TEN-YEAR INCIDENCE OF AGE-RELATED MACULAR DEGENERATION ACCORDING TO DIABETIC RETINOPATHY CLASSIFICATION AMONG MEDICARE BENEFICIARIES

Purpose: To compare the longitudinal incidence over 10 years of dry and wet age-related macular degeneration (AMD) in a U.S. sample of Medicare beneficiaries with no diabetes mellitus, diabetes mellitus without retinopathy, nonproliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR). Methods: Using Medicare claims data, the 10-year incidence of dry and wet AMD from 1995 to 2005 in beneficiaries older than 69 years with newly diagnosed diabetes mellitus (n = 6,621), NPDR (n = 1,307), and PDR (n = 327) compared with each other and matched controls without diabetes for each group. Results: After controlling for covariates, newly diagnosed NPDR was associated with significantly increased risk of incident diagnosis of dry AMD (hazard ratio, 1.24; 95% confidence interval: 1.08-1.43) and wet AMD (hazard ratio 1.68; 95% confidence interval: 1.23-2.31). Newly diagnosed PDR was associated with significantly increased risk of wet AMD only (hazard ratio 2.15; 95% confidence interval: 1.07-4.33). Diabetes without retinopathy did not affect risk of dry or wet AMD. There was no difference in risk of wet AMD in PDR compared with NPDR. Conclusion: Elderly individuals with NPDR or PDR may be at higher risk of AMD compared to those without diabetes mellitus or diabetic retinopathy. RETINA 33: 911-919, 2013