Abstract
Purpose :
Though current treatment guidelines predominantly call for observation of non-proliferative diabetic retinopathy (NPDR), recent studies indicate that intravitreal anti-VEGF can reduce disease progression. In this study, we evaluated trends of intravitreal anti-VEGF and PRP administration to NPDR patients from 2016-2018.
Methods :
We identified patients with an NPDR diagnosis from 2016-2018 in the IRIS registry and excluded patients once they developed proliferative diabetic retinopathy, vitreous hemorrhage, or macular edema. We calculated the percentage of NPDR patients receiving intravitreal anti-VEGF or PRP each year and performed a multivariate regression with patient characteristics of age, sex, and race/ethnicity to determine how these factors influence odds of treatment.
Results :
In 2016, 2017, and 2018 there were 257,446, 400,301, and 504,001 eyes with NPDR, respectively. The yearly increase in number of eyes is in part due to an expanding number of clinicians participating in the IRIS Registry. In 2016, 2017, and 2018, 0.10%, 0.15%, and 0.15% of eyes received PRP, respectively; while 0.87%, 0.88%, and 0.94% of eyes received intravitreal anti-VEGF, respectively. Yearly increases in rates of PRP and anti-VEGF were significant (β = 1.13 and 1.04, respectively). Compared with white patients, Hispanic and Black patients were more likely to receive PRP (OR = 1.53 and 1.26, respectively) and less likely to receive anti-VEGF (OR = 0.85 and 0.73, respectively). Asian patients were less likely to receive anti-VEGF (OR = 0.68). Compared with patients aged 41-60, those aged 0-20, 61-80, and 81-100 were less likely to receive PRP (OR = 0.27, 0.66, 0.36, respectively); while those aged 0-20, 61-80, and 81-100 were more likely to receive anti-VEGF (OR = 2.69, 1.35, 1.83, respectively) and ages 21-40 were less likely (OR = 0.6).
Conclusions :
Among NPDR patients, we found that 1) rates of PRP and anti-VEGF treatment increased slightly year-over-year; 2) Hispanic and Black patients were more likely to receive PRP and less likely to receive anti-VEGF than white patients, while Asian patients had comparable rates of PRP but were less likely to receive anti-VEGF; 3) patients aged 41-60 were more likely than other age groups to receive PRP except for those 21-40 (whose rates are comparable), and less likely than other age groups to receive anti-VEGF except for those 21-40 (whose rates are lower).
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.