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  • IRIS Registry Data Analysis

  • The American Academy of Ophthalmology IRIS® Registry (Intelligent Research In Sight) represents a remarkable opportunity for knowledge discovery and collaborative studies. As of Jan. 1, 2023, the world’s largest specialty clinical data registry, the IRIS Registry has aggregated, de-identified data on over 483.6 million visits and 78.6 million unique patients, growing daily.

    Approximately 15,799 clinicians in ophthalmology practices have registered to contribute their data to the IRIS Registry through their electronic health record systems.

    How It Works

    EHR data is stripped of all unique patient identifiers when it is uploaded into IRIS Registry for privacy purposes. Participating physicians own their own data. The Academy owns the de-identified, aggregated data and can analyze these data. The database has the same legal protections and safeguards from legal discoverability, as do hospital-based peer-review processes.

    Ways to Use Our Data 

    The IRIS Registry’s database can help to inform the natural history of diseases, prevalence of rare diseases, practice patterns, diffusion of technology, comparative effectiveness and more, all in the real-world setting. Data elements include: patient demographics, patient medical and ocular history, clinical examination findings, diagnoses, procedures and medications.

    As an example, the registry currently contains data on the following disease conditions:

    • The rate of endophthalmitis after cataract surgery, the visual outcome of patients with endophthalmitis and specific risk factors associated with developing endophthalmitis
    • The rate of endophthalmitis after anti-VEGF injections across different agents and the comparative effectiveness of these agents based on visual acuity outcomes
    • The prevalence of myopic choroidal neovascularization in the United States, based on both diagnostic code information and clinical data
    • The treatment patterns for patients with myopic choroidal neovascularization, including the visual acuity outcomes for those treated and those not treated

    Current research opportunities 

    IRIS Registry Data Dictionary

    The IRIS Registry database is comprised of data extracted from participants’ electronic health record systems. Review the registry’s data dictionary, which includes data variables accessible for analysis in the IRIS Registry.

    IRIS Registry Publications

    Koo EB, Wiener LA, Syntosi A. Real-world evaluation of amblyopic patient characteristics, clinical outcomes, and treatment patterns using the IRIS Registry [published online ahead of print, 2023 Mar 11]. J AAPOS. 2023;S1091-8531(23)00062-9. doi:10.1016/j.jaapos.2023.01.016 

    Tomaiuolo M, Woreta FA, Li A, et al. Open globe injury repairs in the American Academy of Ophthalmology IRIS® Registry 2014-2018: Incidence, risk factors, and visual outcomes [published online ahead of print, 2023 Mar 14]. Ophthalmology. 2023;S0161-6420(23)00154-9. doi:10.1016/j.ophtha.2023.03.002 

    Hatfield M, Nguyen TH, Chapman R, et al. Identifying the mechanism of missingness for unspecified diabetic retinopathy disease severity in the electronic health record: An IRIS® Registry analysis [published online ahead of print, 2023 Mar 16]. J Am Med Inform Assoc. 2023;ocad037. doi:10.1093/jamia/ocad037

    Khurana RN, Li C, Lum F. Loss to follow up in patients with neovascular age related macular degeneration treated with anti-VEGF therapy in the United States in the IRIS® Registry [published online ahead of print, 2023 Feb 27]. Ophthalmology. 2023;S0161-6420(23)00132-X. doi:10.1016/j.ophtha.2023.02.021 

    Oke I, Elze T, Miller JW, et al. Factors associated with nasolacrimal duct probing failure among children in the Intelligent Research in Sight Registry [published online ahead of print, 2023 Mar 2]. JAMA Ophthalmol. 2023;e230004. doi:10.1001/jamaophthalmol.2023.0004

    Oke I, Reshef ER, Elze T, et al. Smoking is associated with a higher risk of surgical intervention for thyroid eye disease in the IRIS® Registry. Am J Ophthalmol. 2023;S0002-9394(23)00029-6. doi:10.1016/j.ajo.2023.01.020 

    Hunt MS, Chee YE, Saraf SS, et al. Association of environmental factors with age-related macular degeneration using the Intelligent Research in Sight Registry. Ophthalmol Sci. 2022;2:100195. doi:10.1016/j.xops.2022.100195 

    Batchelor A, Lacy M, Hunt M, et al. Predictors of long-term ophthalmic complications after closed globe injuries using the Intelligent Research in Sight (IRIS®) Registry. Ophthalmol Sci. 2022;3:100237. doi:10.1016/j.xops.2022.100237 

    Yang SA, Ciociola EC, Mitchell W, et al. Effectiveness of microinvasive glaucoma surgery in the United States: Intelligent Research in Sight Registry analysis 2013-2019. Ophthalmology. 2023;130:242-255. doi:10.1016/j.ophtha.2022.10.021 

    Uner OE, Aronow ME, Mruthyunjaya P, et al. Uveal melanoma and the Intelligent Research in Sight Registry: A pilot analysis and future directions. Ophthalmol Retina. 2023;7:284-286. doi:10.1016/j.oret.2022.10.019 

    Leng T, Schwartz J, Nimke D, et al. Dry age-related macular degeneration: Distribution of visual acuity and progression risk in a large registry. Ophthalmol Ther. 2022;12:325-340.  

    Baş Z, Sharpe J, Yaghy A, et al. Prevalence of and associated factors for eyelid cancer in the American Academy of Ophthalmology Intelligent Research in Sight Registry. Ophthalmol Sci. 2022;3(1):100227.

    Greenlee TE, Malhotra NA, Iyer AI, Conti TF, Chen AX, Singh RP. Association of socioeconomic health care disparities with use of anti-vascular endothelial growth factor and visual acuity outcomes in patients with diabetic macular edema.  Ophthalmic Surg Lasers Imaging Retina, 2022; 53:380-391. 

    Gallivan MD, Garcia KM, Torres AZ, et al. Emulating VIEW 1 and VIEW 2 clinical trial outcome data using the American Academy of Ophthalmology IRIS Registry. Ophthalmic Surg Lasers Imaging Retina. 2023; 54:6-14.  

    Oke I, Hall N, Elze T, Miller JW, Lorch AC, Hunter DG, Traish AS, IRIS Registry Analytic Center Consortium.  Risk factors associated with pterygium reoperation in the IRIS Registry.  JAMA Ophthalmol 2022; 140:1138-1141  

    Pershing S, Lum F.  The American Academy of Ophthalmology IRIS Registry (Intelligent Research in Sight);  current and future state of big data analytics.  Curr Opin Ophthalmol 2022; 33:394-398.

    Rothman A, Chang TC, Lum F, Vanner EA. Intraocular pressure changes following stand-alone phacoemulsification: an IRIS® Registry analysis. Am J Ophthalmol 2022, in press.

    Repka M, Li C, Lum F.  Multivariable Analyses of Amblyopia Treatment Outcomes from A Clinical Data Registry.  Ophthalmology 2022, in press.

    Armbrust KR, Kopplin LJ.  Characteristics and Outcomes of Patients with Scleritis in the IRIS® Registry (Intelligent Research in Sight) Database.  Ophthalmology Sci 2022; 2:100178.

    Saraf SS, Lacy M, Hunt MS, Lee CS, Lee AY, Chee YE, IRIS Registry Analytic Centers.  Demographics and Seasonality fo Retinal Detachment, Retinal Breaks, and Posterior Vitreous Detachment from the Intelligent Research in Sight Registry.  Ophthalmology Science, 2022; 2:100145.

    Ciociola EC, Yang SA, Hall N, Lorch AC, Miller JW, Friedman DS, Boland MV, Elze T, Zebardast N, IRIS Registry Data Analytic Center Consortium.  Effectiveness of Trabeculectomy and Tube Shunt With Versus Without Concurrent Phacoemulsification:  IRIS Registry Longitudinal Analysis.  J Ophthalmol Glaucoma 2022 in press. 

    Bian Y, Ma KK, Hall NE, Lorch A, Miller JW, Dana R, Yin J.  Neurotrophic Keratopathy in the United States:  an IRI ® Registry (Intelligent Research in Sight) Analysis.  Ophthalmology 2022 in press.   

    Son HS, Lum F, Li C, Schein O, Pramanik S, Srikumaran D.  Risk Factors for Repeat Keratoplasty after Endothelial Keratoplasty – an IRIS® Registry Analysis.   Am J Ophthalmol 2022; 242:77-87.   

    Oke I, Hall N, Elze T, Miller JW, Lorch AC, Hunter DG.  Adjustable suture technique is associated with fewer strabismus reoperations in the IRIS Registry (Intelligent Research in Sight).  Ophthalmology 2022; 129:1028-1033. 

    Hall NE, Chang EK, Samuel S, Gupta S, Klug E, Elze T, Lorch AC, Miller JW, Valle DS.  Risk factors for glaucoma drainage device revision or removal using the IRIS Registry.  Am J Ophthamol 2022; 240:302-320. 

    Srikumaran D, Son HS, Li C, Schein O, Pramanik S.  Disparities in Visual Acuity Outcomes after Endothelial Keratoplasty – an IRIS® Registry Analysis.  Ophthalmology 2022; 129:912-922. 

    Skuta G, Ding K, Lum F, Coleman AL.  An IRIS® Registry-based Assessment of Primary Open-Angle Glaucoma Practice Patterns in Academic versus Non-Academic Settings.  Am J Ophthalmol 2022;242:228-242. 

    Lee CS, Blazes M, Lorch A, Pershing S, Hyman L, HO AC, Haller J, Miller JW, Chew EY, Lum F, Lee AY.  American Academy of Ophthalmology Intelligent Research in Sight (IRIS®) Registry and the IRIS Registry Analytic Center Consortium.  Ophthalmology Science 2022; 2. 

    Horn JD, Fisher BL, Terveen D, Fevrier H, Merchea M, Gu X.  IRIS® Registry analysis of incidence of laser capsulotomy due to posterior capsule opacification after intraocular lens implantation.  Clinical Ophthalmology 2022; 16:1721-1730. 

    Lum F, Li S, Liu L, Li C, Parke DW II, Williams GA.  The Pandemic Not Associated with Increase of Endophthalmitis after Anti-VEGF Injections.  Ophthalmology 2022; 129:719-721.   

    MacCumber MW, Yu JS, Sagkiotis A, Guruprasad B, Burugapalli B, Bi X, Agashivala N, Wykoff CC.  Treatment patterns and outcomes with antivascular endothelial growth factor agents for wet age-related macular generation in clinical practice:  an analysis of the IRIS Registry . Can J Ophthalmol 2021 in press.   

    Khanani AM, Zarbin MA, Albini TA, Kaiser PK, Guruprasad B, Agashivala N, Yu JS, Wykoff CC, MacCumber MW.  Safety Outcomes of Brolucizumab in Neovascular Age-Related Macular Degeneration. Results From the IRIS Registry and Komodo Healthcare Map. JAMA Ophthalmol 2021 in press. 

    Kramer BA, Berdahl J, Gu X, Merchea M.  Real world incidence of monofocal toric IOL repositioning:  Analysis of the American Academy of Ophthalmology IRIS Registry. J Cataract Refract Surg 2021 in press.

    Bagdasarova Y, Lee AY, Maring M, Wen J, Lacy M, Lee CS, Cataract surgery is not associated with decreased risk of retinal vein occlusion, for the IRIS Registry Analytic Centers Study Group. Ophthalmology Science 2021, 1:10041.

    Owen JP, Blazes M, Lucy M, Yanagihara RT, Van Gelder RN, Lee AY, Lee CS, IRIS Registry Analytic Center Consortium. Refractive outcomes after immediate sequential vs delayed sequential bilateral cataract surgery. JAMA Ophthalmol 2021; 139:876-885.

    Lacy M, Kung T-P H, Owen JP, Yanagihara RT, Blazes M, Pershing S, Hyman LG, Van Gelder RN, Lee AY, Lee CS, on behalf of IRIS Registry Analytic Center Consortium.  Endophthalmitis rate in immediate sequential vs delayed sequential bilateral cataract surgery within the IRIS Registry data. Ophthalmology 2021; in press.

    Finn A, Fujino D; Lum F, Rao P.  Etiology, Treatment Patterns, and Outcomes for Choroidal Neovascularization in the Pediatric Population: an IRIS Registry Study. Ophthalmol Retina 2021; in press.

    Yannuzzi NA, Li C, Fujino D, Kelly SP, Lum F, Flynn HW, Parke DW.  Clinical outcomes of rhegmatogenous retinal detachment treated with pneumatic retinopexy. JAMA Ophthalmol 2021; 139:849-853.

    Leng T, Gallivan MD, Kras A, Lum F, Roe MT, Li C, Parke DW, Schwartz SD.  Impact of COVID-19 on ophthalmology care and outcomes – an IRIS Registry study. Ophthalmology 2021; in press.

    Li Y, Hall NE, Pershing S, Hyman L, Haller JA, Lee AY, Lee CS, Chiang M, Lum F, Miller JW, Lorch A, Elze T.  Age, gender, and laterality of retinal vascular occlusion:  A retrospective study from the IRIS Registry. Ophthalmol Retina 2021; in press.

    Chang TC, Vanner EA, Fujino D, Kelly S, Parrish RK.  Factors associated with laser trabeculoplasty response and duration:  Analysis of a large clinical database (IRIS Registry). J Glaucoma 2021; 30:902-910.

    Malhotra NA, Greenlee TE, Iyer AI, Conti TF, Chen AX, Singh RP.  Racial, ethnic and insurance-based disparities upon initiation of anti-VEGF therapy for diabetic macular edema in the United States. Ophthalmology 2021; in press. 

    Anchouche S, Hall N, Bal S, Dana R, Elze T, Miller JW, Lorch AC, Yin J, IRIS Registry Data Analytic Centers.  Chemical and thermal ocular burns in the United States.  An IRIS Registry analysis. The Ocular Surface 2021; in press.

    Yang SA, Mitchell W, Hall N, Elze T, Lorch AC, Miller JW, Zebardast N; IRIS Registry Data Analytics Consortium.  Trends and Usage Patterns of Minimally Invasive Glaucoma Surgery (MIGS) in the US:  IRIS Registry Analysis 2013-2018. Ophthalmol Glaucoma 2021; in press.

    Wykoff CC, Khurana RN, Nguyen QD et al.  Risk of Blindness Among Patients with Diabetes and Newly Diagnosed Diabetic Retinopathy. Diabetes Care 2021;44:748-756.

    Olivier MG, Smith O, Croteau-Chonka C, VanderBeek BL, Maguire MG, Lum F, Fujino D, Kelly SP, Rich W, Miller-Ellis E.  Demographic and clinical characteristics associated with minimally invasive glaucoma surgery use:  An IRIS Registry retrospective cohort analysis. Ophthalmology 2021; in press.

    Vanner EA, Sun CQ, McSoley MJ, Persad PJ, Feuer WJ, Lum F, Kelly S, Parrish RK, Chang TC, Gedde SJ. Tube versus trabeculectomy IRIS Registry one-year composite outcome analysis with comparisons to the randomized controlled trial. Am J Ophthalmology, in press. 

    Sun MM, Kelly SP, Mylavarapu AL, Holland GN, Coleman AL, Yu F, Hsu S, Lum F, Gordon L.  Ophthalmic immune-related adverse events following anti-CTLA-4 or PD-1 therapy recorded in the American Academy of Ophthalmology IRIS Registry. Ophthalmology, in press. Accessed Nov. 5, 2020.

    Ho AC, Kleinman DM, Lum FC et al.  Baseline visual acuity at wet AMD diagnosis predicts long-term vision outcomes:  An analysis of the IRIS Registry.  Ophthalmic Surg Lasers Imaging Retina 2020 Nov 51:633-639. 

    Chang TC, Parrish RK, Fujino D, Kelly SP, Vanner EA, Factors associated with favorable laser trabeculoplasty response: IRIS Registry Analysis, Am J Ophthalmol, in press. 

    Repka MX.  Amblyopia Outcomes Through Clinical Trials and Practice Measurement:  Room for Improvement:  The LXXVII Edward Jackson Memorial Lecture.  Am J Ophthalmol 2020 in press. 

    Rao P et al.  Reoperation rates of patients undergoing primary noncomplex retinal detachment surgery in a cohort of the IRIS Registry. Am J Ophthalmol 2020 in press.

    Lee CS, Owen JP, Yanagihara RT, Lorch A, Pershing S, Hyman L, Miller JW, Haller JA, Chiang MF, Lum F, Lee AY.  Smoking is associated with higher IOP regardless of glaucoma, a retrospective study of 12.5 million patients using the IRIS Registry.  Ophthalmology Glaucoma, in press. Accessed March 31, 2020. 

    Glasser DB, Parikh R, Lum F, Williams GA.  Intravitreal Anti-Vascular Endothelial Growth Factor Cost Savings Achievable with Increased Bevacizumab Reimbursement and Utilization. Ophthalmology 2020; 127:1688-1692.

    Rubino SM, Parke DW III, Lum F.  Return to the Operating Room after Vitrectomy for Vitreous Opacities: IRIS® Registry Analysis.  Ophthalmology Retina, in press. Accessed July 17, 2020.  

    Mahr MA, Lum F, Fujino D, Kelly SP, Erie JC.  Return to the Operating Room for Removal of Retained Lens Fragments after Cataract Surgery:  IRIS® Registry (Intelligent Research in Sight) Analysis. Ophthalmology 2020; 127:698-9.

    Cantrell RA, Lum F, Chia Y, Morse LS, Rich WL, Salman CA, Willis JR.  Treatment Patterns for Diabetic Macular Edema:  An IRIS® Registry Analysis. Ophthalmology, in press.  2020;127:427-9. 

    Pershing S, Lum F, Hsu S, Kelly S, Chiang MF, Rich WL, Parke DW.  Endophthalmitis after Cataract Surgery in the US, A Report from the IRIS Registry, 2013-2017. 2020; 127:151-8. 

    Strabismus, Strabismus Surgery and Reoperation Rate in the United States: Analysis from the IRIS Registry
    Michael X. Repka, MD, et al. Ophthalmology, Volume 125, Issue 10, 1646–1653 (October 2018)

    Return to the Operating Room after Macular Surgery:  IRIS Registry Analysis 
    D. Wilkin Parke III, MD, et al.
    Ophthalmology, Volume 125, Issue 8, 1273–1278 (August, 2018)

    The 2016 American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) Database:  Characteristics and Methods
    Michael F. Chiang, MD, et al
    Ophthalmology, Volume 125, Issue 8, Pages 1143–1148 (August 2018)

    The Real World Effect of Intravitreous Anti-VEGF Drugs on IOP: An Analysis Using the IRIS Registry
    Elizabeth Atchison, MD, et al.
    Ophthalmology, Volume 125, Issue 5, Pages 676–682 (May 2018)

    Performance Rates Measured in the IRIS Registry
    William L. Rich III, MD  et al.
    Ophthalmology, Volume 125, Issue 5, Pages 782–784 (May 2018)

    Real World Vision in Age-Related Macular Degeneration Patients Treated with Bevacizumab, Ranibizumab or Aflibercept only Over One Year in a Cohort of the IRIS Registry
    Prethy Rao, MD, et al
    Ophthalmology, Volume 125, Issue 4, 522–528 (April 2018)

    The American Academy of Ophthalmology’s IRIS Clinical Data Registry: A Look Back and a Look to the Future
    David W. Parke II, MD, et al.
    Ophthalmology Volume 124, Issue 11, 1572-1574 (November 2017)

    Treatment Patterns for Myopic Choroidal Neovascularization in the United States
    Jeffrey R. Willis, MD, et al.
    Ophthalmology, Volume 124, Issue 7, 935 - 943 (July 2017)

    The IRIS Registry:  Purpose and Perspectives
    David W. Parke II, MD, et al. 
    Ophthalmologe (2017)

    The Prevalence of Myopic Choroidal Neovascularization in the United States:  Analysis of the IRIS Data Registry and NHANES 
    Jeffrey R. Willis MD et al.
    Ophthalmology, Volume 123, Issue 8, 1771 - 1782 (August 2016)

    How Big Data Informs Us About Cataract Surgery: The LXXII Edward Jackson Memorial Lecture
    Anne Louise Coleman, MD
    American Journal of Ophthalmology, Volume 160, Issue 6, 1091 - 1103.e3 (December 2015)