ObjectiveTo identify temporal and geographic trends in private equity (PE) backed acquisitions of ophthalmology and optometry practices in the United States from 2012 to 2021.DesignCross-sectional time series analysis using acquisition data from 10/21/2019 to 9/1/2021 compared to previously published data from 1/1/2012-10/20/2019. Acquisition data was compiled from 6 financial databases, 5 industry news outlets, and publicly available press releases. Linear regression models were used to compare rates of acquisition.Subjects245 PE acquisitions of ophthalmology and optometry practices in the United States between 10/21/2019 and 9/1/2021.MeasuresNumber of total acquisitions, practice type, locations, provider details, and geographic footprint.Results245 practices associated with 614 clinical locations and 948 ophthalmologists or optometrists were acquired by 30 PE-backed platform companies. 18 of 30 platform companies were new compared to our prior study. Of these acquisitions from 10/21/2019 - 9/1/2021, 127, 29, and 89 were comprehensive, retina, and optometry practices, respectively. From 2012 to 2021, monthly acquisitions increased by 0.947 acquisitions per year (p<0.001*). Texas, Florida, Michigan, and New Jersey were the states with the greatest number of PE acquisitions with 55, 48, 29, 28 clinic acquisitions, respectively. Average monthly PE acquisitions were 5.71 per month from 1/1/2019 - 2/29/2020 (pre-COVID), 5.30 per month 3/1/2020-12/31/2020 (COVID pre-vaccine, p=0.8072), and were 8.78/month 1/1/2021-9/1/2021 (COVID post-vaccine, p=0.1971).ConclusionPE acquisitions increased from 2012-2021 as companies continue to utilize both regionally focused and multi-state models of add-on acquisitions.
To review the evidence on the safety and efficacy of current anti-vascular endothelial growth factor (VEGF) and intravitreal corticosteroid pharmacotherapies for the treatment of diabetic macular edema (DME).Methods: Literature searches were last conducted on May 13, 2020, in the PubMed database with no date restrictions and limited to articles published in English. The combined searches yielded 230 citations, of which 108 were reviewed in full text. Of these, 31 were deemed appropriate for inclusion in this assessment and were assigned a level of evidence rating by the panel methodologist.Results: Only the 21 articles with level I evidence were included in this assessment. Seventeen articles provided level I evidence for 1 or more anti-VEGF pharmacotherapies, including ranibizumab (14), aflibercept (5), and bevacizumab (2) alone or in combination with other treatments for DME. Level I evidence was identified in 7 articles on intravitreal corticosteroid therapy for treatment of DME: triamcinolone (1), dexamethasone (4), and fluocinolone acetonide (2).Conclusions: Review of the available literature indicates that intravitreal injections of anti-VEGF agents and corticosteroids are efficacious treatments for DME. Elevated intraocular pressure and cataract progression are important potential complications of corticosteroid therapy. Further evidence is required to assess the comparative efficacy of these therapies. Given the limited high-quality comparative efficacy data, choice of therapy must be individualized for each patient and broad therapeutic access for patients is critical to maximize outcomes. Ophthalmology 2021;-:1e12 ª 2021 by the American Academy of Ophthalmology
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