Time to Treatment of Pediatric Retinal Detachments: A US Claims-based Analysis

Abstract

To characterize delays in diagnosis and treatment of retinal detachments (RDs) in a pediatric population. Retrospective cohort study using insurance claims data. Pediatric patients with RD who underwent repair in the outpatient setting. A retrospective analysis of commercially insured patients from a national cohort (IBM MarketScan Research Databases) aged ≤ 18 years with an incident diagnosis of RD between 2007 and 2016. Patients with preceding eye-related visits, time to diagnosis, and time to repair were calculated and compared between patients with pre-existing ocular diagnosis and those without. The time from diagnosis to specialist consultation, time from diagnosis to repair, time from specialist consultation to repair, number of preceding visits, and presence of previous eye-related diagnosis. Our sample consisted of 826 patients, the majority (77%) of whom were diagnosed with rhegmatogenous RD. Only 40% of patients had at least 1 preceding eye-related visit, and 33% had at least 2 visits before RD diagnosis, with a median time from the last eye-related visit of 32 days (4-197 days) and median time from the second to last visit of 118 days (24-437 days). The median time from RD diagnosis to repair was 2 days (0-9 days). The 323 (37.9%) patients with pre-existing ocular diagnoses more frequently had at least 1 (44% vs. 37%; P= 0.079) or 2 preceding eye-related visits (40% vs. 29%; P= 0.002) compared with those without and alsohada shorter time to RD diagnosis (median, 14.5 days vs. 44.5 days; P= 0.011) and repair (1 day vs. 3 days; P= 0.003). Retinal detachment is an important cause of morbidity in children. This work highlighted how pediatric patients without previous ocular diagnoses and visits with eye care professional may have a delayed diagnosis and repair of their RD. Proprietary or commercial disclosure may be found after the references.