Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2014 Jan 29;55(1):542-9.
doi: 10.1167/iovs.13-13034.

Reduced fluorescein angiography and fundus photography use in the management of neovascular macular degeneration and macular edema during the past decade

Eric W Schneider  1 , Prithvi Mruthyunjaya, Nidhi Talwar, Kristen Harris Nwanyanwu, Bin Nan, Joshua D Stein
Affiliations
Comparative Study

Reduced fluorescein angiography and fundus photography use in the management of neovascular macular degeneration and macular edema during the past decade

Eric W Schneider et al. Invest Ophthalmol Vis Sci. .

Abstract

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.

Keywords: age-related macular degeneration; fluorescein angiography; macular edema; optical coherence tomography; utilization.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Percentage of enrollees undergoing specified diagnostic imaging test(s) within one year of incident diagnosis of NVAMD in 2003 compared to 2008. Figure drawn to scale.
Figure 2
Figure 2
Percentage of enrollees undergoing specified diagnostic imaging test(s) within one year of incident diagnosis of ME in 2003 compared to 2008. Figure drawn to scale.
Figure 3
Figure 3
Annual probabilities of undergoing specified diagnostic imaging test from 2001 to 2009 among enrollees diagnosed with NVAMD in a large United States managed care network.
Figure 4
Figure 4
Annual probabilities of undergoing specified diagnostic imaging tests from 2001 to 2009 among enrollees diagnosed with ME in a large United States managed care network.
See this image and copyright information in PMC

References

    1. Swanson E, Huang D. Ophthalmic OCT reaches $1 billion per year: but reimbursement clampdown clouds future innovation. OCT News. July 9 2011. Available at: http://www.octnews.org/articles/2844561/ophthalmic-oct-reaches-1-billion.... Accessed June 29, 2012
    1. Brar M, Yuson R, Kozak I, et al. Correlation between morphologic features on spectral-domain optical coherence tomography and angiographic leakage patterns in macular edema. Retina. 2010; 30: 383–389 - PMC - PubMed
    1. Ossewaarde-Van Norel J, Camfferman LP, Rothova A. Discrepancies between fluorescein angiography and optical coherence tomography in macular edema in uveitis. Am J Ophthalmol. 2012; 154: 233–239 - PubMed
    1. Henschel A, Spital G, Lommatzsch A, Pauleikhoff D. Optical coherence tomography in neovascular age related macular degeneration compared to fluorescein angiography and visual acuity. Eur J Ophthalmol. 2009; 19: 831–835 - PubMed
    1. Khurana RN, Dupas B, Bressler NM. Agreement of time-domain and spectral-domain optical coherence tomography with fluorescein leakage from choroidal neovascularization. Ophthalmology. 2010; 117: 1376–1380 - PubMed

Publication types