Abstract Background Early diagnosis and treatment of neovascular age-related macular degeneration (NvAMD) improve vision outcomes. This analysis investigates associations of English indices of multiple deprivation 2019 (IMD2019) with baseline characteristics, key care processes and visual acuity (VA) outcomes for NvAMD in the National Ophthalmology Database (NOD). Methods Eligible eyes started treatment for NvAMD in England between 01/04/2020 and 31/03/2023. Participating centres with ≥25 eyes with baseline VA and IMD2019 data were included. Results Eligible for analysis were 48,583 eyes from 60 English centres. Between decile 1 (most deprived) and decile 10 (least deprived), median age at start of treatment ranged from 79 to 82 years and median baseline VA ranged from 56 to 60 ETDRS letters. After one year of treatment (−28 to +84 days), the median number of injections administered ranged from 7 to 8 across deciles. Loss to follow-up was observed in 13.7% eyes in decile 1, and 11.8% in decile 10. Median VA at 12 months ranged from 61 to 65 ETDRS letters across deciles. A “good” VA outcome (≥70 ETDRS letters) was achieved by 45.5% in decile 10, compared with 35.9% observed in decile 1 ( p < 0.001). A “poor” VA outcome (≥10 ETDRS letter loss from baseline) occurred in 18.4% of eyes in decile 1 versus 14.5% in decile 10 ( p < 0.001). Conclusions Patients starting NHS-funded treatment in England for NvAMD and living in areas of higher socioeconomic deprivation were typically younger, had lower baseline acuity and achieved worse VA outcomes than those from lower deprivation areas, with little variation in treatment between the deciles.
Shenoy et al. (Tue,) studied this question.