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Susan K. Gelman, Carolyn P. Graeber, Ilyse D. Haberman, Jenna B. Friedenthal, Christopher Baker, Shantan Reddy; High Percentage Of Patients With Retinal Detachments Presenting To A Large City Hospital Fail To Return For Treatment. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6160.
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The purpose of this study is to review demographics, clinical characteristics and compliance with follow-up care of underprivileged patients with a retinal detachment (RD) treated by a level I public trauma center.
A retrospective review was performed of 81 consecutive patients presenting with a loss of vision from a RD at a public hospital between 2003 and 2010, with New York University Institutional Review Board approval. Factors including age, gender, type of RD (rhegmatogenous (RRD), tractional (TRD), or serous (SRD); acute or chronic; macula on or off), visual acuity in LogMar (pre-operative, best-corrected post-operative), and compliance with follow-up were studied. IBM SPSS Statistics 19 (Somers, NY) was used for data analysis.
Of 81 patients with a diagnosis of RD, 26 (32.1%) failed to return for treatment, including 7 of 19 (36.8%) with a macula-on RD (see Table for characteristics of patients lost to follow-up). These patients received multiple certified letters and calls indicating the need for follow-up.Patients with an acute macula-on RD who underwent surgical repair had improved mean visual acuity (0.85 versus 0.71 LogMar) as well as patients with an acute macula-off RD (1.66 versus 1.21 LogMar). Younger age and early repair were correlated with better results.
Positive outcomes were obtained after surgical repair of an acute RD at our public hospital. A large percentage of patients presenting with a diagnosis of RD chose not to return for follow-up after receiving multiple certified requests, including those patients with a macula-on RD. Language and/or socioeconomic barriers may make it less likely for underprivileged patients to return for needed urgent treatment. Improved measures to increase compliance in underprivileged communities should be developed to prevent patient disability and increased costs.
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