ArticleOphthalmology2025
Disparities in Presentation and Anti-VEGF Therapy Initiation for Neovascular Age-Related Macular Degeneration: An Analysis of the Academy IRIS® Registry (Intelligent Research in Sight).
Article in Ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Intravitreal aflibercept 8 mg in patients with neovascular age-related macular degeneration from China: 48-week results from the PULSAR trial.International journal of retina and vitreous · 2026Article
- Social deprivation in neovascular age-related macular degeneration: when equal treatment does not deliver equal vision.Eye (London, England) · 2026Article
- Comparative Real-World Efficacy of Anti-Vascular Endothelial Growth Factor Agents in Neovascular Age-Related Macular Degeneration: A Multicenter Retrospective Study.Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde · 2026Article
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Authors and funding
6 authors.
Funding
Abstract
purposeTo investigate disparities in presentation and initiation of anti-VEGF therapy among patients with neovascular age-related macular degeneration (nAMD).
designRetrospective cohort study.
participantsPatients with nAMD newly diagnosed between October 2016 and October 2021 from the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight).
methodsAssociations between demographic characteristics, presenting visual acuity (VA), and the initiation of anti-VEGF treatment were assessed using multivariable Poisson regression models.
main outcome measuresTreatment initiation with ≥ 1 anti-VEGF injections within 12 months after first presentation with nAMD.
resultsAmong the 918 759 patients with nAMD (61.5% female, 82.3% White), male, Black, and Hispanic patients demonstrated nAMD at younger ages (P < 0.001). Of these, 719 204 patients (78.3%) initiated anti-VEGF treatment within 1 year, with 71.1% of patients (653 340/918 759) receiving the first injection within 1 month. In multivariable regression analysis, Black patients (rate ratio [RR], 0.91; 95% confidence interval [CI], 0.89-0.93; P < 0.001) and Asian patients (RR, 0.95; CI, 0.93-0.97; P < 0.001) were less likely to initiate treatment compared with White patients. Hispanic patients were 4% less likely to initiate treatment than non-Hispanic patients (RR, 0.96; 95% CI, 0.95-0.98; P < 0.001). Patients older than 60 years (vs. those 50-59 years of age) were more likely to initiate treatment (P < 0.001 for all age group comparisons), as were patients from the West (vs. South) region (P < 0.001). Among 701 309 patients with VA data, patients with VA of worse than 20/40 to 20/200 were more likely to initiate treatment (RR, 1.14; 95% CI, 1.12-1.15) than those with 20/20 or better VA, whereas those with hand movements VA (RR, 0.72; 95% CI, 0.69-0.75) and light perception or worse VA (RR, 0.49; 95% CI, 0.44-0.54; all P < 0.001) were less likely to initiate treatment.
conclusionsOver 20% of patients with nAMD did not initiate treatment within 1 year of presentation. Results suggest that lower treatment initiation rates are associated with Black and Asian race, Hispanic ethnicity, age younger than 60 years, and low-vision status. Efforts to improve treatment uptake might prioritize groups with lower initiation rates. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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