Factors associated with lost to follow-up and delayed follow-up in patients with choroidal nevus

Choroidal nevus necessitates regular monitoring due to its potential for malignant transformation. We identified features associated with lost to follow-up (LTFU), delayed follow-up (DFU), and appropriate follow-up (AFU) in choroidal nevus patients.

This retrospective cohort study analysed 825 adults diagnosed with choroidal nevus between January 1, 2006, and December 31, 2015, in Olmsted County, Minnesota. Patient demographics, tumour features, and clinical outcomes were assessed according to follow-up status.

Among the patients, 82 (9.9%) were LTFU, 317 (38.4%) had DFU, and 426 (51.6%) had AFU. Comparing groups (LTFU vs. DFU vs. AFU), LTFU patients were younger (mean age 44.5 vs. 53.3 vs. 59.7 years, p < 0.001) and primarily diagnosed by optometrists (64.6% vs. 64.4% vs. 41.1%, p < 0.001) on routine visits (56.1% vs. 69.7% vs. 45.8%, p < 0.001). They had lower Charlson comorbidity index (0.4 vs. 0.5 vs. 0.7, p = 0.005) and less systemic cancer history (9.5% vs. 15.7% vs. 22.7%, p = 0.013). LTFU and DFU had better visual acuity (>20/50) compared to AFU (93.9% vs. 94.6% vs. 88.5%, p = 0.019). AFU had larger tumour dimensions (basal diameter: 2.5 mm vs. 2.3 mm vs. 2.8 mm, p = 0.003; thickness: 0.1 mm vs. 0.1 mm vs. 0.2 mm, p < 0.001). More LTFU patients had a mean initial recommended follow-up time of 12 months compared to DFU and AFU (80.5% vs. 78.9% vs. 74.2%, p < 0.001).

Factors associated with LTFU in choroidal nevus patients include younger age, lower comorbidity index, absence of cancer history, optometrist diagnosis, routine visit diagnosis, better visual acuity, less suspicious tumour features, and longer follow-up recommendation.