Ferhina S Ali1, Joshua D Stein2, Taylor S Blachley3, Sarah Ackley4, Jay M Stewart1. 1. Department of Ophthalmology, University of California, San Francisco. 2. Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor3Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor4School of Public Health, Department of Health Management and Policy, University of Michigan, Ann Arbor. 3. Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor. 4. Department of Epidemiology and Biostatistics, University of California, San Francisco.
Abstract
Importance: Idiopathic macular holes (MHs) are a cause of decreased vision among older Americans. A better understanding of risk factors for MH may help clarify the pathophysiologic factors of MH and identify potential new avenues for preventing and treating idiopathic MHs. Objective: To determine the incidence of and risk factors associated with the development of idiopathic MH requiring surgical repair with vitrectomy among a large group of managed care plan beneficiaries throughout the United States. Design, Setting, and Participants: A retrospective, longitudinal cohort study was conducted of all beneficiaries 40 years or older who were continuously enrolled for 3 or more years in a nationwide US managed care network between January 1, 2001, and December 31, 2012, who had 2 or more visits to an eye care professional. The managed care network was queried starting in 2009, and data analysis was conducted from December 1, 2014, to August 15, 2016. Main Outcomes and Measures: Development of idiopathic MH requiring surgical repair with vitrectomy. Results: Of the 659 357 enrollees who met inclusion criteria (391 674 females and 267 683 males; mean [SD] age, 56.2 [9.2] years), 144 (0.02%) developed an MH requiring vitrectomy. After adjusting for confounding factors, females had a 64% increased risk of developing MH compared with males (adjusted hazard ratio, 1.64; 95% CI, 1.11-2.43; P = .01), with the effect of sex varying across ages. Compared with white participants, Asian-American enrollees had a 177% increased risk of developing MH (adjusted hazard ratio, 2.77; 95% CI, 1.27-6.02; P = .01). Conclusions and Relevance: In this large cohort, sex was confirmed to be associated with developing an MH requiring vitrectomy; the effect varies across ages differently for females vs males. These differences may be the basis for the underlying pathophysiologic factors contributing to the development of MH.
Importance: Idiopathic macular holes (MHs) are a cause of decreased vision among older Americans. A better understanding of risk factors for MH may help clarify the pathophysiologic factors of MH and identify potential new avenues for preventing and treating idiopathic MHs. Objective: To determine the incidence of and risk factors associated with the development of idiopathic MH requiring surgical repair with vitrectomy among a large group of managed care plan beneficiaries throughout the United States. Design, Setting, and Participants: A retrospective, longitudinal cohort study was conducted of all beneficiaries 40 years or older who were continuously enrolled for 3 or more years in a nationwide US managed care network between January 1, 2001, and December 31, 2012, who had 2 or more visits to an eye care professional. The managed care network was queried starting in 2009, and data analysis was conducted from December 1, 2014, to August 15, 2016. Main Outcomes and Measures: Development of idiopathic MH requiring surgical repair with vitrectomy. Results: Of the 659 357 enrollees who met inclusion criteria (391 674 females and 267 683 males; mean [SD] age, 56.2 [9.2] years), 144 (0.02%) developed an MH requiring vitrectomy. After adjusting for confounding factors, females had a 64% increased risk of developing MH compared with males (adjusted hazard ratio, 1.64; 95% CI, 1.11-2.43; P = .01), with the effect of sex varying across ages. Compared with white participants, Asian-American enrollees had a 177% increased risk of developing MH (adjusted hazard ratio, 2.77; 95% CI, 1.27-6.02; P = .01). Conclusions and Relevance: In this large cohort, sex was confirmed to be associated with developing an MH requiring vitrectomy; the effect varies across ages differently for females vs males. These differences may be the basis for the underlying pathophysiologic factors contributing to the development of MH.
Authors: Paula Anne Newman-Casey; Maxwell Stem; Nidhi Talwar; David C Musch; Cagri G Besirli; Joshua D Stein Journal: Ophthalmology Date: 2014-06-20 Impact factor: 12.079
Authors: Stacy M Meuer; Chelsea E Myers; Barbara E K Klein; Maria K Swift; Yijun Huang; Sapna Gangaputra; Jeong W Pak; Ronald P Danis; Ronald Klein Journal: Ophthalmology Date: 2014-12-31 Impact factor: 12.079
Authors: Joshua D Stein; Nidhi Talwar; Jae H Kang; Olivia I Okereke; Janey L Wiggs; Louis R Pasquale Journal: PLoS One Date: 2015-04-13 Impact factor: 3.240
Authors: Nitish Mehta; Fabio Lavinsky; Ryan Larochelle; Carl Rebhun; Nihaal B Mehta; Rebecca L Yanovsky; Michael N Cohen; Gregory D Lee; Vaidehi Dedania; Hiroshi Ishikawa; Gadi Wollstein; Joel S Schuman; Nadia Waheed; Yasha Modi Journal: Retina Date: 2021-01-01 Impact factor: 3.975