Evolving practice patterns of young retinal specialists: A five-year comparison of treatment and surgical preferences

To describe trends in demographics and practice patterns of young retina specialists over a five-year follow-up period. A cross-sectional study of young retinal specialists conducted through an online social media platform to evaluate practice patterns for common conditions. An anonymous survey was performed among U.S.-based young retinal specialists from a variety of practice environments in early stages of practice between August and September 2022. Results were compared to survey results from 2017. In 2022, the survey population included 358 members with 101 respondents compared to 44 respondents in 2017. Most respondents preferred bevacizumab as first-line treatment for foveal-involving diabetic macular edema (DME) (60%), vein occlusions (54%), and macular degeneration (56%). Aflibercept was more popular as first-line for DME patients with poor vision (51%) compared to those with good vision (18%). For proliferative diabetic retinopathy (PDR) without macular edema, respondents prefer panretinal photocoagulation alone (43%) or in combination with anti-VEGF (48%) over anti-VEGF alone (10%). Respondents repaired rhegmatogenous retinal detachments using combined vitrectomy-buckle (20%), primary scleral buckle (10%), and pneumatic retinopexy (PR) (10%). The percentage of respondents who have used PR at least once increased significantly from 2017 to 2022. From 2017 to 2022, more respondents use masks (29.5% to 82.8%) and post-injection antibiotics (2.3% to 16.0%) when performing injections while a smaller minority use topical gel anesthesia (34.1% to 15.5%). Survey results suggest more providers are more likely to observe good visual acuity in diabetic edema and use laser alone in PDR without edema. In addition, longitudinal trends show increased use of PR, masks and post-injection antibiotics, and decreased use of topical gel anesthesia.