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Dan Gong, Nathan Eli Hall, Tobias Elze, Lucia Sobrin, Joan W Miller, Alice Lorch, John B Miller; Temporal Trends in the Treatment of Proliferative Diabetic Retinopathy: An AAO IRIS Registry Analysis. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1382.
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© ARVO (1962-2015); The Authors (2016-present)
Proliferative diabetic retinopathy (PDR) is a major cause of irreversible vision loss in the United States. Panretinal photocoagulation (PRP) and intravitreal anti-VEGF injections (IVI) are both acceptable treatments to reduce the risk of vision loss in patients with PDR, but it is unclear how treatment patterns are changing over time.
A retrospective, cohort analysis using the AAO IRIS Registry database spanning 2013-2017. A total of 197,273 eyes with a PDR diagnosis code (ICD-10 codes E08.35, E09.35, E10.35, E11.35, E13.35; ICD-9 code 362.02) were included in addition to information on whether these eyes underwent PRP (CPT 67228), IVI (CPT 67028), or observation. Comparison analyses of age, gender, and the presence of diabetic macular edema (DME) were conducted using t-tests, Tukey tests, and Chi-squared tests as appropriate.
From 2013-2017, 80,606 (40.9%) eyes with PDR underwent PRP, 96,413 (48.9%) eyes underwent IVI, and 20,254 (10.2%) underwent observation. While PDR patients receiving PRP were younger than those receiving IVI (57.6 vs 59.7 years old, p<0.001), the average age of both groups declined from 2013 to 2017 (67.9 to 62.8 for IVI, p<0.001; 66.5 to 60.9 for PRP, p<0.001). In 2013, the majority of eyes undergoing treatment for PDR received PRP (57.3% PRP, 42.7% IVI), but by 2017, this treatment pattern had reversed with the majority receiving IVI (42.7% PRP, 57.3% IVI, p<0.001). A higher proportion of women with PDR received IVI than men in 2013 (+1.6%), but a lower proportion of women received IVI than men by 2017 (-1.0%, p=0.007). The proportion of eyes with PDR without concurrent DME receiving IVI increased from 40.7% in 2013 to 44.9% in 2017 although this was not statistically significant (p=0.81).
In this cohort analysis of the AAO IRIS Registry, IVI surpassed PRP as the more common method of treating PDR from 2013 to 2017.
This is a 2020 ARVO Annual Meeting abstract.
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