Williams Andrew M, Wasser Lauren M, Cassidy Julie, Lin Hsing-Hua Sylvia
Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Department of Ophthalmology, Shaare Zedek Medical Center, Affiliated with the Hebrew University, Jerusalem, Israel.
Semin Ophthalmol. 2025 Apr;40(3):188-195. doi: 10.1080/08820538.2024.2391826. Epub 2024 Aug 16.
To identify prevalence of and risk factors for loss to follow up (LTFU) among a national cohort of patients with primary open-angle glaucoma (POAG).
This retrospective cohort study analyzed data from the IRIS® Registry (Intelligent Research in Sight) database from 2014 through 2019 to assess LTFU among adult patients with POAG. POAG patients with at least one clinical encounter in 2014 were included. LTFU was defined as exceeding one year without a clinical encounter during the study period.
Among 553,663 glaucoma patients, 277,019 (50%) became LTFU, of whom 184,548 (67%) never returned to care and 92,471 (33%) re-established follow-up after a lapse. Risk of LTFU was greatest among those younger than 60 years (RR = 1.38; 95% CI: 1.36-1.39) or older than 80 years (RR = 1.39; 95% CI: 1.38-1.40) compared to those in their 60s. Compared to White race, risk for LTFU was highest among Native Hawaiian/Pacific Islander (RR = 1.24; 95% CI: 1.17-1.31), Hispanic ethnicity (RR = 1.19; 95% CI: 1.18-1.20), and Black race (RR = 1.10; 95% CI: 1.09-1.11). Medicare insurance was associated with lower risk of LTFU (RR = 0.79; 95% CI: 0.78-0.79), whereas unknown/missing/no insurance was associated with greater risk (RR = 1.33; 95% CI: 1.32-1.34), compared to private insurance. Compared to mild-stage POAG, risk of LTFU was higher for moderate-stage (RR = 1.10; 95% CI: 1.08-1.13) and severe-stage disease (RR = 1.35; 95% CI: 1.32-1.38).
We found a 50% prevalence of LTFU among POAG patients in the IRIS Registry over a 6-year study period, with greater risk among minority groups and those with more advanced disease.
确定全国原发性开角型青光眼（POAG）患者队列中失访（LTFU）的患病率及危险因素。
这项回顾性队列研究分析了2014年至2019年IRIS®注册中心（视力智能研究）数据库中的数据，以评估成年POAG患者的失访情况。纳入2014年至少有一次临床就诊的POAG患者。失访定义为在研究期间超过一年无临床就诊。
在553,663例青光眼患者中，277,019例（50%）失访，其中184,548例（67%）未再接受治疗，92,471例（33%）在一段时间后重新建立了随访。与60多岁的患者相比，60岁以下（RR = 1.38；95%CI：1.36 - 1.39）或80岁以上（RR = 1.39；95%CI：1.38 - 1.40）的患者失访风险最高。与白人相比，夏威夷原住民/太平洋岛民（RR = 1.24；95%CI：1.17 - 1.31）、西班牙裔（RR = 1.19；95%CI：1.18 - 1.20）和黑人（RR = 1.10；95%CI：1.09 - 1.11）的失访风险最高。与私人保险相比，医疗保险与较低的失访风险相关（RR = 0.79；95%CI：0.78 - 0.79），而未知/缺失/无保险与较高的风险相关（RR = 1.33；95%CI：1.32 - 1.34）。与轻度POAG相比，中度（RR = 1.10；95%CI：1.08 - 1.13）和重度疾病（RR = 1.35；95%CI：1.32 - 1.38）的失访风险更高。
我们发现在为期6年的研究期间，IRIS注册中心的POAG患者中失访患病率为50%，少数群体和疾病更严重的患者风险更高。
