Epidemiology, treatment pattern and health care utilization of myopic choroidal neovascularization: a population based study

• Published in: Japanese journal of ophthalmology Vol. 61; no. 2; pp. 159 - 168
• Main Authors: Yang, Ming-Chin, Chen, Yen-Po, Tan, Elise Chia-Hui, Leteneux, Claudia, Chang, Erin, Chu, Carol HY, Lai, Chi-Chun
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01-03-2017; Springer Nature B.V
• Subjects: Choroidal Neovascularization - epidemiology; Choroidal Neovascularization - etiology; Choroidal Neovascularization - therapy; Clinical Investigation; Female; Fluorescein Angiography; Follow-Up Studies; Fundus Oculi; Humans; Incidence; Male; Medicine; Medicine & Public Health; Middle Aged; Myopia, Degenerative - complications; Myopia, Degenerative - epidemiology; Myopia, Degenerative - therapy; Ophthalmology; Patient Acceptance of Health Care; Population Surveillance - methods; Retrospective Studies; Taiwan - epidemiology; Neovascularization; Epidemiology; Ranibizumab; Myopia; Taiwan
• DOI: 10.1007/s10384-016-0496-3
• EISSN: 1613-2246
• ISSN: 0021-5155

Purpose
To investigate the prevalence and incidence of myopic choroidal neovascularization (CNV) in Taiwan, including the health care utilization and treatment-associated costs.
Methods
A retrospective cohort study using existing data from the Taiwanese National Health Insurance claims database to identify patients who had a diagnosis of myopic CNV recorded from 1 January 2009 to 31 December 2011. The prevalence of myopic CNV was monitored during this period, and the frequency and cost of both treatment visits and monitoring visits were analyzed for 2 years following diagnosis.
Results
The prevalence of myopic CNV was 0.017%. In total, 9068 patients with myopic CNV were identified, 12.3% (
n
 = 1111) of whom were treated. Of those treated, 72.0% (
n
 = 800) received intravitreal anti-vascular endothelial growth factor injections (IVI); the remainder received either photodynamic therapy with verteporfin (vPDT), laser photocoagulation, or a combination of therapies. IVI was associated with the largest number of treatment visits as well as a higher administrative (non-drug) cost per treatment visit (a mean of USD 57.18). vPDT alone was associated with a higher overall cost per treatment visit and more monitoring visits than IVI or laser photocoagulation. Costs for monitoring visits were highest for IVI.
Conclusions
The prevalence of myopic CNV was lower than that reported in previous studies, possibly because of differences in age distribution in the populations studied. The frequencies of treatment administered were similar to those reported in previous studies; however, a cost-effectiveness comparison could not be made owing to lack of data in previous studies.