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Disparities in Retinal Vein Occlusion Presentation and Initiation of Anti-VEGF Therapy: an Academy IRIS Registry Analysis
Journal article   Peer reviewed

Disparities in Retinal Vein Occlusion Presentation and Initiation of Anti-VEGF Therapy: an Academy IRIS Registry Analysis

Julia A. Haller, Maurizio Tomaiuolo, Mary M. Lucas, Christopher C. Yang, Leslie Hyman, Aaron Y. Lee, Cecilia S. Lee, Russ Van Gelder, Alice Lorch, Joan W. Miller, …
Ophthalmology retina
24 Jan 2024
DOI: https://doi.org/10.1016/j.oret.2024.01.017
PMID: 38278175
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Anti-VEGF Disparities Retinal vein occlusion
Investigate disparities in retinal vein occlusion (RVO) presentation and initiation of anti-VEGF treatment. Retrospective cohort study. Patients in the American Academy of Ophthalmology IRIS (Intelligent Research in Sight) Registry database (2015–2021) with branch or central retinal vein occlusion and macular edema (ME). The association of demographic characteristics and presenting visual acuity with anti- VEGF treatment initiation were quantified using multivariable logistic regression. Treatment with ≥ 1 anti-VEGF injection within 12 months after RVO diagnosis. A total of 304 558 eligible patients with RVO and ME were identified. Age at presentation varied by race, ethnicity, sex, and RVO type (all P values < 0.001). Within the first year after RVO presentation, 192 602 (63.2%) patients received ≥1 anti-VEGF injection. In a multivariable regression model adjusting for relevant covariates, female (vs. male) patients had lower odds of receiving injections (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.93–0.96; P < 0.0001) as did Black/African American (vs. White) patients (OR, 0.90; 95% CI, 0.88–0.92; P < 0.0001) and Asian (vs. White) patients (OR, 0.95; 95% CI, 0.91–0.99; P = 0.02), whereas older patients (vs. patients aged < 51 years) had higher odds (61–70 years: OR, 1.20; 95% CI, 1.16–1.24; 71–80 years: OR, 1.20; 95% CI, 1.16–1.24; > 80 years: OR, 1.15; 95% CI, 1.11–1.18; all P values < 0.0001). Hispanic (vs. non-Hispanic) patients had a small increased odds of treatment initiation (OR, 1.08; 95% CI, 1.04–1.11; P < 0.0001). Results were similar in the subset of 226 143 patients with visual acuity (VA) data. In this subset, patients with presenting VA < 20/40 to 20/200 were most frequently treated in the first year after diagnosis (∼ 70%) and patients with light perception/no light perception (LP-NLP) vision or VA of 20/20 or better were treated least frequently (36.9% and 41.9%, respectively). In this large national clinical registry, 37% of RVO patients with macular edema had no anti-VEGF treatment documented in the first year after diagnosis. Black/African American, Asian, and female patients and patients with VA of LP-NLP were least likely to receive treatment. Awareness of this undertreatment and these disparities highlight the need for initiatives to ensure all RVO patients receive timely anti-VEGF injections for optimized visual outcomes. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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Domestic collaboration
Web of Science research areas
Ophthalmology
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