Abstract
Purpose :
Diabetic retinopathy, encompassing proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME), stands as a global contributor to vision loss, yet there have been limited comparative studies on treatment outcomes for patients with PDR or DME, especially in those lost to follow-up (LTFU). This retrospective study aims to analyze patients with PDR or DME who received panretinal photocoagulation (PRP) or anti-vascular endothelial growth factor (anti-VEGF) injections but were LTFU for over six months after treatment to elucidate significant differences.
Methods :
A retrospective cohort study was performed at a tertiary medical center between January 2013 and March 2020. Patients with PDR or DME treated with PRP or anti-VEGF injections and lost to follow up for at least 6 months were included. Their demographics, clinical exams, fluorescein angiography (FA), and Optical Coherence Tomography (OCT) results were analyzed.
Results :
Our study identified 37 eligible patients and 66 eyes out of a total cohort of 438 patients, for a LTFU rate of 8.45%. The mean age of LTFU patients was 58.5 years, mean duration of the initial LTFU period was 12.4 months, mean pre LTFU A1c was 8.93% compared to a mean post LTFU A1c of 8.80%. The race of the LTFU patients was disproportionately split to be 46% Black, 40.5% Hispanic, 5.4% White, and 8.1% as Other.
In comparison, the mean demographics of the non-LTFU group were 47.6% Black, 26.7% Hispanic, 16.0% Other, and 12.2% White. This group was characterized by a mean age of 64.9 and a mean HbA1c of 7.64%. Between these groups, there were no significant differences in visual acuity (p= 0.25), A1c (p= 0.74), age (p= 0.71), race (p= 0.63), or gender (p=0.21).
Conclusions :
In conclusion, our retrospective cohort study showed an 8.45% LTFU rate, aligning with prior research on PDR or DME patients. The mean pre-LTFU A1c surprisingly declined from 8.93% to 8.80%, potentially reflecting our limited sample size. Demographic similarities between LTFU and non-LTFU groups were noted, though non-LTFU patients exhibited better HbA1c control, suggesting more consistent follow-up with primary care, endocrinologists, and diabetes management. The variations in visual acuity and patient demographics warrant further investigation, as LTFU patients may experience greater visual acuity loss over time, a concern potentially compounded by broader healthcare access disparities.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.