ASRS 2025: Neighborhood-level characteristics associated with delay in surgery and loss to follow-up

Sally S. Ong, MD, an assistant professor of ophthalmology at Atrium Health Wake Forest Baptist School of Medicine, presented research examining the relationship between neighborhood-level social determinants of health and disease severity in patients with tractional retinal detachments (TRD) associated with proliferative diabetic retinopathy. Ong gave this presentation at the 2025 ASRS scientific meeting in Long Beach, California.

The study investigated how various social determinants affected baseline disease severity and patient follow-up patterns. Ong's team analyzed multiple neighborhood-level factors and their impact on patient outcomes and care accessibility. The research revealed several significant findings. Patients living in neighborhoods with higher mobile home prevalence demonstrated increased rates of foveal-involving TRD, indicating more severe disease presentation. Additionally, patients from areas with greater mobile home prevalence, higher minority populations, limited vehicle access, and increased household cost burden—defined as spending over 30% of income on housing—showed higher odds of being lost to follow-up or experiencing longer follow-up durations.

The study also found that patients from neighborhoods with higher rates of reported disability status experienced longer delays between surgical decision-making and actual surgical procedures. Ong noted that even when surgery was scheduled, patients often required multiple rescheduling attempts before procedures could proceed. Ong emphasized that these findings demonstrated how neighborhood-level social determinants significantly influenced both disease severity at presentation and patients' ability to access ongoing care. She highlighted that access to care directly impacts surgical outcomes, making awareness of these factors crucial for healthcare providers.

The presentation concluded with practical recommendations for retina specialists. Ong suggested that physicians should become more cognizant of these social factors to better advocate for their patients. She recommended connecting patients with social workers when they faced barriers such as transportation issues or caregiving responsibilities that interfered with appointment attendance.

On a broader scale, Ong argued that this data could inform policymakers about the impact of social determinants on health outcomes, potentially leading to policies that improve patient access to care and ultimately enhance health outcomes for patients with TRD related to proliferative diabetic retinopathy.