FACTORS ASSOCIATED WITH PERSISTENT VISION LOSS IN EYES WITH DIABETIC MACULAR EDEMA AND NONPROLIFERATIVE DIABETIC RETINOPATHY AFTER LOST-TO-FOLLOW-UP.

PURPOSE: To determine factors associated with persistent vision loss among eyes with nonproliferative diabetic retinopathy and diabetic macular edema who return to care after loss to follow-up (LTFU).

METHODS

This retrospective study was conducted at the Wills Eye Hospital/Mid Atlantic Retina between January 1st, 2015 and January 1st, 2023. Patients were included if they met the following study inclusion criteria (1) ≥1 anti-vascular endothelial growth factor injection before LTFU; (2) history of LTFU for >6 months; (3) returned for care with ≥12 months of follow-up after LTFU.

RESULTS

A total of 169 eyes of 169 patients met our inclusion criteria. Approximately 38% of eyes (N = 64/169) worsened after returning to care, with ≥10-letter decline in visual acuity compared with their pre-LTFU visit. At 12 months postreturn, 27.2% (N = 46/169) had a persistent ≥10-letter decrease in visual acuity from their pre-LTFU baseline. On multivariable analysis, White race (OR 0.42, 95% CI: 0.20-0.92, P = 0.03) was associated with decreased likelihood of ≥10-letter loss at the 12-month follow-up visit. Visual acuity at time of return (OR 6.47, 95% CI: 1.96-21.33, P = 0.002) was also associated with vision loss at the 12-month visit. Increasing central foveal thickness at time of return (OR 1.004, 95% CI: 1.001-1.007, P = 0.012) was the only factor associated with a ≥10-letter loss at the return visit.

CONCLUSION

Approximately 1/4th of eyes had persistent vision loss at 1-year despite resumption of treatment. Race and visual acuity upon return after LTFU were associated with vision loss at the 12-month visit. Increased macular edema was associated with vision loss at return visit.