• Written By:
    Retina/Vitreous

    Review of: Predictors of Lost to Follow-Up in Patients Being Treated for Proliferative Diabetic Retinopathy

    Green M, Tien T, Ness S. American Journal of Ophthalmology, August 2020

    This study identified risk factors for patients who are lost to follow-up (LTFU) while undergoing anti-VEGF therapy and/or panretinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR).

    Study design

    Researchers performed a retrospective chart review assessing 418 adult patients with PDR who received intravitreal anti-VEGF injections and/or PRP at a single institution during a 4.5-year period. The study investigated the rate of LTFU at the largest safety-net hospital in New England. Patients with at least 1 interval between appointments that exceeded 6 months, unless a follow-up of more than 6 months was suggested, were designated as LTFU.

    Outcomes

    During the study period, 61% of patients had at least 1 episode of LTFU, with 25% lost within 12 months. Statistically significant variables that were associated with higher LTFU rates included non-English primary language, age of 65 years or older, living 20 miles or less from the institution, presence of 5 or more comorbidities, visiting 20 or more medical departments, missing greater than 10% of non-eye care appointments, and treatment by PRP alone.

    Limitations

    The retrospective study design and the variable duration of follow-ups are limitations to this study. Variables associated with LTFU were obtained from electronic medical records which can have incomplete documentation and may have affected the results. Findings from an inner-city location may not be generalizable to all diabetic populations.

    Clinical significance

    Understanding the variables associated with LTFU may help retina specialists mitigate the consequences of gaps in care. In addition, identifying patients at high risk for LTFU is important when selecting optimal treatments.