Week in review: Myopic macular degeneration, kidney disease and glaucoma risk, cost barriers to medication adherence

A weekly roundup of ophthalmic news from around the web.

A future rise in myopic macular degeneration may parallel the current rise in myopia. The increasing incidence of myopia worldwide could lead to a corresponding increase in myopic macular degeneration (MMD) in the future. To determine the occurrence of myopic macular features in high myopia, 626 participants of European ancestry with high myopia were enrolled in 2 Dutch population cohort studies and underwent extensive ophthalmologic examinations. Through grading and evaluation of retinal images, the overall prevalence rate of MMD was found to be 25.9%. Risk factors for MMD included older age (though MMD was seen in 10% of participants aged 20–39 years), greater axial length, and lower spherical equivalent of refractive error. Clinicians will need to be ready for potentially higher numbers of patients with myopia-related visual complications. JAMA Ophthalmology

Chronic kidney disease leaves patients at risk for glaucoma development. A study used data from 1.1 million patients in the 2002–2015 South Korean National Health Insurance Service-National Sample Cohort to evaluate the association between chronic kidney disease (CKD) and risk of developing open-angle glaucoma (OAG). The hazard ratio for OAG development in patients with CKD over a 12-year period was 1.55, indicating a significantly higher risk than in patients without CKD. Women were more likely to develop OAG than men. The cumulative hazard was greater in those with advanced CKD than in those with mild or moderate CKD. These findings support performing additional glaucoma screenings in this patient population. Science Reports

Black and Hispanic Americans encounter cost-related barriers to glaucoma medication adherence. The All of Us research program, run by the National Institutes of Health, aims to enroll 1 million people with a goal of creating a broad, diverse nationwide cohort. Using data from the 331,380 participants already enrolled in the program, investigators studied what effect race and ethnicity might have on rates of self-reported, cost-related barriers to glaucoma medication adherence. In both univariate and adjusted multivariate logistic regression models, non-Hispanic Black and Hispanic individuals were significantly more likely to report not being able to afford glaucoma medications than non-Hispanic White individuals. To support health equity and encourage medication adherence, patients with glaucoma should be prescribed treatments that are the easiest for them to afford. JAMA Ophthalmology