Disengagement and loss to follow-up in intravitreal injection clinics for neovascular age-related macular degeneration

Jones, Rebecca, Stratton, Irene M, Scanlon, Peter H ORCID: 0000-0001-8513-710X and Theodoropoulou, Sofia (2023) Disengagement and loss to follow-up in intravitreal injection clinics for neovascular age-related macular degeneration. Eye, 37 (15). pp. 3186-3190. doi:10.1038/s41433-023-02474-3

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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. Results 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. Conclusions 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.

Item Type: Article
Article Type: Article
Additional Information: Online first version of the article is available via the publisher link. A Correction to this article was published on 30 June 2023
Uncontrolled Keywords: Biological therapy; Health services; Macular degeneration
Related URLs:
Subjects: R Medicine > RE Ophthalmology
Divisions: Schools and Research Institutes > School of Health and Social Care
Depositing User: Susan Turner
Date Deposited: 15 Mar 2023 13:07
Last Modified: 18 Oct 2023 11:45
URI: https://eprints.glos.ac.uk/id/eprint/12491

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