Epidemiology of Pediatric Ocular Surface Inflammatory Diseases in the United States Using the Optum Labs Data Warehouse
Authors: Simon S.M. Fung, Tanya Boghosian, Claudia Perez, Fei Yu, Anne Coleman, Lynn Gordon, Asim Ali, Stacy Pineles
Journal: Ophthalmology (2023)

PurposeTo benchmark the epidemiology of pediatric ocular surface inflammatory diseases (POSID).DesignRetrospective cohort study.ParticipantsPatients ≤18 years with a medical claim for a diagnosis of POSID in the Optum Labs Data Warehouse between 2007 and 2020.MethodsPatients with claims of blepharokeratoconjunctivitis (BKC), herpes simplex keratoconjunctivitis (HSK), or vernal keratoconjunctivitis (VKC) were included. Those with <6 months of follow-up before the initial diagnosis of POSID were excluded. Odds ratios (ORs) were derived from multivariate logistic regression evaluating the associations between epidemiological variables and POSID development.Main Outcome MeasuresThe primary outcome was the estimated prevalence of POSID. Prevalence of POSID subtypes and changes in prevalence over time were also evaluated.Results2,168 patients with POSID were identified in 2018-2019, yielding an estimated prevalence of 3.32 per 10,000. The prevalence of POSID was higher among children between the ages of 5-10 years old, males, of Asian descent, and those living in the Northeast and the West census regions of the United States. The prevalence (per 10,000) of BKC, HSK, and VKC in the same period were 0.59 (95% CI: 0.53–0.65), 0.74 (95% CI: 0.68–0.81) and 1.99 (95% CI: 1.88–2.10) respectively and there were significant differences in terms of age, gender, racial and ethnic and regional distributions among the diagnoses. Between 2008-2009 and 2018-2019, there was a significant increase in POSID among Asians (6.26, 95% CI: 5.28-7.36 to 11.80, 95% CI: 10.40-13.34) driven by changes in VKC. Multivariate analysis demonstrated that age groups >5 years (ORs 2.57 to 3.75, 95% CI: 2.17-4.34); male gender (OR 1.38, 95% CI: 1.26-1.50); Asian (OR 3.12, 95% CI: 2.70-3.60) and Black or African American descent (OR 1.26, 95% CI: 1.02-1.55) were associated with POSID development.ConclusionsThis study provides the first estimate of the prevalence of POSID and its three common subtypes in the United States, with important epidemiological differences between them. To benchmark the epidemiology of pediatric ocular surface inflammatory diseases (POSID). Retrospective cohort study. Patients ≤18 years with a medical claim for a diagnosis of POSID in the Optum Labs Data Warehouse between 2007 and 2020. Patients with claims of blepharokeratoconjunctivitis (BKC), herpes simplex keratoconjunctivitis (HSK), or vernal keratoconjunctivitis (VKC) were included. Those with <6 months of follow-up before the initial diagnosis of POSID were excluded. Odds ratios (ORs) were derived from multivariate logistic regression evaluating the associations between epidemiological variables and POSID development. The primary outcome was the estimated prevalence of POSID. Prevalence of POSID subtypes and changes in prevalence over time were also evaluated. 2,168 patients with POSID were identified in 2018-2019, yielding an estimated prevalence of 3.32 per 10,000. The prevalence of POSID was higher among children between the ages of 5-10 years old, males, of Asian descent, and those living in the Northeast and the West census regions of the United States. The prevalence (per 10,000) of BKC, HSK, and VKC in the same period were 0.59 (95% CI: 0.53–0.65), 0.74 (95% CI: 0.68–0.81) and 1.99 (95% CI: 1.88–2.10) respectively and there were significant differences in terms of age, gender, racial and ethnic and regional distributions among the diagnoses. Between 2008-2009 and 2018-2019, there was a significant increase in POSID among Asians (6.26, 95% CI: 5.28-7.36 to 11.80, 95% CI: 10.40-13.34) driven by changes in VKC. Multivariate analysis demonstrated that age groups >5 years (ORs 2.57 to 3.75, 95% CI: 2.17-4.34); male gender (OR 1.38, 95% CI: 1.26-1.50); Asian (OR 3.12, 95% CI: 2.70-3.60) and Black or African American descent (OR 1.26, 95% CI: 1.02-1.55) were associated with POSID development. This study provides the first estimate of the prevalence of POSID and its three common subtypes in the United States, with important epidemiological differences between them.