Patients in socioeconomically deprived neighborhoods more likely to have severe RRD
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Key takeaways:
- An association was found between neighborhood-level adverse social determinants of health and severity of rhegmatogenous retinal detachment.
- Contributing factors included insurance and per capita income.
Patients who reside in socioeconomically deprived neighborhoods have a higher chance to present with more severe rhegmatogenous retinal detachment, according to a study.
“Adverse social determinants of health (SDOH) can present barriers to timely presentation for repair and limit vision outcomes,” Sally S. Ong, MD, and co-authors wrote.
The association between multiple neighborhood SDOH and severity of primary rhegmatogenous retinal detachment (RRD) in terms of visual acuity and foveal status was evaluated in a retrospective cohort study of adult patients undergoing RRD repair at Wilmer Eye Institute between 2008 and 2018. Seven hundred patients, 268 women and 432 men, from 19 states were evaluated. Variables examined included whether visual acuity was better or worse than 20/40 at presentation and whether the RRD was fovea involving or fovea sparing at presentation.
Patient addresses were geocoded and matched to a number of neighborhood-level SDOH that included, among others, the Area Deprivation Index (ADI), per capita income, type of insurance, percentage of uninsured individuals and mode of transportation to work.
Patients residing in neighborhoods with a higher ADI score with more people who drove to work and had lower per capita income were more likely to present with visual acuity worse than 20/40 and fovea-involving RRD.
“Each $1,000 increase in per capita income was associated with lower odds of presenting with worse vision,” the authors wrote.
Older patients, non-Hispanic Black patients, and patients with public insurance or no insurance were also more likely to have more severe RRD at presentation.
“Findings from this study might help highlight neighborhoods that will benefit from policy changes and interventions that promote earlier presentation with RRD. Ultimately, interventions targeting these vulnerable populations may lead to earlier surgical repair, improved functional outcomes, reduced complication rates and reduced health care spending,” the authors wrote.
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