Trends and Sociodemographic Patterns in Keratoconus Management 2015-2020 : An American Academy of Ophthalmology IRIS® Registry Analysis
Copyright © 2024 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved..
PURPOSE: Investigate trends in keratoconus (KCN) treatment patterns and diagnosis age from 2015 to 2020 and evaluate sociodemographic associations with the treatment approach.
DESIGN: Retrospective cohort study.
PARTICIPANTS: Patients with a new KCN diagnosis from 2015 to 2020 were identified in the Academy IRIS® Registry (Intelligent Research in Sight).
METHODS: Associations between sociodemographic factors and treatment were evaluated using multivariable logistic regression.
MAIN OUTCOME MEASURES: Outcomes included percentages and rates of each treatment (collagen crosslinking [CXL], keratoplasty, or no procedure) from 2015 to 2020, age at diagnosis during this period, and sociodemographic factors associated with treatment type.
RESULTS: A total of 66 199 patients with a new diagnosis of KCN were identified. The percentage of patients undergoing CXL increased from 0.05% in 2015 to 29.5% in 2020 (P = 0.008). The average age (standard deviation) of KCN patients decreased from 44.1 (±16.9) years in 2015 to 39.2 (±16.9) years in 2020 (P < 0.001). In multivariable analyses comparing CXL versus no procedure and keratoplasty versus no procedure, patients undergoing CXL tended to be younger with the odds of having CXL decreasing with increasing age, for example, comparing CXL and no procedure patients, using ages 0-20 years as reference, the odds ratio (OR) (95% confidence interval [CI]) decreased from 0.62 (0.57-0.67; P < 0.0001) for patients aged 21-40 years to 0.03 (0.02-0.04; P < 0.0001) for patients aged > 60 years. Men were more likely than women to have CXL (OR, 1.31; 95% CI, 1.23-1.40; P < 0.0001) and keratoplasty (OR, 1.30; 95% CI, 1.19-1.42; P < 0.0001). Black patients were less likely than White patients to have CXL (OR, 0.70; 95% CI, 0.63-0.77; P < 0.0001) and more likely to have keratoplasty (OR, 2.24; 95% CI, 2.01-2.50; P < 0.0001). Likewise, Hispanic patients had higher odds of CXL (OR, 1.12; 95% CI, 1.00-1.24; P < 0.05) and keratoplasty (OR, 1.29; 95% CI, 1.12-1.50; P < 0.001) compared with non-Hispanic patients. Collagen crosslinking and keratoplasty also varied by region and insurance status.
CONCLUSIONS: A significant increase in use of CXL was noted from 2015 to 2020. Sociodemographic differences in treatment among KCN patients may reflect differences in access, use, or care patterns, and future studies should aim to identify strategies to improve access for all patients.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Ophthalmology - (2024) vom: 03. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Syed, Zeba A [VerfasserIn] |
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| Links: |
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| Themen: |
Corneal collagen crosslinking |
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| Anmerkungen: |
Date Revised 10.04.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.ophtha.2024.01.036 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368004791 |
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| 100 | 1 | |a Syed, Zeba A |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Trends and Sociodemographic Patterns in Keratoconus Management 2015-2020 |b An American Academy of Ophthalmology IRIS® Registry Analysis |
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| 500 | |a Date Revised 10.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a PURPOSE: Investigate trends in keratoconus (KCN) treatment patterns and diagnosis age from 2015 to 2020 and evaluate sociodemographic associations with the treatment approach | ||
| 520 | |a DESIGN: Retrospective cohort study | ||
| 520 | |a PARTICIPANTS: Patients with a new KCN diagnosis from 2015 to 2020 were identified in the Academy IRIS® Registry (Intelligent Research in Sight) | ||
| 520 | |a METHODS: Associations between sociodemographic factors and treatment were evaluated using multivariable logistic regression | ||
| 520 | |a MAIN OUTCOME MEASURES: Outcomes included percentages and rates of each treatment (collagen crosslinking [CXL], keratoplasty, or no procedure) from 2015 to 2020, age at diagnosis during this period, and sociodemographic factors associated with treatment type | ||
| 520 | |a RESULTS: A total of 66 199 patients with a new diagnosis of KCN were identified. The percentage of patients undergoing CXL increased from 0.05% in 2015 to 29.5% in 2020 (P = 0.008). The average age (standard deviation) of KCN patients decreased from 44.1 (±16.9) years in 2015 to 39.2 (±16.9) years in 2020 (P < 0.001). In multivariable analyses comparing CXL versus no procedure and keratoplasty versus no procedure, patients undergoing CXL tended to be younger with the odds of having CXL decreasing with increasing age, for example, comparing CXL and no procedure patients, using ages 0-20 years as reference, the odds ratio (OR) (95% confidence interval [CI]) decreased from 0.62 (0.57-0.67; P < 0.0001) for patients aged 21-40 years to 0.03 (0.02-0.04; P < 0.0001) for patients aged > 60 years. Men were more likely than women to have CXL (OR, 1.31; 95% CI, 1.23-1.40; P < 0.0001) and keratoplasty (OR, 1.30; 95% CI, 1.19-1.42; P < 0.0001). Black patients were less likely than White patients to have CXL (OR, 0.70; 95% CI, 0.63-0.77; P < 0.0001) and more likely to have keratoplasty (OR, 2.24; 95% CI, 2.01-2.50; P < 0.0001). Likewise, Hispanic patients had higher odds of CXL (OR, 1.12; 95% CI, 1.00-1.24; P < 0.05) and keratoplasty (OR, 1.29; 95% CI, 1.12-1.50; P < 0.001) compared with non-Hispanic patients. Collagen crosslinking and keratoplasty also varied by region and insurance status | ||
| 520 | |a CONCLUSIONS: A significant increase in use of CXL was noted from 2015 to 2020. Sociodemographic differences in treatment among KCN patients may reflect differences in access, use, or care patterns, and future studies should aim to identify strategies to improve access for all patients | ||
| 520 | |a FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Corneal collagen crosslinking | |
| 650 | 4 | |a Keratoconus | |
| 650 | 4 | |a Keratoplasty | |
| 700 | 1 | |a Tomaiuolo, Maurizio |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Qiang |e verfasserin |4 aut | |
| 700 | 1 | |a Prajna, Venkatesh |e verfasserin |4 aut | |
| 700 | 1 | |a Hyman, Leslie |e verfasserin |4 aut | |
| 700 | 1 | |a Rapuano, Christopher J |e verfasserin |4 aut | |
| 700 | 0 | |a IRIS® Registry Analytic Center Consortium∗ |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Aaron Y |e investigator |4 oth | |
| 700 | 1 | |a Lee, Cecilia S |e investigator |4 oth | |
| 700 | 1 | |a Van Gelder, Russ |e investigator |4 oth | |
| 700 | 1 | |a Lorch, Alice |e investigator |4 oth | |
| 700 | 1 | |a Miller, Joan W |e investigator |4 oth | |
| 700 | 1 | |a Pershing, Suzann |e investigator |4 oth | |
| 700 | 1 | |a Goldberg, Jeffrey |e investigator |4 oth | |
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