Trends in the Use of Laser and Anti-Vascular Endothelial Growth Factor Injection for Proliferative Diabetic Retinopathy in the United States.

BACKGROUND AND

OBJECTIVE

The DRCR Retina Network Protocol S established anti-vascular endothelial growth factor (anti-VEGF) therapy as non-inferior to panretinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR). This study examines PDR treatment trends in the United States from 2016 to 2023.

PATIENTS AND

METHODS

This retrospective study used the TriNetX US Collaborative Network to identify PDR patients diagnosed between 2016 and 2023. Patients were stratified by treatment type (anti-VEGF, laser/PRP, or both) and demographic factors. Treatment rates were analyzed using prevalence ratios (PRs) with 95% confidence intervals (CIs).

RESULTS

From 2016 to 2023, laser/PRP treatment rates decreased (PR 0.76, CI 0.71-0.80), while anti-VEGF (PR 1.61, CI 1.52-1.71) and combination treatment rates (PR 1.21, CI 1.12-1.32) increased. Hispanic patients had declining anti-VEGF rates during 2020 to 2023 but had higher laser rates than White patients.

CONCLUSION

There is a growing preference for multimodal treatment, though single therapies remain dominant. Disparities among minority groups warrant further investigation.