Gloucestershire Retinal Research Group, Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, GL53 7AN, UK.
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Eye (Lond). 2023 Oct;37(15):3186-3190. doi: 10.1038/s41433-023-02474-3. Epub 2023 Mar 14.
BACKGROUND/OBJECTIVES: Timely assessment and treatment of patients with neovascular AMD (nAMD) are crucial to preservation of vision. Loss to follow up (LTFU) in these patients is a problem but this has not been systematically investigated.
SUBJECTS/METHODS: A retrospective review of electronic medical records of patients with nAMD first treated with anti-VEGF therapy from 1st Jan 2014 to 31st Dec 2018, was conducted in January 2021. Any patient not seen for more than 12 months was classed as no longer attending.
Of the 1328 patients who attended between 2014 and 2018, 348 had failed to attend and were eligible for inclusion in this study. Reasons noted for discontinuation of care: discharged by clinician (33.3%), died (20.7%), moved to another unit outside of area (17.5%), stopped attending due to ill-health (13.5%), discharged due to failure to attend (5.6%) and patient choice to no longer attend (4.6%). There were 16 (4.6%) who did not receive any further appointments despite clinician request for follow-up. After 5 years, 50.5% of patients were no longer attending for treatment. Age was a factor in failure to attend, with 7 out of 12 patients aged >100 years no longer being followed up, compared to 1 out of 11 of 50-59 year-olds.
When analysing visual outcomes in an AMD service it is important to characterise the patients who are lost to follow up. The outcomes for this group may be avoidably poor and understanding the factors influencing LTFU rate is crucial to addressing shortcomings in a hospital AMD service.
背景/目的：及时评估和治疗新生血管性年龄相关性黄斑变性（nAMD）患者对保持视力至关重要。这些患者的随访失访（LTFU）是一个问题，但尚未对此进行系统研究。
受试者/方法：2021 年 1 月，对 2014 年 1 月 1 日至 2018 年 12 月 31 日期间首次接受抗血管内皮生长因子（VEGF）治疗的 nAMD 患者的电子病历进行了回顾性审查。任何超过 12 个月未就诊的患者均被归类为不再就诊。
在 2014 年至 2018 年就诊的 1328 名患者中，有 348 名患者失访，符合本研究纳入标准。停止治疗的原因包括：临床医生安排出院（33.3%）、死亡（20.7%）、搬到所在区域外的其他单位（17.5%）、因健康状况不佳而停止就诊（13.5%）、因未就诊而被安排出院（5.6%）以及患者选择不再就诊（4.6%）。尽管临床医生要求随访，但仍有 16 名（4.6%）患者未再接受任何预约。5 年后，50.5%的患者不再接受治疗。年龄是失访的一个因素，12 名年龄>100 岁的患者中有 7 人不再接受随访，而 50-59 岁的患者中只有 1 人。
在分析 AMD 服务的视觉结果时，重要的是要对失去随访的患者进行特征描述。这群患者的结果可能是本可避免的不良，了解影响 LTFU 率的因素对于解决医院 AMD 服务中的缺陷至关重要。
