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Elise Boulanger-Scemama, Giuseppe Querques, Nathalie Puche, Mayer Srour, Eric H Souied; Ranibizumab for exudative age-related macular degeneration: 5 years follow-up dropout rate. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3929.
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The objective of this study was to determine the follow-up dropout rate and its main causes at a tertiary referral eye care center (Creteil University Eye Clinic, ECC), five years after the first intravitreal injections of ranibizumab in exudative age-related macular degeneration (AMD).
We reviewed retrospectively the charts of 201 consecutive patients who underwent their first intravitreal ranibizumab injection between October 2006 and March 2007. Patient’s baseline characteristics (age, gender, type of choroidal neovascularisation (CNV), previous treatment and best-corrected visual acuity (BCVA)) were recorded. Distance from patient’s home to ECC (home-ECC distance) was measured for each patient. For patients lost to follow-up, we conducted a phone survey in order to determine their actual follow-up status and main reasons of their ECC follow-up dropout. Patients were classified in four follow-up status groups: ECC follow-up ongoing, transferred care, definitive follow-up cessation, unknown follow-up status. Baseline characteristics of patients (gender, age, naïve status, opposite eye involvement, BCVA, ECC-patient’s home distance) were compared according to the four groups, using the ECC follow-up ongoing group as the reference group.
The five years ECC follow-up dropout rate was 57% (115/201 patients). Among the 115 patients lost to follow-up, 40 patients were discharged to a local hospital or clinic and 20 patients had definitively stopped their follow-up. Remaining patients were either deceased (12 patients) or not reachable (43 patients). The main follow-up dropout reasons declared by patients were moving to a local hospital or a local clinic (65.5%, 38/58 patients) and/or a too long home-ECC distance (51.7%, 30/58 patients). Two factors were significantly associated with a higher risk of definitive follow-up cessation: a poor BCVA at baseline (0,83 logMar vs 0,66 logMar, P=0,027) and long home-ECC distance (105,5 km vs 18 km, P < 0,001), the latter remaining significant after adjustement for age and visual acuity (P < 0,001).
Five years after the first intravitreal ranibizumab injections, the ECC follow-up dropout rate was relatively high (57%). BCVA at baseline and home-ECC distance were the major predictive factors for long-term regular follow-up.
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