Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA.
Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA.
Am J Ophthalmol. 2019 Dec;208:12-18. doi: 10.1016/j.ajo.2019.06.026. Epub 2019 Jun 29.
To characterize temporal trends and regional variance in retinal imaging utilization in the United States Medicare fee-for-service population from 2012-2016.
Cross-sectional, retrospective database analysis.
This study addresses office or operating-room based retinal imaging. Our study population included retina specialists, defined as ophthalmologists performing either intravitreal anti-vascular endothelial growth factor injections or posterior segment laser photocoagulation and no neodymium-doped yttrium aluminum garnet laser capsulotomy. We recorded fundus photography, optical coherence tomography (OCT), intravenous fluorescein angiography (IVFA), indocyanine-green angiography, and ophthalmic ultrasound (B-scan) billed in the Medicare fee-for-service population from 2012-2016. Imaging obtained on any platform or device was eligible for inclusion (eg, posterior pole imaging vs ultrawidefield imaging). The main outcome measure was the relative utilization of retinal imaging modalities.
National relative utilization of OCT increased from 61.5% in 2012 to 70.5% in 2016 (P < .001), while IVFA fell from 20.9% to 15.1% over the same interval (P < .001). Fundus photography decreased from 14.6% in 2012 to 11.7% in 2016 (P < .001). By 2016, the Midwest region had the highest relative utilization of OCT (75.2%) and lowest of IVFA (12.0%), while the West region had the lowest OCT (68.4%) and highest IVFA (17.0%).
Among retina specialists, OCT usage increased while the utilization of fundus photography and IVFA has declined. The Midwest region had the highest utilization of OCT and lowest of IVFA.
描述 2012-2016 年美国医疗保险服务项目中，视网膜成像利用的时间趋势和区域差异。
横断面、回顾性数据库分析。
本研究针对的是办公室或手术室的视网膜成像。我们的研究人群包括视网膜专家，定义为进行玻璃体腔内抗血管内皮生长因子注射或后节激光光凝，且不进行钕掺杂钇铝石榴石激光囊切开术的眼科医生。我们记录了 2012-2016 年医疗保险服务项目中眼底照相、光学相干断层扫描（OCT）、静脉内荧光素血管造影（IVFA）、吲哚青绿血管造影和眼部超声（B 型扫描）的使用情况。任何平台或设备上获得的成像都有资格被纳入（例如，后极部成像与超广角成像）。主要观察指标为视网膜成像方式的相对利用情况。
全国范围内，OCT 的相对利用率从 2012 年的 61.5%增加到 2016 年的 70.5%（P<.001），而 IVFA 同期从 20.9%下降到 15.1%（P<.001）。眼底照相从 2012 年的 14.6%下降到 2016 年的 11.7%（P<.001）。到 2016 年，中西部地区 OCT 的相对利用率最高（75.2%），IVFA 的相对利用率最低（12.0%），而西部地区 OCT 的相对利用率最低（68.4%），IVFA 的相对利用率最高（17.0%）。
在视网膜专家中，OCT 的使用增加，而眼底照相和 IVFA 的使用减少。中西部地区 OCT 的利用率最高，IVFA 的利用率最低。
