Health care claims for primary open-angle glaucoma and retinal vein occlusion from an 11-year nationwide dataset

Hae-Young Lopilly Park,Chan Kee Park,Kyungdo Han,Younhea Jung,Mee Yon Lee

doi:10.1038/s41598-017-07890-6

Abstract

To evaluate the risk of retinal vein occlusion (RVO) development after primary open-angle glaucoma (POAG) and the risk of POAG development after RVO, we conducted a nationwide, population-based 11-year longitudinal study. National registry data were collected from the Korean National Health Insurance Research Database, comparing 1 025 340 (~2.2%) subjects who were selected from 46 605 433 Korean residents in 2002. Each sampled patients was tracked until 2013. POAG developed in 0.92% of the RVO group (n = 6 826) and in 0.22% of the comparison group. RVO developed in 0.99% of the POAG group (n = 4 138) and in 0.37% of the comparison group. RVO was associated with an increased risk of POAG development (hazard ratio [HR], 3.25; 95% confidence interval [CI], 2.39–4.42) and POAG was associated with an increased risk of RVO development (HR, 5.05; 95% CI, 3.94–6.47). Comorbidity of systemic hypertension and diabetes mellitus further increased the risk of POAG development in the RVO group (HR, 3.58 and HR, 5.98, respectively). Patients with RVO exhibit a significantly higher risk of POAG development and patients with POAG exhibit a significantly higher risk of RVO development, based on an 11-year follow-up period.

Highlights

Glaucoma is the leading cause of irreversible blindness worldwide
We investigated the association between retinal vein occlusion (RVO) and the prospective risk of primary open-angle glaucoma (POAG) development and the association between POAG and the prospective risk of RVO development using a nationwide sample of 1,025,340 representative residents of South Korea in the National Health Insurance Service National Sample Cohort 2002–2013 (NHIS-NSC 2002–2013)
Total of 6,826 subjects were regarded as new incident cases of RVO and 4,138 subjects were regarded as new incident cases of POAG

Summary

Introduction

Glaucoma is the leading cause of irreversible blindness worldwide. Retinal vein occlusion (RVO) is the second most frequent retinal vascular disease and one of the sight-threatening conditions. The Beaver Dam Eye Study reported that increased cup-to-disc ratio was a significant risk factor of RVO10. The Ocular Hypertension Treatment Study showed that greater cup-to-disc ratio was associated with the development of RVO in ocular hypertensive participants, with no difference between the observation group and the group that received glaucoma hypotensive medications[12]. 5-year incidence of RVO was not associated with glaucoma or ocular hypertension in the Beaver Dam Study[8], participants with RVO after 10 years of follow-up were more likely to have definite or probable glaucoma at baseline[10]. There are few reports of the development of POAG after RVO. One study reported that only one case (2.5%) of POAG developed after CRVO in 40 patients during a 10-year follow-up[13]. Primary open-angle glaucoma No event Event Age (≥65 yrs) Sex (Male) Hypertension No Yes Diabetes mellitus No Yes Dyslipidemia No Yes Household income relative to the median (0–50%) Residential area (Rural)

Methods

Results

Conclusion