Dr. Willis spoke to the strengths and limitations of the IRIS registry.
“In this study, we were able to show that the IRIS registry can be utilized to identify a very large cohort of newly diagnosed, treatment-naïve individuals with DME,” he said. “I believe the IRIS registry is an up and coming data source with promising utility for ophthalmic research that will lead to improvements in patient care.”
However, he acknowledged that its dataset is incomplete. Limitations specific to this study include the fact that DME diagnosis is based on ICD coding and OCT data were not available. “We don’t know if these patients truly had DME and if the DME was clinically significant,” Dr. Willis said.
Additionally, information was incomplete on patients’ medical history (e.g., HbA1c levels, duration of diabetes) and visual function, and it cannot be ruled out that some patients categorized as being managed with observation may have been referred for subsequent care to ophthalmologists not participating in the registry.
The point was also made that the reasons underlying the “suboptimal” number of injections are not known.
“In the world I live in, failure to get injections is not because of the providers, but it is a problem with access to care,” said Marco Zarbin, MD, PhD, Alfonse Cinotti, MD/Lions Eye Research Professor and Chair, Institute of Ophthalmology and Visual Science, Rutgers-New Jersey Medical School, Newark, NJ.
“It is a failure of how the health care system is working.”