Trends in the Use of Eye Care Services in Adults Treated for Diabetes between 2008 and 2017 in France: A Nationwide Study

Purpose:To describe the use of eye care services among adults treated for diabetes from 2008 to 2017 in the French population.Methods:We used a random representative sampling of the French national health insurance database. Participants were adults treated for diabetes. Data regarding visits to ophthalmologists, eye examination procedures, and medical treatments were extracted using reimbursement codes. Cross-sectional analyses of eye care claims were performed each year from 2008 to 2017.Results:Less than 50% of people with diabetes underwent an annual eye examination (2008: 44.7%; 2017: 47.9%), and less than two-thirds underwent a biennial eye examination (2008-2009: 62.6%; 2016-2017: 66.4%). From 2008 to 2017, the yearly use of optical coherence tomography examinations increased steadily and markedly from 2.7% to 16.2%, while the use of fluorescein and indocyanine green angiographies decreased from 2.4% to 0.9%. In the same period, the yearly rate of intravitreal injection increased from 0.3% to 1.5%, and the use of laser photocoagulation decreased progressively from 2008 to 2014 (1.3% vs. 0.7%) but slightly increased from 2015 to 2017 (0.8% vs. 1.0%).Conclusions:Strategies to increase compliance with eye care recommendations are needed to improve early detection and management of diabetic eye complications.