Supplementary Material for: 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.研究目的：描述2008年至2017年法国人群中接受糖尿病治疗的成年人的眼科服务使用情况。研究方法：本研究采用法国国民健康保险数据库的随机代表性抽样数据集，研究对象为接受糖尿病治疗的成年人。通过医保报销编码提取眼科医师就诊记录、眼部检查项目及药物治疗相关数据，并于2008年至2017年每年开展眼部医疗报销申报的横断面分析。研究结果：仅不足50%的糖尿病患者接受了年度眼部检查（2008年为44.7%；2017年为47.9%），且不足三分之二的患者接受了两年一次的眼部检查（2008-2009年为62.6%；2016-2017年为66.4%）。2008年至2017年，光学相干断层扫描（optical coherence tomography）检查的年使用率从2.7%持续显著增长至16.2%，而荧光素血管造影（fluorescein angiography）与吲哚菁绿血管造影（indocyanine green angiography）的使用率则从2.4%降至0.9%。同期，玻璃体内注射（intravitreal injection）的年使用率从0.3%升至1.5%；激光光凝术（laser photocoagulation）的使用率自2008年至2014年呈渐进式下降（2008年为1.3%，2014年为0.7%），但在2015年至2017年略有回升（2015年为0.8%，2017年为1.0%）。研究结论：亟需制定提升眼科护理依从性的相关策略，以优化糖尿病眼部并发症的早期筛查与管理工作。