增殖性糖尿病视网膜病变患者失访的原因及临床影响
Causes and Clinical Impact of Loss to Follow-Up in Patients with Proliferative Diabetic Retinopathy.
作者信息
Abdelmotaal Hazem, Ibrahim Walid, Sharaf Mohamed, Abdelazeem Khaled
机构信息
Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt.
出版信息
J Ophthalmol. 2020 Feb 8;2020:7691724. doi: 10.1155/2020/7691724. eCollection 2020.
PURPOSE
This study determined the clinical impact and causes of loss to follow-up (LTFU) from the patients' perspective in individuals with proliferative diabetic retinopathy (PDR) who received panretinal photocoagulation (PRP) and/or intravitreal injections (IVIs) of antivascular endothelial growth factor (VEGF).
METHODS
This prospective cohort study included 467 patients with PDR who received PRP and/or IVIs of anti-VEGF between May 2013 and June 2018. LTFU was defined as missing any follow-up visit for any interval exceeding 6 months, provided that patients eventually resumed care. Main outcome measures include rates and causes of LTFU.
RESULTS
A total of 391 patients (83.7%) were followed up, and 76 patients (16.3%) were LTFU over the study period. Rates of LTFU decreased with age (=0.005). Questionnaire analysis conducted for patients' LTFU showed a significant positive correlation between best corrected visual activity (BCVA) loss and patient's lack of trust and satisfaction with treatment (rs = 0.458, =0.005). Questionnaire analysis conducted for patients' LTFU showed a significant positive correlation between best corrected visual activity (BCVA) loss and patient's lack of trust and satisfaction with treatment (rs = 0.458, =0.005). Questionnaire analysis conducted for patients' LTFU showed a significant positive correlation between best corrected visual activity (BCVA) loss and patient's lack of trust and satisfaction with treatment (rs = 0.458, =0.005). Questionnaire analysis conducted for patients' LTFU showed a significant positive correlation between best corrected visual activity (BCVA) loss and patient's lack of trust and satisfaction with treatment (rs = 0.458.
CONCLUSIONS
LTFU threatens vision in PDR patients receiving PRP and/or IVIs of anti-VEGF. Possibly, patient-specific LTFU causes should be addressed before treatment in order to minimize the risk of LTFU. The clinical trial is registered with NCT04018326 (trial registration: ClinicalTrials.gov Identifier: NCT04018326, 10th of July 2019 "Retrospectively registered").
目的
本研究从患者角度确定接受全视网膜光凝（PRP）和/或玻璃体内注射抗血管内皮生长因子（VEGF）的增殖性糖尿病视网膜病变（PDR）患者失访（LTFU）的临床影响及原因。
方法
这项前瞻性队列研究纳入了2013年5月至2018年6月期间接受PRP和/或抗VEGF玻璃体内注射的467例PDR患者。LTFU定义为在任何间隔超过6个月的情况下错过任何一次随访，前提是患者最终恢复治疗。主要结局指标包括LTFU的发生率及原因。
结果
在研究期间，共有391例患者（83.7%）接受了随访，76例患者（16.3%）失访。LTFU发生率随年龄降低（=0.005）。对患者失访情况进行的问卷调查分析显示，最佳矫正视力（BCVA）下降与患者对治疗缺乏信任和满意度之间存在显著正相关（rs = 0.458，=0.005）。对患者失访情况进行的问卷调查分析显示，最佳矫正视力（BCVA）下降与患者对治疗缺乏信任和满意度之间存在显著正相关（rs = 0.458，=0.005）。对患者失访情况进行的问卷调查分析显示，最佳矫正视力（BCVA）下降与患者对治疗缺乏信任和满意度之间存在显著正相关（rs = 0.458，=0.005）。对患者失访情况进行的问卷调查分析显示，最佳矫正视力（BCVA）下降与患者对治疗缺乏信任和满意度之间存在显著正相关（rs = 0.458。
结论
LTFU对接受PRP和/或抗VEGF玻璃体内注射的PDR患者的视力构成威胁。为将LTFU风险降至最低，可能应在治疗前针对患者特定的LTFU原因进行处理。该临床试验已在NCT04018326注册（试验注册：ClinicalTrials.gov标识符：NCT04018326，2019年7月10日“回顾性注册”）。
Zotero 插件