Persistent Vision Loss of Eyes Lost to Follow-Up with Diabetic Macular Edema Receiving Intravitreal Anti-VEGF Therapy

Purpose: To describe the visual and anatomic outcomes after being lost to follow-up (LTFU) among patients with diabetic macular edema (DME) that treated by intravitreal anti-vascular endothelial growth factor (VEGF) therapies, and to determine the risk factors of persistent vision loss.Design: A retrospective cohort study using national registry data.Participants: A total of 5660 patients who were LTFU >6 months after anti-VEGF treatments from April 2020 through July 2024.Methods: Visual and anatomic outcomes at the visit before being LTFU, the return visit, 3 month, 6 month, and 12 month after return, and the final visit were collected.Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of risk factors for persistent vision loss. Main Outcome Measures: Visual acuity (VA) and central foveal thickness (CFT).Results: After a mean LTFU period of 11.3 months, 2712 (47.9%) patients had vision decline at return visit.Identified risk factors included increasing age (45-64 years vs ≤44 years: OR, 1.30; 95% CI, 1.07-1.56;p=0.007; ≥65 years vs ≤44 years: OR, 1.41; 95% CI, 1.15-1.72;p=0.001), being treated in less developed regions (OR, 1.20; 95% CI, 1.08-1.34;p=0.001), better baseline VA (20/50-20/200 vs worse than 20/200: OR, 3.20; 95% CI, 2.67-3.83;p