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Outcomes of Eyes Lost to Follow-up with Proliferative Diabetic Retinopathy That Received Panretinal Photocoagulation versus Intravitreal Anti-Vascular Endothelial Growth Factor.

Publication ,  Journal Article
Obeid, A; Su, D; Patel, SN; Uhr, JH; Borkar, D; Gao, X; Fineman, MS; Regillo, CD; Maguire, JI; Garg, SJ; Hsu, J
Published in: Ophthalmology
March 2019

PURPOSE: To compare anatomic and functional outcomes in eyes with proliferative diabetic retinopathy (PDR) that were lost to follow-up (LTFU) for more than 6 months after treatment with either intravitreal injection (IVI) of anti-vascular endothelial growth factor (VEGF) agents or panretinal photocoagulation (PRP). DESIGN: Retrospective cohort study. PARTICIPANTS: Fifty-nine patients who were LTFU immediately after treatment for more than 6 months between September 2013 and September 2016. METHODS: Patients with eyes receiving either intravitreal anti-VEGF treatment or PRP with the next follow-up visit occurring more than 6 months after treatment were identified. Visual acuity (VA) and anatomic outcomes at the visit before being LTFU, the return visit, the 6-month visit after return, the 12-month visit after return, and the final visit were gathered and compared between the 2 treatment groups. MAIN OUTCOMES MEASURES: Visual acuity and anatomic outcomes. RESULTS: Seventy-six eyes of 59 patients were included in the study, of which 30 received IVI with anti-VEGF and 46 received PRP. In the anti-VEGF group, mean VA worsened significantly when comparing the visit before being LTFU (0.43±0.38 logarithm of the minimum angle of resolution [logMAR]) with the return visit (0.97±0.80 logMAR; P = 0.001) as well as with the final visit (0.92±0.94 logMAR; P = 0.01). In the PRP group, mean VA worsened significantly when comparing the visit before being LTFU (0.42±0.34 logMAR) with the return visit (0.62±0.64 logMAR; P = 0.03). However, no significant difference was observed at the final visit (0.46±0.47 logMAR; P = 0.38). There was a significantly greater number of eyes with tractional retinal detachment in the IVI group compared with the PRP group at the final visit (10 vs. 1, respectively; P = 0.005). There was a significantly greater incidence of neovascularization of the iris in the IVI arm compared with the PRP arm at the final visit (4 vs. 0, respectively; P = 0.02). CONCLUSIONS: Eyes with PDR that received only intravitreal anti-VEGF demonstrated worse anatomic and functional outcomes after being LTFU compared with eyes that received PRP. Given the potential sequelae of being LTFU, the choice of treatment for PDR must be considered carefully.

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Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

March 2019

Volume

126

Issue

3

Start / End Page

407 / 413

Location

United States

Related Subject Headings

  • Visual Acuity
  • Vascular Endothelial Growth Factor A
  • Treatment Outcome
  • Tomography, Optical Coherence
  • Retrospective Studies
  • Retinal Neovascularization
  • Recombinant Fusion Proteins
  • Receptors, Vascular Endothelial Growth Factor
  • Ranibizumab
  • Ophthalmology & Optometry
 

Citation

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Obeid, A., Su, D., Patel, S. N., Uhr, J. H., Borkar, D., Gao, X., … Hsu, J. (2019). Outcomes of Eyes Lost to Follow-up with Proliferative Diabetic Retinopathy That Received Panretinal Photocoagulation versus Intravitreal Anti-Vascular Endothelial Growth Factor. Ophthalmology, 126(3), 407–413. https://doi.org/10.1016/j.ophtha.2018.07.027
Obeid, Anthony, Daniel Su, Samir N. Patel, Joshua H. Uhr, Durga Borkar, Xinxiao Gao, Mitchell S. Fineman, et al. “Outcomes of Eyes Lost to Follow-up with Proliferative Diabetic Retinopathy That Received Panretinal Photocoagulation versus Intravitreal Anti-Vascular Endothelial Growth Factor.Ophthalmology 126, no. 3 (March 2019): 407–13. https://doi.org/10.1016/j.ophtha.2018.07.027.
Obeid, Anthony, et al. “Outcomes of Eyes Lost to Follow-up with Proliferative Diabetic Retinopathy That Received Panretinal Photocoagulation versus Intravitreal Anti-Vascular Endothelial Growth Factor.Ophthalmology, vol. 126, no. 3, Mar. 2019, pp. 407–13. Pubmed, doi:10.1016/j.ophtha.2018.07.027.
Obeid A, Su D, Patel SN, Uhr JH, Borkar D, Gao X, Fineman MS, Regillo CD, Maguire JI, Garg SJ, Hsu J. Outcomes of Eyes Lost to Follow-up with Proliferative Diabetic Retinopathy That Received Panretinal Photocoagulation versus Intravitreal Anti-Vascular Endothelial Growth Factor. Ophthalmology. 2019 Mar;126(3):407–413.
Journal cover image

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

March 2019

Volume

126

Issue

3

Start / End Page

407 / 413

Location

United States

Related Subject Headings

  • Visual Acuity
  • Vascular Endothelial Growth Factor A
  • Treatment Outcome
  • Tomography, Optical Coherence
  • Retrospective Studies
  • Retinal Neovascularization
  • Recombinant Fusion Proteins
  • Receptors, Vascular Endothelial Growth Factor
  • Ranibizumab
  • Ophthalmology & Optometry