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Incidence of exudative age-related macular degeneration and treatment load under the Korean national health insurance system in 2010–2015
  1. Tyler Hyungtaek Rim1,
  2. Tae Keun Yoo1,
  3. Seo Hee Kim1,
  4. Dong Wook Kim2,
  5. Sung Soo Kim1
  1. 1 Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
  2. 2 Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Korea
  1. Correspondence to Professor Sung Soo Kim, Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul 03722, Korea; semekim{at}


Background/Aim The aim of this study was to estimate the nationwide incidence of clinically diagnosed exudative age-related macular degeneration (AMD) and associated use of ranibizumab and aflibercept in South Korea.

Methods In this retrospective, population-based cohort study, claims data for 2010–2015 were analysed in a randomly selected sample of 519 661 adults aged ≥40 years. The incidence per 10 000 person-years was estimated, along with the 95% CI. Incident exudative AMD was defined based on the registration code for rare intractable diseases. Use of ranibizumab and aflibercept and the incidence of exudative AMD were recorded.

Results Nine hundred and twelve patients were newly diagnosed with exudative AMD in 2010–2015. The 6-year incidence in the general population aged ≥40 years was 2.9 (95% CI 2.8 to 3.0) per 10 000 person-years. The incidence was highest in individuals aged 75–79 years (12.0, 95% CI 10.3 to 13.8). The incidence was higher in men than in women in all age groups. Six hundred and twenty-five (69%) of the 912 newly diagnosed patients started ranibizumab or aflibercept as a first-line treatment. The average number of injections administered was 6.1 (SD 3.9; minimum of 1 injection and maximum government-supported limit of 14) during 2010–2015; the number increased with increasing government funding support (from 5 to 10 and from 10 to 14 in 2013 and 2014, respectively).

Conclusions This study describes the incidence of exudative AMD in South Korea and its treatment under the national health insurance system in this country. Its findings could be used for reference purposes and be useful when planning treatment for exudative AMD.

  • retina
  • age-related macular degeneration

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  • Author contributions Research design: THR, SSK. Data acquisition and/or research execution: THR, DWK, SSK. Data analysis and/or interpretation: THR, TKY, SHK, DWK, SSK. Manuscript preparation: THR, TKY, SSK. Overall responsibility: THR, SSK.

  • Funding This study was supported by a faculty research grant from Yonsei University College of Medicine in 2017 (6-2017-0089).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This retrospective nationwide cohort study was approved by the Institutional Review Board of Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, and adhered to the tenets of the Declaration of Helsinki. The requirement for informed consent was waived in view of the retrospective observational nature of the research and the anonymity of data.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement NHIS-NSC data can be accessed from the NHIS website ( after completing the application process and receiving approval ( Detailed cohort profile and the methods for obtaining data are explained in the following source: Lee J, Lee JS, Park SH, Shin SA, Kim K. Cohort Profile: The National Health Insurance Service-National Sample Cohort (NHIS-NSC), South Korea. International Journal of Epidemiology. 2017. doi: 10.1093/ije/dyv319.

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