EFFECTS OF SOCIOECONOMIC FACTORS ON VISUAL OUTCOME AND MANAGEMENT OF PATIENTS WITH WET AGE-RELATED MACULAR DEGENERATION.

Abstract

To analyze the relationship between socioeconomic status and neovascular age-related macular degeneration outcomes and management. Retrospective analysis of 1,449 patients diagnosed with neovascular age-related macular degeneration, treated with anti-vascular endothelial growth factor between January 2016 and January 2024. Lower income was associated with poorer baseline ( P < 0.001) and final ( P < 0.001) best-corrected visual acuity. Worse final visual acuity correlated with lower baseline best-corrected visual acuity ( P < 0.001), lower income ( P = 0.05), and older age ( P < 0.001); insurance type did not ( P = 0.558). Non-Hispanic/non-Latino patients exhibited a higher rate of delayed injections per scheduled visit than Hispanics ( P =0.002). Ethnicity correlated with insurance status ( P = 0.008); Hispanic or Latino patients more often had Medicaid or commercial insurance; non-Hispanics/non-Latino patients more often had Medicare. Higher-income patients were more likely to receive aflibercept ( P < 0.001) and faricimab ( P =0.021). Hispanic or Latino were more likely to receive bevacizumab (OR 2.49; P < 0.001), but insurance type modified this association (OR 3.42; P = 0.010). Lower income correlated with worse neovascular age-related macular degeneration visual outcomes, and the type of anti-vascular endothelial growth factor treatment used varied across income and ethnicity groups, but not insurance type.