{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:50:31Z","timestamp":1792057831879,"version":"4.4.0"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"abstract":"Abstract<\/jats:title>\n \n Purpose<\/jats:title>\n Analysing longitudinal trends in recorded diagnosis and medical management of glaucoma in Germany over a 10\u2010year period.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective cohort study using nationwide outpatient claims and prescription data from the German statutory health insurance system. Patients with documented glaucoma or glaucoma suspect (ICD\u201010 H40.*) between 2014 and 2023 were included. Analyses assessed annual diagnosed glaucoma patients, demographic characteristics, proportions of medically treated patients and prescribing patterns of glaucoma medications. Trends in medication classes and number of active ingredients per patient were evaluated.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In 2014, 2\u2009065\u2009065 glaucoma patients were registered. Documented patient numbers increased until 2019, reaching 2\u2009129\u2009673 and subsequently declined after the pandemic year to 2\u2009025\u2009226 in 2023. Mean patient age increased from 71.0 to 72.4\u2009years. The proportion of medically treated patients increased from 68% to 71.5% across all glaucoma subtypes, except for primary open\u2010angle glaucoma, where it remained stable (86.2%\u201386.1%) and primary angle\u2010closure glaucoma, where it decreased (68.7%\u201365.6%). Among treated patients, monotherapy declined from 54.8% to 46.8%, while the proportion on two medications increased from 30.7% to 33.7%, three medications from 10.3% to 12.3%, four medications from 3.2% to 4.9% and 5 or more from 1.0% to 1.9%. Among patients receiving multiple agents, fixed\u2010combinations increased from 75.7% to 80.5%. Prescribing patterns shifted towards greater use of prostaglandin analogues and reduced use of beta\u2010blockers.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n After increasing until 2019, the number of documented glaucoma patients in Germany declined despite an ageing population. Concurrently, treatment strategies shifted towards intensified medical therapy with greater use of multiple medications and fixed combinations, particularly prostaglandin\u2010based regimens.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/aos.70261","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:40:13Z","timestamp":1792057213000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends in glaucoma diagnosis and medical management in Germany: A nationwide claims data analysis over 10\u2009years"],"prefix":"10.1111","author":[{"given":"Somar M.","family":"Hasan","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University Medical Center Mannheim, Medical Faculty Mannheim Heidelberg University Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonore","family":"Bovy","sequence":"additional","affiliation":[{"name":"Department of Prescription Data Central Research Institute of Ambulatory Health Care Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maike","family":"Below","sequence":"additional","affiliation":[{"name":"Department of Prescription Data Central Research Institute of Ambulatory Health Care Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Klimke","sequence":"additional","affiliation":[{"name":"Department of Prescription Data Central Research Institute of Ambulatory Health Care Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander K.","family":"Schuster","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Darius","family":"Unterlauft","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University Hospital Leipzig Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6041-1264","authenticated-orcid":false,"given":"Carl","family":"Erb","sequence":"additional","affiliation":[{"name":"Augenklinik Wittenbergplatz Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Argyrios","family":"Chronopoulos","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center Mannheim, Medical Faculty Mannheim Heidelberg University Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert P.","family":"Finger","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center Mannheim, Medical Faculty Mannheim Heidelberg University Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s40123-018-0131-0","article-title":"Systematic literature review of clinical and economic outcomes of micro\u2010invasive glaucoma surgery (MIGS) in primary open\u2010angle glaucoma","volume":"7","author":"Agrawal P.","year":"2018","journal-title":"Ophthalmology and Therapy"},{"key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.ophtha.2019.04.034","article-title":"A prospective randomized trial comparing Hydrus and iStent microinvasive glaucoma surgery implants for standalone treatment of open\u2010angle glaucoma: the COMPARE study","volume":"127","author":"Ahmed I.I.K.","year":"2020","journal-title":"Ophthalmology"},{"key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.ajo.2026.02.024","article-title":"Assessing the fragility of statistically significant outcomes in randomized controlled trials of minimally invasive glaucoma surgery (MIGS)","volume":"286","author":"Ansari A.S.","year":"2026","journal-title":"American Journal of Ophthalmology"},{"key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1016\/S0140-6736(16)30956-4","article-title":"Effectiveness of early lens extraction for the treatment of primary angle\u2010closure glaucoma (EAGLE): a randomised controlled trial","volume":"388","author":"Azuara\u2010Blanco A.","year":"2016","journal-title":"Lancet"},{"key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"e144","DOI":"10.1016\/S2214-109X(20)30489-7","article-title":"Causes of blindness and vision impairment in 2020 and trends over 30\u2009years, and prevalence of avoidable blindness in relation to VISION 2020: the right to sight: an analysis for the global burden of disease study","volume":"9","author":"Blindness G.B.D.","year":"2021","journal-title":"The Lancet. 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