Abstract
Purpose :
To evaluate the effect of loss to follow up (LTFU) on outcomes in eyes with retinal vein occlusion (RVO) treated with anti-vascular endothelial growth factor (VEGF) injections
Methods :
In this retrospective single center case series, patients with RVO receiving intravitreal injections who were LTFU >6 months were eligible for inclusion. Visual acuity (VA) and optical coherence tomography features were collected from the visit before LTFU, the return visit, 3 months after return, 6 months after return, 12 months after return and the final follow-up visit.
Results :
Ninety-one eyes of 84 patients with a mean age (±standard deviation) of 74.2 (±11.2) years were included. Forty-nine (58.4%) of the patients were female. Fifty (54.9%) patients had branch RVO and 41 (45.1%) had central RVO. Mean LTFU duration was 278.2 (±108.8) days and patients were followed for mean 739.8 (±366.7) days after return. Patients had received a mean of 8.5 (±5.7) injections before being LTFU and received a mean of 8.3 (±7.6) injections after return. Mean logMAR VA at the visit before LTFU was 0.72 (±0.67) [Snellen 20/104] which significantly worsened at the return visit [1.05 (±0.79), Snellen 20/224, p<0.001], 3 months after return [0.92 (±0.70), Snellen 20/166, p< 0.001], 6 months after return [0.97 (±0.80), Snellen 20/186, p<0.001], 12 months after return [ 0.94 (±0.78), Snellen 20/174, p<0.001] and the final follow-up visit [1.02 (±0.85), Snellen 20/209, p<0.001] (Figure1). The mean central foveal thickness (CFT) increased when comparing the visit before LTFU [251 (±129) µm] to the return visit [404 (± 241) µm, p<0.001]. No significant difference in CFT was noted by 3 months [256 (±139) µm, p=0.68], 6 months [241 (±122) µm, p=0.59], or 12 months after return [250 (±134) µm, p=0.98]. The CFT was significantly thinner at the final visit [214 (±114) µm, p=0.017](Figure2). Three (4.2%) eyes (2 CVRO, 1 BRVO) presented with neovascular glaucoma (NVG) and 4 (4.5%) eyes (3 CRVO, 1 BRVO) with new onset vitreous hemorrhage (VH) at the return visit.
Conclusions :
RVO patients receiving anti-VEGF treatment who were LTFU for a prolonged duration experienced a significant decline in VA that did not return to the levels seen before LTFU despite restarting therapy and subsequent improvement in CFT. LTFU might also increase the risk of unfavorable outcomes like NVG and VH in RVO patients.
This is a 2021 ARVO Annual Meeting abstract.