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Samuel Burke, Anh Bui, Dingcai Cao, Jennifer I Lim; Clinic Attendance Rate and Loss to Follow Up In a Proliferative Diabetic Retinopathy Patient Population. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3843.
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Recent studies have evaluated risk factors and rates of loss to follow up (LTFU) for proliferative diabetic retinopathy (PDR) patients treated with intravitreal anti-vascular endothelial growth factor (anti-VEGF) versus pan-retinal photocoagulation (PRP). This study aims to assess rates and risk factors for consistent follow up in addition to LTFU during periods of poorly controlled and active PDR.
All visit dates were recorded including complications from PDR, treatments performed, and intended follow up length. Visits beginning 3 months before initial PDR diagnosis or treatment and ending after a period of 12 months were analyzed. The interval between consecutive visits during this period was determined. Missed visits were defined as an interval exceeding the shorter of 1.5 times the intended follow up or 2 weeks. LTFU was defined as an interval exceeding 6 months.
89 patients were followed with number of visits ranging from 1 to 65 with a mean of 11.4 ± 12.0. Overall clinic attendance rate was 81% ± 17%. Univariate analysis indicated that white race, longer distance from clinic, better initial visual acuity, prior PRP, and having surgery were associated with significantly higher rates while AMD and treatment with anti-VEGF were significantly associated with lower rates. All these variables remained significant with multivariate analysis. Age at presentation, gender, income, type of diabetes, and medical co-morbidities (dialysis, congestive heart failure, chronic obstructive pulmonary disorder, stroke, cancer) were not found to have significant association. LTFU occurred in 35% of patients for an average duration of 25.5 ± 35.4 months. Among this cohort 39% were LTFU for 6-12 months, 26% for 12-24 months, and 35% for greater than 24 months. Univariate analysis indicated significantly higher rates of LTFU with AMD and significantly lower rates with further distance from clinic. All the other aforementioned risk factors were not found to have significant association.
Clinic attendance rates were high overall but a large percentage of patients were lost to follow up. Factors associated with higher clinic attendance rate were race, distance from clinic, initial visual acuity, AMD, previous PRP, and treatment with surgery or anti-VEGF. Factors associated with LTFU were AMD and distance from clinic.
This is a 2020 ARVO Annual Meeting abstract.
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