Effects of Socioeconomic Factors on Visual Outcome and Management of Wet Age-Related Macular Degeneration Patients

Purpose: To analyze the relationship between socioeconomic status (SES) and neovascular age-related macular degeneration (nAMD) outcomes and management. Methods: Retrospective analysis of 1449 patients diagnosed with nAMD, treated with anti-VEGF between January 2016-January 2024 Results: Lower income was associated with poorer baseline (p < .001) and final (p < .001) BCVA. Worse final visual acuity correlated with lower baseline BCVA (p < .001), lower income (p = .05) and older age (p < .001); insurance type did not (p = .558). Non-Hispanic/non-Latino patients exhibited a higher rate of delayed injections per scheduled visit than Hispanics (p =.002). Ethnicity correlated with insurance status (p = .008); Hispanic or Latino patients more often had Medicaid or commercial insurance; non-Hispanics/non-Latino patients more often had Medicare. Higher-income patients were more likely to receive aflibercept (p < .001) and faricimab (p =.021). Hispanic or Latino were more likely to receive bevacizumab (OR 2.49; p < .001), but insurance type modified this association (OR 3.42; p = .010). Conclusions: Lower income correlated with worse nAMD visual outcomes, and the type of anti-VEGF treatment used varied across income and ethnicity groups, but not insurance type.