Association of Socioeconomic Health Care Disparities With Use of Anti-Vascular Endothelial Growth Factor and Visual Acuity Outcomes in Patients With Diabetic Macular Edema

BACKGROUND AND OBJECTIVE: This study character-izes the impact of race, ethnicity, insurance status, and geographic location on anti-vascular endothe-lial growth factor (VEGF) use for the treatment of diabetic macular edema (DME). PATIENTS AND METHODS: This study is a retrospec-tive cohort study. The American Academy of Oph-thalmology Intelligent Research in Sight Registry was queried for patients diagnosed with DME who received at least one anti-VEGF injection between 2012 and 2020 (n = 203,707). Multivariate regres-sion analyses investigated associations between race, ethnicity, insurance status, and geographic location and anti-VEGF use and visual outcomes. RESULTS: White race, non-Hispanic/Latino eth-nicity, and private insurance were associated with higher use of anti-VEGF injections during a 60-month period (incidence rate ratio, 1.2, 1.25, and 1.17, respectively; P < .01). Furthermore, being of non-Hispanic/Latino ethnicity and having private health insurance were associated with higher longi-tudinal visual acuity (odds ratio, 1.44 [P = .02] and odds ratio, 1.43 [P < .01], respectively). CONCLUSION: Ethnicity and insurance status are associated with anti-VEGF use and visual acuity outcomes in DME.