Incidence and Clinical Practice of Exudative Age-related Macular Degeneration

Ai Kido, MD; Masahiro Miyake, MD, PhD; Hiroshi Tamura, MD, PhD; Shusuke Hiragi, MD, PhD; Takeshi Kimura, MD, PhD; Satomi Yoshida, PhD; Masato Takeuchi, MD, PhD; Shosuke Ohtera, PhD; Ayako Takahashi, MD, PhD; Sotaro Ooto, MD, PhD; Koji Kawakami, MD, PhD; Tomohiro Kuroda, PhD; Akitaka Tsujikawa, MD, PhD

Ophthalmology Science (Jun 2022)

Incidence and Clinical Practice of Exudative Age-related Macular Degeneration

Ai Kido, MD,
Masahiro Miyake, MD, PhD,
Hiroshi Tamura, MD, PhD,
Shusuke Hiragi, MD, PhD,
Takeshi Kimura, MD, PhD,
Satomi Yoshida, PhD,
Masato Takeuchi, MD, PhD,
Shosuke Ohtera, PhD,
Ayako Takahashi, MD, PhD,
Sotaro Ooto, MD, PhD,
Koji Kawakami, MD, PhD,
Tomohiro Kuroda, PhD,
Akitaka Tsujikawa, MD, PhD

Affiliations

Ai Kido, MD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Phamacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
Masahiro Miyake, MD, PhD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan; Correspondence: Masahiro Miyake, MD, PhD, MPH, Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin, Kawahara, Sakyo, Kyoto 606-8507, Japan.
Hiroshi Tamura, MD, PhD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan; Center for Innovative Research and Education in Data Science, Institute for Liberal Arts and Sciences, Kyoto University, Kyoto, Japan
Shusuke Hiragi, MD, PhD: Division of Medical Informatics and Administration Planning, Kyoto University Hospital, Kyoto, Japan; Kitano Hospital, Medical Research Institute, the Tazuke Kofukai Medical Research Institute, Osaka, Japan
Takeshi Kimura, MD, PhD: Department of Phamacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
Satomi Yoshida, PhD: Department of Phamacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
Masato Takeuchi, MD, PhD: Department of Phamacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
Shosuke Ohtera, PhD: Division of Medical Informatics and Administration Planning, Kyoto University Hospital, Kyoto, Japan; Center for Outcomes Research and Economic Evaluation for Health, The National Institute of Public Health, Saitama, Japan
Ayako Takahashi, MD, PhD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
Sotaro Ooto, MD, PhD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
Koji Kawakami, MD, PhD: Department of Phamacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
Tomohiro Kuroda, PhD: Division of Medical Informatics and Administration Planning, Kyoto University Hospital, Kyoto, Japan
Akitaka Tsujikawa, MD, PhD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan

Journal volume & issue: Vol. 2, no. 2
p. 100125

Abstract

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Purpose: To elucidate the incidence and treatment pattern of active exudative age-related macular degeneration (AMD). Design: A population-based cohort study conducted using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), a national claims database managed by the Japanese Ministry of Health, Labour, and Welfare (MHLW). Participants: The entire Japanese population aged 40 years or older (76 million people). Methods: With the permission of the MHLW, we accessed the complete NDB dataset and identified patients with newly diagnosed active exudative AMD between 2011 and 2018. The incidence of active exudative AMD was categorized by age and sex per year between 2011 and 2018; moreover, details regarding first-line therapy and number of anti-vascular endothelial growth factor (VEGF) injections per elapsed year since initial treatment were obtained and changes in treatment pattern were investigated. Main Outcome Measures: Incidence rate of active exudative AMD. Results: During the specified 8-year period, 246 064 incident cases of active exudative AMD were identified; 61.4% of these patients were men. The overall incidence rate was 40.66 per 100 000 person-years (95% confidence interval [CI], 40.49–40.82) in the general population aged 40 years or older, 53.22 (95% CI, 52.95–53.49) in men, and 29.78 (95% CI, 29.60–29.98) in women. Mean age of onset was lower in men than in women (72.51 ± 10.50 years vs. 73.90 ± 10.46 years). Among patients with newly diagnosed active exudative AMD, 92.9% received anti-VEGF injections for initial treatments, whereas 1.8% underwent combination therapy with photodynamic therapy. The number of anti-VEGF injections in the first year (0–12 months), second year (13–24 months), and third year (25–36 months) after the initial injection was 3.66 ± 2.30, 1.39 ± 2.20, and 1.23 ± 2.19, respectively. Patients who received fewer injections in the first year received fewer injections in subsequent years and vice versa. Conclusions: This is a relatively large population-based study on the detailed epidemiology and actual treatment patterns of active exudative AMD in clinical practice. Our results can be a fundamental information source to ensure healthy eyes and promote well-being for all at all ages.

Published in Ophthalmology Science

ISSN: 2666-9145 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Ophthalmology
Website: https://www.journals.elsevier.com/ophthalmology-science/

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