Epidemiology and demographic features related to eye diseases

Epidemiology and demographic features related to eye diseases


The public health system is continually reminded of the challenges posed by the limited understanding of the diseases. It was recommended that every public health agency should collect, assemble, analyze, and make available information on the health of the community, including statistics on health status, community health needs, and epidemiologic and other studies of health problems.[1] Ocular diseases management is a crucial part of the health care system as some ocular diseases are of high prevalence, like cataract and myopia, and will heavily affect the living quality of people. In addition, some are closely related to other systemic diseases like diabetic retinopathy and retinal vascular occlusion.

Regarding the lack of comprehensive pathologic mechanism knowledge and the complexity of proper detection, diagnosis, and treatment, population-based cohort studies provide a choice to investigate the interactions of genes, environment, society, and personal lifestyle with disease onset and progression. Large, comprehensive, and systemic population-based cohort studies are necessary and are the trend of future clinical studies. There are two examples of cohort studies.

The American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) [2] is one of the large clinical ocular disease registries in the United States. It consists of data from more than 349 million patient visits of 60 million unique patients in the United States (as of September 1, 2020). The IRIS® Registry collects 5 eye care measures, 10 general prevention and patient safety measures, and 18 outcome measures from over 3,800 ophthalmic practices in the United States, and continually tracks patients’ history in the same specialty, including initial patient visit, intervention, and longitudinal follow-up. The IRIS platform provides a large-scale glimpse into the trends of eye disease, features, and real-world conditions such as patients’ identification and diagnosis, choices of treatment, and outcomes.

LIFE-Adult-Study[3] is a population-based study conducted by the Leipzig Research Centre for Civilization Diseases (LIFE) in Leipzig, Germany. The study collects the baseline examination and follow-up results of 10,000 participants that were randomly selected from 550,000 inhabitants in Leipzig. The baseline examination was finished before November 2014, and the follow-up examination commenced in 2016 and is running till now. The measurements are not limited to ophthalmic measurements like high-quality non-mydriatic fundus imaging and optical coherence tomography (OCT) results, but also comprise structured personal interviews, self-administered questionnaires, physical and medical examinations, psychometric tests, more than 80 clinical chemical biomarkers as well as comprehensive molecular-genetic profiling comprising genotyping, transcriptome, metabolome, and proteome analyses based on blood and urine samples. Some participants have additional cognition and depression tests and an MRI scan of the brain.

What We Do

As the databases of IRIS® Registry and LIFE-Adult-Study are both large and complex, our team is participating in the analysis work of these two databases using big-data-related methods. For IRIS® Registry, we investigate the association of demographic features, social histories, and onset clinical characteristics of different diseases. We also focus on the clinical stage of diseases and their relationship with other factors. For the LIFE-Adult-Study, we associate the ophthalmic imaging data (fundus imaging and OCT results) with chemical measurements to find predictive biomarkers of certain diseases, like age-related macular edema and diabetic retinopathy.

Selected Publications

1. Li Y, Mitchell W, Elze T, Zebardast N. Association Between Diabetes, Diabetic Retinopathy, and Glaucoma. Curr Diab Rep. 2021 Sep 8;21(10):38. doi: 10.1007/s11892-021-01404-5. Review. PubMed PMID: 34495413.

2. 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 May 12;. doi: 10.1016/j.oret.2021.05.004. [Epub ahead of print] PubMed PMID: 33991710.

3. Baniasadi N, Rauscher FG, Li D, Wang M, Choi EY, Wang H, Peschel T, Wirkner K, Kirsten T, Thiery J, Engel C, Loeffler M, Elze T. Norms of Interocular Circumpapillary Retinal Nerve Fiber Layer Thickness Differences at 768 Retinal Locations. Transl Vis Sci Technol. 2020 Aug;9(9):23. doi: 10.1167/tvst.9.9.23. eCollection 2020 Aug. PubMed PMID: 32879779; PubMed Central PMCID: PMC7442876.

4. Dian Li, Franziska G. Rauscher, Eun Young Choi, Mengyu Wang, Neda Baniasadi, Kerstin Wirkner, Toralf Kirsten, Joachim Thiery, Christoph Engel, Markus Loeffler and Tobias Elze, “Sex-Specific Differences in Circumpapillary Retinal Nerve Fiber Layer Thickness", Ophthalmology 127 (2020): 357-368.


[1] Institute of Medicine (US) Forum on Emerging Infections, Harrison PF, Lederberg J, eds. Antimicrobial Resistance: Issues and Options. Washington (DC): National Academies Press (US); 1998.

[2] Parke II DW, Lum F, Rich WL. The IRIS®-Registry Purpose and perspective. Der Ophthalmologe. 2016;113(6):463-468

[3] Loeffler M, Engel C, Ahnert P, et al. The LIFE-Adult-Study: objectives and design of a population-based cohort study with 10,000 deeply phenotyped adults in Germany. BMC PUBLIC HEALTH 2015;15.