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 Jul;53(7):380-391. doi: 10.3928/23258160-20220615-01. Epub 2022 Jul 1.

Abstract

Background and objective: This study characterizes the impact of race, ethnicity, insurance status, and geographic location on anti-vascular endothelial growth factor (VEGF) use for the treatment of diabetic macular edema (DME).

Patients and methods: This study is a retrospective cohort study. The American Academy of Ophthalmology Intelligent Research in Sight Registry was queried for patients diagnosed with DME who received at least one anti-VEGF injection between 2012 and 2020 (n = 203,707). Multivariate regression analyses investigated associations between race, ethnicity, insurance status, and geographic location and anti-VEGF use and visual outcomes.

Results: White race, non-Hispanic/Latino ethnicity, and private insurance were associated with higher use of anti-VEGF injections during a 60-month period (incidence rate ratio, 1.2, 1.25, and 1.17, respectively; P < .01). Furthermore, being of non-Hispanic/Latino ethnicity and having private health insurance were associated with higher longitudinal visual acuity (odds ratio, 1.44 [P = .02] and odds ratio, 1.43 [P < .01], respectively).

Conclusion: Ethnicity and insurance status are associated with anti-VEGF use and visual acuity outcomes in DME. [Ophthalmic Surg Lasers Imaging Retina 2022; 53:380-391.].

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Diabetes Mellitus* / drug therapy
  • Diabetic Retinopathy* / diagnosis
  • Endothelial Growth Factors / therapeutic use
  • Healthcare Disparities
  • Humans
  • Intravitreal Injections
  • Macular Edema* / etiology
  • Ranibizumab / therapeutic use
  • Retrospective Studies
  • Socioeconomic Factors
  • Visual Acuity

Substances

  • Angiogenesis Inhibitors
  • Endothelial Growth Factors
  • Ranibizumab