Race and Socioeconomic Status in Anti-VEGF Treatment of Diabetic Macular Edema

Ophthalmic Surg Lasers Imaging Retina. 2021 Nov;52(11):578-585. doi: 10.3928/23258160-20211018-01. Epub 2021 Nov 1.

Abstract

Background and objective: Although people of low socioeconomic status (SES) and certain racial groups are at greater risk of developing diabetic macular edema (DME), the extent these high-risk groups experience treatment differences is unknown. This study characterizes anti-vascular endothelial growth factor (anti-VEGF) injection use for DME.

Patients and methods: Data were collected from an electronic health record at the Cole Eye Institute, Cleveland Clinic Foundation for patients who received anti-VEGF treatment for DME between 2012 and 2019 (N = 500).

Results: White patients on average received more injections over a 1-year period than Black patients (4.93 ± 3.14 vs 3.20 ± 2.43; P < .0001) and had fewer no-show appointments (1.39 ± 2.08 vs 3.23 ± 3.39; P < .0001). There is an association between living in communities with lower average incomes and receiving fewer anti-VEGF injections (3.06 ± 2.70 vs 4.88 ± 3.19; P = .005).

Conclusions: DME treatment differs based on race and SES. Racial and SES associations with anti-VEGF injections present potential obstacles for delivering optimal ophthalmic care. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:578-585.].

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Diabetes Mellitus* / drug therapy
  • Diabetic Retinopathy* / drug therapy
  • Humans
  • Intravitreal Injections
  • Macular Edema* / drug therapy
  • Macular Edema* / etiology
  • Ranibizumab
  • Retrospective Studies
  • Social Class
  • Vascular Endothelial Growth Factor A

Substances

  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A
  • Ranibizumab