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Daniel Rahul Agarwal, Belinda Udeh, Brittany Lapin, Jack Campbell, Aleksandra V. Rachitskaya; Impact of Appointment Compliance on Visual Outcomes in Patients with Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1051.
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The paradigm of diabetic retinopathy (DR) and diabetic macular edema (DME) is changing. The current study examined how certain behavioral and sociodemographic factors predict patients’ visual outcomes after treatment. Research suggests that poor attendance at screenings may increase the risk of DR progression.1 We studied whether missed follow-up appointments contributed to reduced visual acuity (VA).
This IRB-approved retrospective study of patients diagnosed with DR and DME was conducted at Cleveland Clinic. Treatment naïve patients seen from 01/2014 to 06/2017, initiated on anti-angiogenic therapy, and with at least one year of follow-up were included. Patients with missing data or VA of light perception or worse were excluded. VA was assessed at each visit and the ratio of missed to completed appointments, as found in the electronic medical record, was calculated for each patient. The logarithm of the minimum angle of resolution (LogMAR) VA change between the initial and last visit was compared to the ratio of missed to completed appointments for each patient using Pearson correlations. A T-test compared the ratio of missed to completed appointments between patients above and below the median LogMAR VA change.
A total of 229 patients (115 males, 114 females) fit our inclusion criteria. The Pearson correlation coefficient for all patients between LogMAR VA change and the ratio of missed to completed appointments was 0.019 in the right (OD) eye and 0.001 in the left (OS) eye (p=0.77 and 0.99 respectively). Median LogMAR VA change was 0 OD and OS with a range of -2.00 to 2.60 OD and -2.82 to 2.12 OS. The median and range of missed to completed appointment ratios was 0.47 and 0 to 4.11 respectively. Missed to completed appointment ratios between patients above versus below the median LogMAR VA change were 0.57±0.41 versus 0.60±0.58 for OD, respectively (p=0.52), and 0.56±0.43 versus 0.61±0.56 for OS (p=0.67).
There was no correlation between an increased ratio of missed to completed appointments and VA changes. In addition, there was no statistically significant difference in the ratio of missed to completed appointments between those who gained or lost vision between initial and final follow-up visits. Further studies will evaluate the role of other sociodemographic factors on VA outcomes in this population.1. Forster AS et al. Diabetologia. 2013;56(10):2187-2193
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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