Multivariable Analyses of Amblyopia Treatment Outcomes from a Clinical Data Registry.

Abstract

To present multivariable analyses of factors associated with amblyopia treatment success using outcomes from a clinical registry. Retrospective database study. New patients 3 to 12 years of age being enrolled in the registry from 2013 to 2019. The IRIS-50 is an outcome measure for amblyopia treatment developed by the American Academy of Ophthalmology for use with data in the Intelligent Research in Sight (IRIS®) Registry. The measure specifications include unilateral amblyopia associated with strabismus, refractive error, or both. Clinical care prescribed by the ophthalmologist. Eighteen thousand eight hundred forty-one children 3 to 7 years of age were eligible for IRIS-50, with 77.3% successful. Nine thousand seven hundred sixty-two children 8 to 12 years of age were eligible, with 55.5% successful. For the younger age group, multivariable analyses found that odds ratios (ORs) for success were significantly lower for Black children (0.71; 95% confidence interval [CI], 0.62-0.83) compared with White children. Medicaid insurance was associated independently with significantly lower success (OR, 0.65; 95% CI, 0.60-0.71). Among older children, Black children were less likely to be treated successfully (OR, 0.81; 95% CI, 0.68-0.96) compared with White children, whereas Hispanic children showed an increased chance of success (OR, 1.16; 95% CI, 1.03-1.31). Medicaid insurance for the older children also was associated with a decreased chance of success (OR, 0.84; 95% CI, 0.77-0.93). Amblyopia treatment outcomes measured by IRIS-50 were significantly poorer for Black children and those with Medicaid insurance 3 to 12 years of age. Disparate health outcomes demonstrated for these two factors emphasize the need to develop and test strategies to improve treatment outcomes for these children.