{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:11:00Z","timestamp":1755216660858,"version":"3.43.0"},"reference-count":25,"publisher":"The Journal of Health Economics and Outcomes Research","issue":"1","license":[{"start":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T00:00:00Z","timestamp":1711670400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["jheor.org"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"background\"> <jats:title>Background<\/jats:title> <jats:p>The association of neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), and retinal vein occlusion (RVO) with functional status in the general Medicare population are not well established.<\/jats:p> <\/jats:sec> <jats:sec id=\"objectives\"> <jats:title>Objectives<\/jats:title> <jats:p>This study examined patient-reported survey data linked with Medicare claims to describe the burden of these vision-threatening retinal diseases (VTRDs) among Medicare beneficiaries.<\/jats:p> <\/jats:sec> <jats:sec id=\"methods\"> <jats:title>Methods<\/jats:title> <jats:p>Medicare Current Beneficiary Survey data linked with Medicare Fee-for-Service claims data from 2006 to 2018 were used in a nationally representative retrospective pooled cross-sectional population-based comparison study. Outcomes between community-dwelling beneficiaries with nAMD (n\u2009=\u20091228), DME (n\u2009=\u2009101), or RVO (n\u2009=\u2009251) were compared with community-dwelling beneficiaries without any VTRDs (n\u2009=\u2009104\u202f088), controlling for baseline demographic and clinical differences. Beneficiaries with a diagnosis of nAMD, DME, or RVO during the data year were included; those with other VTRDs were excluded. Outcomes included vision function and loss, overall functioning as assessed by difficulties with activities of daily living (ADLs) and instrumental ADLs (iADLs), anxiety\/depression, falls, and fractures.<\/jats:p> <\/jats:sec> <jats:sec id=\"results\"> <jats:title>Results<\/jats:title> <jats:p>In patient cohorts with nAMD, DME, and RVO, approximately one-third (34.2%-38.3%) reported \u201ca little trouble seeing\u201d (vs 28.3% for controls), and 26%, 17%, and 9%, respectively, reported \u201ca lot of trouble seeing\/blindness\u201d (vs 5% of controls). Difficulty walking and doing heavy housework were the most reported ADLs and iADLs, respectively. Compared with those without VTRDs, beneficiaries with nAMD had higher odds of diagnosed vision loss (odds ratio [OR], 5.39; 95% confidence interval, 4.06-7.16; P\u2009&lt;\u2009.001) and difficulties with iADLs (odds ratio, 1.41; 95% confidence interval, 1.11-1.80; P\u2009=\u2009.005); no differences were observed for DME or RVO vs control. After adjusting for age, sex, race\/ethnicity, poverty status, comorbidities, and other relevant covariates, nAMD, DME, and RVO were not significantly associated with anxiety\/depression, falls, or fractures.<\/jats:p> <\/jats:sec> <jats:sec id=\"discussion\"> <jats:title>Discussion<\/jats:title> <jats:p>Patients with nAMD or DME were more likely to report severe visual impairment than those without VTRDs, although only those with nAMD were more likely to be diagnosed with vision loss.<\/jats:p> <\/jats:sec> <jats:sec id=\"conclusions\"> <jats:title>Conclusions<\/jats:title> <jats:p>Patients with nAMD continue to experience more vision impairment and worse functional status compared with a similar population of Medicare beneficiaries despite availability of therapies like antivascular endothelial growth factor to treat retinal disease.<\/jats:p> <\/jats:sec>","DOI":"10.36469\/001c.93022","type":"journal-article","created":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T10:08:54Z","timestamp":1711706934000},"update-policy":"https:\/\/doi.org\/10.36469\/00001","source":"Crossref","is-referenced-by-count":1,"title":["The Association of Retinal Disease with Vision Impairment and Functional Status in Medicare Patients"],"prefix":"10.36469","volume":"11","author":[{"given":"Vincent","family":"Garmo","sequence":"first","affiliation":[{"name":"Genentech, Inc., South San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaohui","family":"Zhao","sequence":"additional","affiliation":[{"name":"IQVIA, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen D.","family":"Ng","sequence":"additional","affiliation":[{"name":"Genentech, Inc., South San Francisco, California, 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USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Biskupiak","sequence":"additional","affiliation":[{"name":"University of Utah, Salt Lake City, Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferhina S.","family":"Ali","sequence":"additional","affiliation":[{"name":"New York Medical College, Valhalla, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Archad M.","family":"Khanani","sequence":"additional","affiliation":[{"name":"Sierra Eye Associates, Reno, Nevada"},{"name":"University of Nevada, Reno","department":["School of Medicine"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia","family":"Menezes","sequence":"additional","affiliation":[{"name":"Genentech, Inc., South San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim M.","family":"Abbass","sequence":"additional","affiliation":[{"name":"Genentech, Inc., South San 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