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Lapses in care and outcomes among patients assigned to ranibizumab for proliferative diabetic retinopathy

JAMA Dec 19, 2021

Maguire MG, Liu D, Bressler SB, et al. - A long lapse in care was observed, during 5 years, in about half of the participants assigned to ranibizumab for proliferative diabetic retinopathy (PDR), despite substantial effort by the DRCR Retina Network to facilitate timely completion of examinations. When selecting treatment for PDR, the probability of a long lapse in care during long-term follow-up requires to be considered.

  • In this post hoc analysis of a randomized clinical trial, a total of 170 participants (median age was 51 years) were analyzed to assess completion of scheduled examinations among patients assigned to intravitreous injections of ranibizumab for PDR.

  • Within 5 years, 55.3% (n=94/170) of participants reported at least 1 instance when they were late for their next scheduled appointment by 8 or more weeks, and those who ultimately dropped out comprised 29.4%.

  • Of 120 participants who completed the 5-year examination, those who had 1 or more long lapse were found to have median change from baseline in visual acuity of −2 letters vs +5 letters for those without a long lapse.

  • Post-multivariable adjustment, the odds ratio for baseline links with 1 or more long lapse was 1.21, 2.19, and 3.48 for each 5-letter decrement in visual acuity score, for neovascularization of the disc and elsewhere, and for no prior laser treatment for diabetic macular edema, respectively.

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