Visual Acuity Outcomes in Socioeconomically Disadvantaged Patients With Vitreous Hemorrhage Resulting From Proliferative Diabetic Retinopathy Treated at a County Hospital

Abstract

Purpose: To evaluate real-world visual acuity (VA) outcomes in a socioeconomically disadvantaged population of patients with vitreous hemorrhage (VH) resulting from proliferative diabetic retinopathy (PDR) who received primary treatment with either intravitreal antivascular endothelial growth factor (anti-VEGF) injections, pars plana vitrectomy (PPV), or panretinal photocoagulation (PRP). Methods: This retrospective cohort study included patients with newly diagnosed VH resulting from PDR at Eskenazi Hospital (Indianapolis, IN). VA outcomes were compared in patients before and during the COVID-19 pandemic, between race/ethnicity groups, and between initial treatment groups of intravitreal anti-VEGF injections, PPV, or PRP. Results: Of the 100 patients included in the study, mean VA was 1.44 logMAR at baseline (Snellen equivalent, 20/550; n = 100), which improved to 0.79 logMAR (Snellen equivalent, 20/125; n = 45), 0.80 logMAR (Snellen equivalent, 20/125; n = 41), and 0.87 logMAR (Snellen equivalent, 20/150; n = 38) at 6 months, 1 year, and 2 years following diagnosis, respectively. VA outcomes between the time periods prior to and during the pandemic, race/ethnicity groups, and initial treatment groups were similar, with the exception of significantly better VA at 2 years in the PRP group compared with the anti-VEGF group (P < .01). Conclusions: Long-term VA outcomes in a socioeconomically disadvantaged population with VH resulting from PDR at a county hospital were worse than those observed in a randomized control trial, influenced by worse presenting VA and poor follow-up rate.