{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:06:01Z","timestamp":1790697961723,"version":"4.1.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T00:00:00Z","timestamp":1704326400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"2019 Hoskins Grant"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of VitreoRetinal Diseases"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>Purpose: To examine disparities in visual acuity (VA) outcomes 1 year and 2 years after initiation of diabetic retinopathy (DR) or diabetic macular edema (DME) treatment in patients based on race\/ethnicity and insurance status, accounting for disease severity. Methods: This retrospective analysis used the IRIS Registry and included DR patients older than 18 years with documented antivascular endothelial growth factor (anti-VEGF) treatment and VA data for at least 2 years. International Classification of Diseases, Tenth Revision, Clinical Modification codes were used to determine the severity of DR and DME presence. VA outcomes were assessed using multivariable linear regressions and anti-VEGF drug use by multivariable logistic regressions, with race and insurance status as independent variables. Main outcome measures comprised the mean VA change at 1 year and 2 years and percentage of patients treated with bevacizumab. Results: The study included 43\u2009274 eyes. White patients presented with a higher mean VA and lower mean DR severity than Black patients and Hispanic patients. Multivariable logistic regression showed Hispanic patients were significantly more likely to be treated with bevacizumab than White patients across all insurance types, controlling for disease severity and VA. After 1 year, the letter improvement was 1.73, 1.33, and 1.13 in White patients, Black patients, and Hispanic patients, respectively. Multivariable linear regression suggested that across races, Medicaid-insured patients had significantly smaller gains in VA than privately insured patients. Conclusions: Race-based and insurance-based differences in 1-year and 2-year outcomes after anti-VEGF treatment for DR and anti-VEGF treatment patterns suggest a need to ensure earlier and more effective treatment of minority and underserved patients in the United States.<\/jats:p>","DOI":"10.1177\/24741264231221607","type":"journal-article","created":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T06:26:55Z","timestamp":1704349615000},"page":"270-279","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Effect of Race and Insurance Status on Treatment and Outcomes in Diabetic Retinopathy: Analysis of 43\u2009274 Eyes Using the IRIS Registry"],"prefix":"10.1177","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9995-2962","authenticated-orcid":false,"given":"Jay","family":"Maturi","sequence":"first","affiliation":[{"name":"Johns Hopkins University School of Medicine, Baltimore, MD, USA"},{"name":"Retina Service, Midwest Eye Institute, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Maturi","sequence":"additional","affiliation":[{"name":"Retina Service, Midwest Eye Institute, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne W.","family":"Scott","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine, Baltimore, MD, USA"},{"name":"Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1548-6918","authenticated-orcid":false,"given":"Kathryn A.","family":"Carson","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine, Baltimore, MD, USA"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5557-6777","authenticated-orcid":false,"given":"Thomas","family":"Ciulla","sequence":"additional","affiliation":[{"name":"Retina Service, Midwest Eye Institute, Indianapolis, IN, USA"},{"name":"Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj","family":"Maturi","sequence":"additional","affiliation":[{"name":"Retina Service, Midwest Eye Institute, Indianapolis, IN, USA"},{"name":"Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,1,4]]},"reference":[{"key":"bibr1-24741264231221607","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.9.2653"},{"key":"bibr2-24741264231221607","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2016.02.022"},{"key":"bibr3-24741264231221607","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2011.12.039"},{"key":"bibr4-24741264231221607","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2014.05.006"},{"key":"bibr5-24741264231221607","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414264"},{"key":"bibr6-24741264231221607","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S128509"},{"key":"bibr7-24741264231221607","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S60893"},{"key":"bibr8-24741264231221607","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2018.04.010"},{"key":"bibr9-24741264231221607","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0149450"},{"key":"bibr10-24741264231221607","doi-asserted-by":"publisher","DOI":"10.3928\/23258160-20160229-09"},{"key":"bibr11-24741264231221607","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2019.10.019"},{"key":"bibr12-24741264231221607","doi-asserted-by":"publisher","DOI":"10.1016\/j.oret.2018.06.004"},{"key":"bibr13-24741264231221607","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2020-315933"},{"key":"bibr14-24741264231221607","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2020.03.021"},{"issue":"2","key":"bibr15-24741264231221607","first-page":"97","volume":"19","author":"Levine DA","year":"2009","journal-title":"Ethn Dis"},{"key":"bibr16-24741264231221607","unstructured":"KFF. 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