Given the events of the past two years, “the need has grown yet more urgent” for greater diversity, equity, and inclusion in retina, said Julia A. Haller, MD, at Friday’s Retina Subspecialty Day.
Underrepresentation of women. The benefits of diverse viewpoints are well documented, and Dr. Haller noted that a good start has been made on looking at and addressing gender-based issues. Women don’t perform as many retinal surgeries; and while women have made progress in junior authorship, they are underrepresented in senior authorship, accounting for only 25% to 45% of authors in total. Furthermore, a study found that women filled less than 25% of main podium faculty roles at vitreoretinal meetings.1
Gender stereotypes still exist. “Stereotypes kill self-confidence, and words matter,” said Dr. Haller, calling out the #BanBossy and #ILookLikeASurgeon campaigns that are working on combating stereotypes.
Less evidence on other disparities. There are much fewer data on racial, ethnic, geographic, and financial disparities. One study that reviewed clinical trial enrollment in the United States found that Midwestern and Southern areas were further away from clinical trial sites. Distance from trial sites was associated with rural locations, higher poverty, lower education levels, and White populations. Consequently, those populations were underrepresented in the trials.
In addition, research into the impact of race on visual outcomes looked at patients with diabetic macular edema who were treated with ranibizumab. Results showed that visual improvement was greater in White patients than Black patients, but so few Black patients were enrolled that the investigators deemed that there were insufficient data to determine ranibizumab’s efficacy in this population. This finding is important because diabetic retinopathy disproportionately affects underrepresented minorities.
Lack of racial/ethnic diversity in ophthalmology. Historically, there has also been a lack of diversity in the ophthalmology workforce. In fact, data on race and ethnicity were not collected by the San Francisco Ophthalmology Match until 2016.
Future ways forward. Dr. Haller ended her talk by saying that, moving forward, ways to improve diversity, equity, and inclusion include:
- Recruiting representative patient populations for clinical trials
- Identifying barriers to care
- Training health care professionals who reflect patient populations
- Harnessing the outrage and determination unleashed by the events of the last two years
- Developing and delivering cutting edge treatment to all our patients
—Stephanie Leveene, ELS
1 Sridhar J et al Am J Ophthalmol. 2021:221:131-136.
Financial disclosures: Dr. Haller: Aura Biosciences: C; Bionic Sight LLC: C; Bristol Myers Squibb: O; Eyenovia: O; KalVista: C; Lowy Medical Research Institute: C; Novartis Pharmaceuticals Corporation: C; Opthea: O.
Disclosure key. C = Consultant/Advisor; E = Employee; L = Lecture Fees; O = Equity Owner; P = Patents/Royalty; S = Grant Support.