Abstract
Purpose :
Retinal detachment is a sight-threatening ophthalmic emergency and timely repair is critical to optimize long-term visual outcomes. Sex and race/ethnicity health disparities have been previously identified in many fields but data for retinal detachments is limited. The purpose of this study is to investigate differences in rhegmatogenous retinal detachment (RRD) repair by race, ethnicity, and sex.
Methods :
A retrospective study of a nationally representative claims database (ClinformaticsTM Data Mart Database [OptumInsight, Eden Prairie, MN]) for patients with an incident RRD between 2003-2019 was performed. Patients with pre-existing ocular conditions, discontinuous coverage, less than a year of coverage prior to the index diagnosis of RRD, and less than 30 days of follow-up after the index diagnosis were excluded. Two diagnoses of RRD were required for the primary outcome model. Models were adjusted for age, year of diagnosis, ocular comorbidities, systemic comorbidities. Primary outcomes were adjusted odds of receiving surgery, time to repair, and type of surgery.
Results :
Among 10,339 eligible cases of incident RRD, 44% (n=4536) were women, 72% (n=7450) were White, 11% (n=1111) were Hispanic, and 11% (n=1137) were Black. The primary outcome model had 2755 confirmed RRD cases and 95% (n=2622) of these patients received surgery. Women had 20% reduced odds of receiving an RRD repair after adjustment (odds ratio [OR]: 0.80, 95% CI 0.74-0.87). Asian (OR 0.71, 0.57-0.90), Black (OR 0.83, 0.73-0.95), and Hispanic patients (OR 0.79, 0.69-0.90) also had lower odds of repair. Delays in RRD repair were not observed by sex, but Hispanic patients were more often delayed relative to their White counterparts (16 days, p=0.009).
Conclusions :
In a retrospective national claims-analysis, women and racial/ethnic minorities were found to have significantly lower odds of rhegmatogenous retinal detachment repair relative to men and White patients, respectively. Hispanic patients experience delays in care relative to their White counterparts. While the reason for these differences is likely multi-faceted, health disparities and delays in care are known to have devastating implications on patient outcomes and warrant further investigation.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.