FACTORS ASSOCIATED WITH PERSISTENT VISION LOSS IN EYES WITH DIABETIC MACULAR EDEMA AND NONPROLIFERATIVE DIABETIC...

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).

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.

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.

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.