Clinical Ophthalmology (Oct 2023)
Vitreoretinal Specialist Use of Ancillary Testing: An IRIS® Registry Analysis
Abstract
Saloni Vishwakarma,1 Durga S Borkar,2 Andrew LaPrise,1 Michael Mbagwu,1 Theodore Leng3 1Quantitative Sciences Department, Verana Health, San Francisco, CA, USA; 2Ophthalmology Department, Duke University Eye Center, Duke University School of Medicine, Durham, NC, USA; 3Ophthalmology Department, Byers Eye Institute at Stanford, Stanford University School of Medicine, Palo Alto, CA, USACorrespondence: Theodore Leng, Byers Eye Institute, Stanford University School of Medicine, 2452 Watson Court, Palo Alto, CA, 94303, USA, Tel +1 (650) 498 4262, Fax +1 (888) 565-2640, Email [email protected]: To investigate patterns of ancillary imaging testing among vitreoretinal specialists for patients with vitreoretinal disease in the United States (US).Methods: Optical coherence tomography (OCT), color fundus photography (CFP), and fluorescein angiography (FA), ordered by vitreoretinal specialists and documented within the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) between 01 January 2018 and 31 December 2020, were retrospectively assessed. Trends in imaging modality choice were analyzed by payer type, geographic region, and practice type. Sub-analyses were conducted according to categorization of vitreoretinal specialists into those treating a high versus low volume of patients with neovascular age-related macular degeneration (nAMD).Results: OCT was the most common imaging modality used, followed by CFP and FA. Following normalization, the highest volume of OCT procedures performed were identified among Medicare Advantage and Medicare Fee-for-Service beneficiaries, within the South of the US, and at medium and large practices. Minimal differences were observed for CFP and FA volume across payer types and regions. Across practice types, the largest volume of CFP and FA procedures were identified in small and private equity owned practices, respectively. Vitreoretinal specialists with a high nAMD volume more frequently performed OCT than those with a low nAMD volume.Conclusion: Vitreoretinal specialists demonstrated a strong preference for OCT, with real-world associations according to payer type, geographic location, and practice type. Volume of nAMD patients seen impacted the likelihood of specialists ordering OCTs.Plain Language Summary: Optical coherence tomography (OCT), color fundus photography (CFP), and fluorescein angiography (FA) are key imaging modalities used by vitreoretinal specialists in routine eye care. This study aimed to uncover patterns of OCT, CFP, and FA usage in the United States from 2018 to 2020, and investigated the impact of volume of patients with neovascular age-related macular degeneration on these trends. Higher rates of OCT use, compared with CFP and FA, were identified in the US.Keywords: color fundus photography, fluorescein angiography, optical coherence tomography, retinal disease, vitreoretinal disease
