Matsunaga Douglas R, Salabati Mirataollah, Obeid Anthony, Wibbelsman Turner D, Wu Connie, Mahmoudzadeh Raziyeh, Ojalvo Israel, Bilello Justin, Sivalingam Arunan, Ho Allen C, Chiang Allen, Hsu Jason
Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania, USA.
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Am J Ophthalmol. 2022 Jan;233:1-7. doi: 10.1016/j.ajo.2021.06.028. Epub 2021 Jul 17.
To evaluate the effect of loss to follow-up (LTFU) on outcomes in eyes with diabetic macular edema (DME) treated with anti-vascular endothelial growth factor (VEGF).
Retrospective cohort study.
Single-center study of 90 eyes of 73 patients with nonproliferative diabetic retinopathy (NPDR) and DME treated with anti-VEGF injections who were LTFU for >6 months. Main outcomes were the change in mean visual acuity (VA) and central foveal thickness at the return and final visits compared with the visit before LTFU.
The mean age was 64.5 years, the mean LTFU duration was 322 days, and the mean follow-up duration after return was 502 days. Compared with the mean VA at the visit before LTFU (0.42, Snellen ∼20/52), mean VA worsened at the return visit (0.54, Snellen ∼20/69, P = .004). No significant change in the mean VA was noted at the 3-month after return visit (0.50, Snellen ∼20/63), the 6-month after return visit (0.46, Snellen ∼20/57), the 12-month after return visit (0.42, Snellen ∼20/52), or the final follow-up (0.47, Snellen ∼20/59). When analyzed by NPDR severity before LTFU, no difference in VA was found from the visit before LTFU to the final visit. Mean central foveal thickness increased when comparing the visit before LTFU (270 μm) with the return visit (305 μm, P = .012), but no difference was found by the final visit (247 μm, P = .07).
Anti-VEGF-treated patients with DME who were LTFU for a prolonged period experienced a modest decline in VA that recovered after restarting treatment.
评估失访（LTFU）对接受抗血管内皮生长因子（VEGF）治疗的糖尿病性黄斑水肿（DME）患眼治疗效果的影响。
回顾性队列研究。
对73例非增殖性糖尿病视网膜病变（NPDR）和DME患者的90只患眼进行单中心研究，这些患者接受了抗VEGF注射治疗且失访超过6个月。主要结局指标为与失访前就诊时相比，复诊和末次随访时平均视力（VA）及中心凹厚度的变化。
平均年龄为64.5岁，平均失访时长为322天，复诊后的平均随访时长为502天。与失访前就诊时的平均视力（0.42，Snellen视力表约为20/52）相比，复诊时平均视力变差（0.54，Snellen视力表约为20/69，P = 0.004）。复诊后3个月（0.50，Snellen视力表约为20/63）、复诊后6个月（0.46，Snellen视力表约为20/57）、复诊后12个月（0.42，Snellen视力表约为20/52）或末次随访时（0.47，Snellen视力表约为20/59），平均视力均无显著变化。根据失访前NPDR严重程度进行分析时，从失访前就诊到末次随访，视力无差异。与失访前就诊时（270μm）相比，复诊时中心凹平均厚度增加（305μm，P = 0.012），但末次随访时无差异（247μm，P = 0.07）。
接受抗VEGF治疗的DME患者若长期失访，视力会有适度下降，但重新开始治疗后视力会恢复。
