Reduced Fluorescein Angiography and Fundus Photography Use in the Management of Neovascular Macular Degeneration and Macular Edema During the Past Decade
Reduced Fluorescein Angiography and Fundus Photography Use in the Management of Neovascular Macular Degeneration and Macular Edema During the Past Decade
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DOI：
10.1167/iovs.13-13034
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发表时间：
2014-01-01
影响因子：
4.4
通讯作者：
Stein, Joshua D.
中科院分区：
文献类型：
--
作者：
Schneider, Eric W.;Mruthyunjaya, Prithvi;Stein, Joshua D.
目的.我们评估了新生血管性年龄相关性黄斑变性（NVAMD）和黄斑水肿（ME）诊断测试的最新趋势。分析了来自管理式医疗网络的NVAMD（n = 22，954）或ME（n = 31，810）患者的索赔数据，以评估2001年至2009年期间荧光素血管造影（FA）、眼底照相（FP）和光学相干断层扫描（OCT）的使用情况。进行重复测量logistic回归，以比较2001年、2005年和2009年患者接受这些手术的几率。此外，还比较了2003年或2008年接受FA、FP和OCT检查的NVAMD或ME诊断患者的比例。从2001年到2009年，在NVAMD患者中，接受OCT的几率增加了23倍，而接受FA和FP的几率分别下降了68%和79%。2003 - 2008年，首次诊断1年内行OCT的患者比例，NVAMD增加315%，ME增加143%; 1年内行OCT而不行FA的患者比例，NVAMD增加463%，ME增加216%。在过去的十年中，OCT的使用急剧增加，而FA和FP的使用大幅下降，这表明OCT可能会取代NVAMD或ME患者的更传统的诊断测试。未来的研究应评估这种增加对OCT而不是FA和FP的依赖是否会影响患者的结局。
PURPOSE. We assessed recent trends in the use of diagnostic testing for neovascular age-related macular degeneration (NVAMD) and macular edema (ME).METHODS. Claims data from a managed-care network were analyzed on patients with NVAMD (n = 22,954) or ME (n = 31,810) to assess the use of fluorescein angiography (FA), fundus photography (FP), and optical coherence tomography (OCT) from 2001 to 2009. Repeated-measures logistic regression was performed to compare patients' odds of undergoing these procedures in 2001, 2005, and 2009. In addition, the proportions of patients with an incident NVAMD or ME diagnosis in 2003 or 2008 who underwent FA, FP, and OCT were compared.RESULTS. From 2001 to 2009, among patients with NVAMD, the odds of undergoing OCT increased 23-fold, whereas the odds of receiving FA and FP decreased by 68% and 79%, respectively. Similar trends were observed for ME. From 2003 to 2008, the proportion of patients undergoing OCT within 1 year of initial diagnosis increased by 315% for NVAMD and by 143% for ME; the proportion undergoing OCT without FA within 1 year increased by 463% for NVAMD and by 216% for ME.CONCLUSIONS. Use of OCT increased dramatically during the past decade, whereas use of FA and FP declined considerably, suggesting that OCT may be replacing more traditional diagnostic testing in patients with NVAMD or ME. Future studies should evaluate whether this increased reliance on OCT instead of FA and FP affects patient outcomes.