Abstract
Purpose :
To identify demographic and disease-related characteristics predictive of Lost-to-Follow-Up (LTFU) status in patients with intermittent exotropia (IXT) after pediatric optometric evaluation.
Methods :
Retrospective chart review of patients presenting with IXT to the last author (AR) from 2010 to 2019. Inclusion criteria: <18 years old, no ocular, neurodevelopmental, genetic, or prenatal comorbidities, and last author requested follow-up. Lost-to-Follow-Up (LTFU) was defined as patients who did not return after initial visit, excluding those who came for second opinions. Returned to care (RTC) was defined as patients who returned to the clinic. Univariate analysis utilized non-parametric statistics assessed differences in group distribution and data is presented using medians and interquartile ranges. Multivariable logistic regression analysis was performed to determine risk factors associated with increased odds of LTFU.
Results :
Of the 380 patient charts reviewed, 147 (39%) were included in the analysis. Of this group, 44 (30%) were LTFU, and 103 (70%) were RTC. Univariate analysis revealed sex, family history of strabismus, prior IXT treatment, insurance provider, baseline visual acuity, stereopsis, fusional vergence ranges and facility, magnitude, control, and type of IXT, and prescribed treatments were similar between groups (all p values ≥ 0.08). Patients who were LTFU were older (10.9 years (7.3, 13.8 years) than those who RTC (8.8 years (7.2, 11.1 years); p < 0.03) Patients who were LTFU had better near point of convergence compared to those who RTC (LTFU: 10.0 cm (7, 14 cm), RTC: 11.5 cm (8.5, 16.5 cm); p < 0.04). Patients who were LTFU were also recommended to follow up at longer intervals (168 days (60, 365 days) compared to those who RTC (60 days (47, 120 days); p < 0.001). Multivariate logistic regression identified older presenting age as an independent predictor of LTFU status (Odds Ratio & 95% CI: 1.12 (1.01 - 1.23); p < 0.022).
Conclusions :
Follow-up is critical for the successful management and treatment of IXT. While older patients were most likely to be LTFU, additional research is needed to validate if similar findings are present among other pediatric optometric and ophthalmic providers. Identifying these patient characteristics may help providers create targeted strategies for promoting follow-up in at-risk patients.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.