabolk1, Bärbel Rohrer1,2, Kit N Simpson3
1Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, United States.
Purpose:
AMD is the leading cause of blindness in the United States. The role of secondary inflammatory disease on AMD progression is largely unknown. Here we investigate the association between AMD and rheumatoid arthritis (RA), using MarketScan data for patients aged ≥65 years on Medicare.
Methods:
Baseline data were extracted for subjects with at least two International Classification, Ninth Revision (ICD-9) diagnosis codes of RA and control subjects (no RA) and were matched at baseline by propensity score. Matched cohort data were extracted post-baseline time and examined up to 4.5 years of follow-up for ICD-9 diagnosis code AMD records. Multivariable regression models compared risk of an AMD diagnosis post-baseline for RA subjects and matched controls. Days until first AMD diagnosis between RA patients and controls was examined using survival analysis.
Results:
Risk of new AMD diagnosis was elevated in RA patients (odds ratio [OR] 2.08; 95% confidence interval [CI] 1.98-2.18), with an increase in nonexudative AMD patients (P < 0.0001). Risk was elevated in female (n = 27,548) (OR 1.11; 95% CI 1.05-1.17) compared with male (n = 9704; P < 0.001) patients. The time to first AMD diagnosis was shorter for RA subjects than controls (P < 0.0001).
Conclusions:
Our analysis provides support of association between RA diagnosis and increased nonexudative AMD diagnosis.
Insights
Rheumatoid arthritis (RA) patients have a doubled risk of developing age-related macular degeneration (AMD), particularly the nonexudative form. This study highlights a significant association between RA and increased AMD diagnosis rates.
Area of Science:
- Ophthalmology
- Rheumatology
- Epidemiology
Background:
- Age-related macular degeneration (AMD) is a primary cause of blindness in the US.
- The impact of secondary inflammatory conditions on AMD progression remains unclear.
Purpose of the Study:
- To investigate the association between rheumatoid arthritis (RA) and the risk of developing AMD.
- To analyze AMD progression in patients aged 65 and older with Medicare data.
Main Methods:
- Propensity score matching was used to create cohorts of RA patients and controls.
- Follow-up data up to 4.5 years were analyzed for AMD diagnosis codes.
- Multivariable regression and survival analysis compared AMD risk and time to diagnosis.
Main Results:
- RA patients showed a significantly elevated risk of new AMD diagnosis (OR 2.08).
- The risk was particularly pronounced for nonexudative AMD.
- RA patients were diagnosed with AMD sooner than controls.
Conclusions:
- This study supports an association between rheumatoid arthritis diagnosis and an increased incidence of nonexudative AMD.
- Findings suggest a potential link between systemic inflammation in RA and AMD development.
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