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Epidemiology of Pediatric Ocular Surface Inflammatory Diseases in the United States Using the Optum Labs Data
Simon S M Fung1, Tanya Boghosian2, Claudia Perez3
1Department of Ophthalmology, University of California, Los Angeles, Los Angeles, California.
Insights
Pediatric ocular surface inflammatory diseases (POSID) affect 3.32 per 10,000 children, with higher prevalence in males and those of Asian descent. Vernal keratoconjunctivitis (VKC) significantly increased among Asian children over a decade.
Area of Science:
- Ophthalmology
- Epidemiology
- Public Health
Background:
- Pediatric ocular surface inflammatory diseases (POSID) represent a significant clinical challenge.
- Understanding the epidemiology of POSID is crucial for targeted interventions and resource allocation.
Purpose of the Study:
- To establish the prevalence and epidemiologic characteristics of pediatric ocular surface inflammatory diseases (POSID) in the United States.
- To analyze the prevalence of common POSID subtypes: blepharokeratoconjunctivitis (BKC), herpes simplex keratoconjunctivitis (HSK), and vernal keratoconjunctivitis (VKC).
Main Methods:
- Retrospective cohort study utilizing the Optum Labs Data Warehouse (2007-2020).
- Inclusion of patients aged 18 or younger diagnosed with BKC, HSK, or VKC.
- Multivariable logistic regression analysis to identify factors associated with POSID development.
Main Results:
- An estimated prevalence of 3.32 per 10,000 for POSID was observed between 2018-2019.
- POSID prevalence was higher in children aged 5-10 years, males, those of Asian descent, and residents of the Northeast and West regions.
- Significant increases in POSID, particularly VKC, were noted among Asian children between 2008-2009 and 2018-2019.
- Factors associated with POSID included age over 5 years, male sex, Asian, and Black or African American descent.
Conclusions:
- This study provides crucial epidemiological data on POSID prevalence and subtypes in the US.
- Significant variations in age, sex, race, ethnicity, and region highlight the diverse nature of POSID.
- The findings underscore the need for further research into the rising prevalence of specific subtypes like VKC in certain populations.
Purpose:
To benchmark the epidemiologic features of pediatric ocular surface inflammatory diseases (POSID).
Design:
Retrospective cohort study.
Participants:
Patients 18 years of age or younger with a medical claim for a diagnosis of POSID in the Optum Labs Data Warehouse between 2007 and 2020.
Methods:
Patients with claims of blepharokeratoconjunctivitis (BKC), herpes simplex keratoconjunctivitis (HSK), or vernal keratoconjunctivitis (VKC) were included. Those with less than 6 months of follow-up before the initial diagnosis of POSID were excluded. Odds ratios (ORs) were derived from multivariable logistic regression analyses evaluating the associations between epidemiologic variables and POSID development.
Main Outcome Measures:
The primary outcome was the estimated prevalence of POSID. Prevalence of POSID subtypes and changes in prevalence over time were also evaluated.
Results:
Two thousand one hundred sixty-eight patients with POSID were identified from 2018 through 2019, yielding an estimated prevalence of 3.32 per 10 000. The prevalence of POSID was higher among children between 5 and 10 years of age, male children, those of Asian descent, and those living in the Northeast and the West census regions of the United States. The prevalence (per 10 000) of BKC, HSK, and VKC in the same period were 0.59 (95% confidence interval [CI], 0.53-0.65), 0.74 (95% CI, 0.68-0.81), and 1.99 (95% CI, 1.88-2.10), respectively, and significant differences were found in terms of age, sex, racial, ethnic, and regional distributions among the diagnoses. Between 2008 through 2009 and 2018 through 2019, a significant increase in POSID was noted among Asians (from 6.26 [95% CI, 5.28-7.36] to 11.80 [95% CI, 10.40-13.34]) driven by changes in VKC. Multivariable analysis demonstrated that age older than 5 years (OR, 2.57-3.75; 95% CI, 2.17-4.34), male sex (OR, 1.38; 95% CI, 1.26-1.50), Asian descent (OR, 3.12; 95% CI, 2.70-3.60), and Black or African American descent (OR, 1.26; 95% CI, 1.02-1.55) were associated with POSID development.
Conclusions:
This study provides an estimated prevalence of POSID and its 3 common subtypes in the United States, with important epidemiologic differences among them.
Financial Disclosure(S):
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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