Purpose: To evaluate vision loss progression and the association of vision loss with medical care cost, falls, and fractures in patients with geographic atrophy (GA), using the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight). Methods: Patients aged 50 years or older who were diagnosed with GA between April 2016 and December 2021 and had a valid visual acuity (VA) measurement within 90 days before and 1 year after the date of GA diagnosis were evaluated. This post hoc analysis included a homogeneous cohort, a subset of patients for whom the incidence of eye diseases/procedures beyond GA that may affect vision and healthcare resource utilization was controlled. Further evaluation of this cohort described patients with and without subfoveal involvement. Homogeneous claims-linked cohorts were assessed using the IRIS Registry linked to the Komodo Health Research Dataset. Multivariable logistic regression was used to assess the associations of VA with total medical care cost and with incident falls and fractures. Results: A total of 63 616 patients were included. VA was less than 20/100 for 12.8% of patients at diagnosis and 24.3% by year 2. Median time to VA less than 20/40 was 3 years and was faster for those with subfoveal involvement (2.2 years) vs those without (3.8 years). A total of 5827 patients were included in the closed-claims cohorts. By year 2, VA impairment was associated with an increase of more than 26% in total cost of care. Moderate to severe VA impairment was suggestive of an increased risk of falls/fractures. Conclusions: This retrospective study demonstrates an association between vision loss from GA and increased healthcare costs and also suggests a potentially elevated risk of falls and fractures.
Borkar et al. (Mon,) studied this question.