Eye care utilization and visual outcomes among glaucoma patients in the Intelligent Research in Sight Registry from 2015 – 2020

Abstract

Purpose : To evaluate racial and ethnic differences in eye care utilization and associated vision outcomes among glaucoma patients in the IRIS® Registry (Intelligent Research in Sight).

Methods : Data were extracted from the IRIS Registry from patients with minimum one diagnosis code for glaucoma at least 6 months prior to January 1^st, 2015 and at least one eye exam, visual field (VF), optical coherence tomography (OCT), or eye related emergency department (ED) or inpatient encounter code in the 2015 calendar year. Counts per 100 person years for eye exams, VFs, OCTs, ED/inpatient encounters, and eye laser/surgical procedures were calculated from 2015 to 2020. Negative binomial regression analyses adjusted for age and sex were used to report likelihood of utilization by race/ethnicity. The percentage of patients with low vision diagnoses was statistically compared across groups.

Results : A total of 1,170,754 patients were included; 62% were Non-Hispanic White, 13% Non-Hispanic Black, 8% Hispanic, 2% Asian/Pacific Islander, and 0.3% Native American and Alaska Native. Compared to White patients, Black patients were significantly less likely to receive eye exams (IR 0.96 (95% CI 0.96-0.96), p<0.001) and OCTs (IR 0.85 (0.84 – 0.85), p<0.001) (Table 1). Black patients were more likely to have ED/inpatient encounters (IR 2.56 (2.16 – 3.06), p<0.001) or require laser/surgical procedures (IR 1.06 (1.04 – 1.08), p<0.001) compared to Whites. Similarly, Hispanics were less likely to receive OCTs (IR 0.96 (95% CI 0.95 – 0.97), p<0.001) and more likely to have ED/inpatient encounters (IR 1.37 (1.11-1.72), p=0.004) or laser/surgical procedures (IR 1.02 (1.00-1.04), p=0.04) compared to Whites. Asian patients had the highest counts of eye visits and VFs and were less likely to undergo laser/surgical procedures compared to White patients (IR 0.94 (0.90 – 0.97), p<0.001). Beyond year one, Black and Hispanic patients had higher rates of low vision diagnoses compared with White and Asian patients at all time points (p<0.001, Figure 1).

Conclusions : Black and Hispanic patients received fewer eye exams and OCTs which correlated with higher rates of low vision diagnoses. Lower eye care utilization and disease monitoring may put Black and Hispanic patients at higher risk for glaucoma-related vision loss.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

Table 1. Counts per 100 person years by race

 

Figure 1. Percentage of low vision diagnoses by race