Identifying Characteristics Predictive of Lost-to-Follow-Up Status in Amblyopia

Shoshany, Talia N.; Chinn, Ryan N.; Staffa, Steven J.; Bishop, Kaila; Michalak, Suzanne M.; Hunter, David G.

doi:10.1016/j.ajo.2021.05.002

Cited by 9 publications

(3 citation statements)

References 16 publications

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“…These findings are supported by previous studies, which also found an exacerbation of preexisting barriers, resulting in loss to follow-up. [22][23][24][25] Our study also emphasized the impact of visit nonadherence on short-term (6-month) and long-term (1-year) VA. Although some studies found some resolution of OCT findings, improvement in central macular thickness, and a nonsignificant improvement in VA after reinitiation of treatment, other studies support our findings of long-term vision loss resulting from visit nonadherence.…”

Section: Discussionmentioning

confidence: 65%

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Socioeconomic Disparities in Patients Receiving Intravitreal Injections for Age-Related Macular Degeneration Amid the COVID-19 Pandemic

Nguyen

Davoudi

Dong

et al. 2023

Journal of VitreoRetinal Diseases

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Purpose: To determine the effects of socioeconomic factors on visit adherence and the resultant visual outcomes for patients receiving intravitreal injections for neovascular age-related macular degeneration during the COVID-19 pandemic. Methods: In this retrospective case-control study, medical records were reviewed to collect appointment attendance, age, sex, self-reported race/ethnicity, primary language, marital status, insurance, distance from clinic, and Area Deprivation Index (ADI), a measure of socioeconomic disadvantage. Multivariate regression models were created to determine differences in socioeconomic factors between individuals who attended (show group) and those who did not attend (no-show group) appointments. Results: The study enrolled 126 patients in the show group and 115 in the no-show group. On univariate analysis, nonadherence was significantly higher in non-White patients than in White patients ( P = .04), urban sites than in suburban sites ( P = 1.7 × 10−4), and non-English-speaking patients than in English-speaking patients ( P = 4.0 × 10−3). The associations remained significant in multivariate analysis for non-English-speaking patients ( P = .03) and urban-site patients ( P = .01) after adjusting for age, sex, self-reported race/ethnicity, primary language, marital status, insurance, distance from clinic, site of visit, and ADI. At 6 months and 1 year, a 1-, 2-, and 3-line vision loss was significantly higher in the no-show group than in the show group on univariate and multivariate analysis after adjusting for age, sex, race, lens status, and presence of glaucoma and diabetic retinopathy. Conclusions: Non-English-speaking patients and urban-based patients were less likely to present for intravitreal injection appointments during the initial peak of the COVID-19 pandemic. This disparity translated to worse vision outcomes at 6 months and 1 year.

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Section: Discussionmentioning

confidence: 65%

“…These findings are supported by previous studies, which also found an exacerbation of preexisting barriers, resulting in loss to follow-up. 22–25…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic Disparities in Patients Receiving Intravitreal Injections for Age-Related Macular Degeneration Amid the COVID-19 Pandemic

Nguyen

Davoudi

Dong

et al. 2023

Journal of VitreoRetinal Diseases

View full text Add to dashboard Cite

show abstract

“…Our findings likely represent underlying social and economic inequities in access to vision care services . Children from disadvantaged backgrounds may have fewer ocular diagnoses, lower vision care utilization, and a higher chance of being lost to follow-up . By adolescence, the combination of underdiagnosis and undertreatment may contribute to the observed differences in subjective and objective visual function.…”

Section: Discussionmentioning

confidence: 78%

Association of Race, Ethnicity, and Socioeconomic Status With Visual Impairment in Adolescent Children in the US

2022

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ImportanceAlthough racial, ethnic, and socioeconomic disparities in visual impairment have been described in adults, few studies have focused on the adolescent population, which may provide insight into the emergence of vision health inequities.ObjectiveTo describe visual health disparities among adolescent children in the US.Design, Setting, and ParticipantsThis was a cross-sectional study of adolescents from the 2005 to 2008 National Health and Nutrition Examination Survey. Participants were aged 12 to 18 years with a completed visual function questionnaire and eye examination. Data analyses were conducted from January 19 to July 20, 2022.Main Outcomes and MeasuresOutcomes included subjective (self-reported poor vision) and objective (visual acuity worse than 20/40 in the better-seeing eye) measures of visual function. Multivariable logistic and linear regression analyses were conducted to examine the association between the sociodemographic risk factors and each outcome, adjusting for age, sex, and other covariates.ResultsThe 2833 included participants (mean [SD] age, 15.5 [2.0] years; 1407 female participants [49%]) represent a survey-weighted 57 million US adolescent children, of whom 14% were non-Hispanic Black participants (876), 11% were Mexican American participants (828), 63% were non-Hispanic White participants (816), and 11% were other race and ethnicity (313). A total of 5% of participants (266) were not US citizens, and 19% (773) had a family income below the poverty threshold. There were increased odds of self-reported poor vision among Black (odds ratio [OR], 2.85; 95% CI, 2.00-4.05; P &lt; .001), Mexican American (OR, 2.83; 95% CI, 1.70-4.73; P &lt; .001), and low-income (OR, 2.44; 95% CI, 1.63-3.65; P &lt; .001) adolescent children. Similarly, there were increased odds of visual acuity worse than 20/40 in the better-seeing eye among Black (OR, 2.13; 95% CI, 1.41-3.24; P = .001), Mexican American (OR, 2.13; 95% CI, 1.39-3.26; P = .001), and non-US citizen (OR, 1.96; 95% CI, 1.10-3.49; P = .02) participants.Conclusions and RelevanceIn this nationally representative sample from 2005 to 2008, adolescent children identifying as Black, Mexican American, low-income, or non-US citizen were more likely to report poor subjective visual function and perform worse on objective visual acuity testing. A greater understanding of the underlying etiology of these disparities may yield opportunities for improving vision at the population level.

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