Predictors of Lost to Follow-Up in Patients Being Treated for Proliferative Diabetic Retinopathy

Abstract

Purpose: To identify risk factors for patients with proliferative diabetic retinopathy (PDR) who are lost to follow-up (LTFU) while undergoing intravitreal injections of anti-VEGF (IVIs) and/or panretinal photocoagulation (PRP) at an urban institution.

Design: Retrospective cohort study.

Methods: A chart review was performed in a total of 418 adult patients with PDR who received IVI and/or PRP between January 1, 2014, and June 1, 2018, at the authors' institution. Rates of LTFU, risk factors associated with LTFU, and vision outcomes were assessed.

Results: Of a total of 418 patients, 256 patients (61%) were LTFU. Risk factors positively associated with LTFU on multivariate analysis included non-English as the primary language (odds ratio [OR], 1.83; P = .006); age 56-65 years old (OR, 1.86; P = .014); age older than 65 years (OR, 1.94; P = .027) compared to age 55 years or younger; living 20 miles or less from the institution (OR, 2.68; P = .009); having greater than 5 comorbidities (OR, 2.38; P = .034); seeing 20 or more distinct departments (OR, 4.66; P = .007); missing more than 10% of non-eye care appointments (OR, 1.61; P = .038); and receiving only PRP compared to only IVIs (OR, 1.93; P = .031).

Conclusions: A high percentage of patients treated for PDR at the authors' institution were LTFU over a 4-year time span. Identifying patients at high risk for being LTFU may help in choosing treatment modality and appropriate patient counseling.