Photo Credit: Sruilk

The following is a summary of “Socioeconomic and Demographic Disparities in Keratoconus Treatment,” published in the November 2024 issue of Ophthalmology by Erukulla et al. 

Researchers conducted a retrospective study to investigate healthcare disparities in patients with keratoconus (KCN) receiving treatment, including collagen cross-linking (CXL) and keratoplasty, as well as comorbidities associated with the condition.  

They used data from 3,224 patients in the UI-Health database between 2020 and 2024, consisting of 1,612 patients with an ICD-10 diagnosis of KCN and 1,612 patients with ophthalmology as a control group. Multivariable and univariable logistic regression analyses were used to examine the association between sociodemographic factors and the rates of CXL and keratoplasty. Sociodemographic factors included age, sex, race/ethnicity, insurance status, and neighborhood social vulnerability. Best corrected visual acuity (BCVA) and manifest cylinder served as indicators of disease impact. Comorbid disease rates were compared to a 1:1 distance-matched control group.  

The results showed the females received fewer keratoplasties than males (OR=0.55, P <0.001). Black individuals underwent less CXL than White individuals (OR=0.68, P <0.05), as did those with Medicaid (OR=0.27, P <0.0001) or no insurance (OR=0.41, P <0.001) compared to those with commercial insurance. Residents of socially vulnerable neighborhoods received less CXL (OR=0.56, P <0.01) and keratoplasty (OR=0.66, P <0.05). Black females were the most disadvantaged, undergoing fewer procedures than White females (OR=0.58, P <0.01) and Black males (OR=0.65, P <0.05). Black and Hispanic/Latin-X individuals had more severe disease (P<0.01, P<0.0001). Down syndrome was more common (P<0.01), while diabetes was less common (P<0.0001) in patients with (KCN).  

Investigators concluded the significant disparities in the treatment of KCN exist across sociodemographic groups, emphasizing the need for further research and interventions to ensure equitable access to care.   

Source: ajo.com/article/S0002-9394(24)00553-1/abstract