Outcomes of Eyes Lost to Follow-up with Proliferative Diabetic Retinopathy That Received Panretinal Photocoagulation versus Intravitreal Anti–Vascular Endothelial Growth Factor
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...
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| Veröffentlicht in: | Ophthalmology (Rochester, Minn.) Minn.), 2019-03, Vol.126 (3), p.407-413 |
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| creator | Obeid, Anthony Su, Daniel Patel, Samir N. Uhr, Joshua H. Borkar, Durga Gao, Xinxiao Fineman, Mitchell S. Regillo, Carl D. Maguire, Joseph I. Garg, Sunir J. Hsu, Jason |
| description | 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).
Retrospective cohort study.
Fifty-nine patients who were LTFU immediately after treatment for more than 6 months between September 2013 and September 2016.
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.
Visual acuity and anatomic outcomes.
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).
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. |
| doi_str_mv | 10.1016/j.ophtha.2018.07.027 |
| format | Article |
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Retrospective cohort study.
Fifty-nine patients who were LTFU immediately after treatment for more than 6 months between September 2013 and September 2016.
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.
Visual acuity and anatomic outcomes.
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).
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.</description><identifier>ISSN: 0161-6420</identifier><identifier>EISSN: 1549-4713</identifier><identifier>DOI: 10.1016/j.ophtha.2018.07.027</identifier><identifier>PMID: 30077614</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Angiogenesis Inhibitors - therapeutic use ; Bevacizumab - therapeutic use ; Diabetes Mellitus, Type 1 - complications ; Diabetes Mellitus, Type 2 - complications ; Diabetic Retinopathy - drug therapy ; Diabetic Retinopathy - physiopathology ; Diabetic Retinopathy - surgery ; Diabetic Retinopathy - therapy ; Female ; Humans ; Intravitreal Injections ; Laser Coagulation ; Lost to Follow-Up ; Male ; Middle Aged ; Ranibizumab - therapeutic use ; Receptors, Vascular Endothelial Growth Factor - therapeutic use ; Recombinant Fusion Proteins - therapeutic use ; Retinal Neovascularization - drug therapy ; Retinal Neovascularization - physiopathology ; Retinal Neovascularization - surgery ; Retinal Neovascularization - therapy ; Retrospective Studies ; Tomography, Optical Coherence ; Treatment Outcome ; Vascular Endothelial Growth Factor A - antagonists & inhibitors ; Visual Acuity - physiology</subject><ispartof>Ophthalmology (Rochester, Minn.), 2019-03, Vol.126 (3), p.407-413</ispartof><rights>2018 American Academy of Ophthalmology</rights><rights>Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3237-dec23994c597945501475f4930315d3d924810b2b6cdf932c013adc16440ab3e3</citedby><cites>FETCH-LOGICAL-c3237-dec23994c597945501475f4930315d3d924810b2b6cdf932c013adc16440ab3e3</cites><orcidid>0000-0002-3050-9129 ; 0000-0002-3203-1544 ; 0000-0002-2761-4219</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ophtha.2018.07.027$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30077614$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Obeid, Anthony</creatorcontrib><creatorcontrib>Su, Daniel</creatorcontrib><creatorcontrib>Patel, Samir N.</creatorcontrib><creatorcontrib>Uhr, Joshua H.</creatorcontrib><creatorcontrib>Borkar, Durga</creatorcontrib><creatorcontrib>Gao, Xinxiao</creatorcontrib><creatorcontrib>Fineman, Mitchell S.</creatorcontrib><creatorcontrib>Regillo, Carl D.</creatorcontrib><creatorcontrib>Maguire, Joseph I.</creatorcontrib><creatorcontrib>Garg, Sunir J.</creatorcontrib><creatorcontrib>Hsu, Jason</creatorcontrib><title>Outcomes of Eyes Lost to Follow-up with Proliferative Diabetic Retinopathy That Received Panretinal Photocoagulation versus Intravitreal Anti–Vascular Endothelial Growth Factor</title><title>Ophthalmology (Rochester, Minn.)</title><addtitle>Ophthalmology</addtitle><description>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).
Retrospective cohort study.
Fifty-nine patients who were LTFU immediately after treatment for more than 6 months between September 2013 and September 2016.
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.
Visual acuity and anatomic outcomes.
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).
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.</description><subject>Adult</subject><subject>Aged</subject><subject>Angiogenesis Inhibitors - therapeutic use</subject><subject>Bevacizumab - therapeutic use</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetic Retinopathy - drug therapy</subject><subject>Diabetic Retinopathy - physiopathology</subject><subject>Diabetic Retinopathy - surgery</subject><subject>Diabetic Retinopathy - therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Intravitreal Injections</subject><subject>Laser Coagulation</subject><subject>Lost to Follow-Up</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Ranibizumab - therapeutic use</subject><subject>Receptors, Vascular Endothelial Growth Factor - therapeutic use</subject><subject>Recombinant Fusion Proteins - therapeutic use</subject><subject>Retinal Neovascularization - drug therapy</subject><subject>Retinal Neovascularization - physiopathology</subject><subject>Retinal Neovascularization - surgery</subject><subject>Retinal Neovascularization - therapy</subject><subject>Retrospective Studies</subject><subject>Tomography, Optical Coherence</subject><subject>Treatment Outcome</subject><subject>Vascular Endothelial Growth Factor A - antagonists & inhibitors</subject><subject>Visual Acuity - physiology</subject><issn>0161-6420</issn><issn>1549-4713</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcGO0zAQhi0EYsvCGyDkI5dkx7GTNBek1W67rFRpK7RwtRx7QlylcbGdVr3xDrwJj8ST4Kq7HLl4JM_3e8b6CHnPIGfAqqtN7nZ97FVeAJvnUOdQ1C_IjJWiyUTN-EsySxjLKlHABXkTwgYAqoqL1-SCA9R1xcSM_H6YonZbDNR1dHFMdeVCpNHRpRsGd8imHT3Y2NO1d4Pt0Kto90hvrWoxWk2_pHN0OxX7I33sVUwXGhNh6FqN_tRUA133Ljrt1PdpSHE30j36MAV6P0av9jZ6TND1GO2fn7--qaAT5uliNC72ONjUu_PukHZYKh2df0tedWoI-O6pXpKvy8Xjzeds9XB3f3O9yjQveJ0Z1AVvGqHLpm5EWQITddmJhgNnpeGmKcScQVu0lTZdwwsNjCujWSUEqJYjvyQfz-_uvPsxYYhya4PGYVAjuinIAuaCi-QCEirOqPYuBI-d3Hm7Vf4oGciTLbmRZ1vyZEtCLZOtFPvwNGFqt2j-hZ71JODTGcD0z71FL4O2OGo01qOO0jj7_wl_AcSYrEs</recordid><startdate>201903</startdate><enddate>201903</enddate><creator>Obeid, Anthony</creator><creator>Su, Daniel</creator><creator>Patel, Samir N.</creator><creator>Uhr, Joshua H.</creator><creator>Borkar, Durga</creator><creator>Gao, Xinxiao</creator><creator>Fineman, Mitchell S.</creator><creator>Regillo, Carl D.</creator><creator>Maguire, Joseph I.</creator><creator>Garg, Sunir J.</creator><creator>Hsu, Jason</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3050-9129</orcidid><orcidid>https://orcid.org/0000-0002-3203-1544</orcidid><orcidid>https://orcid.org/0000-0002-2761-4219</orcidid></search><sort><creationdate>201903</creationdate><title>Outcomes of Eyes Lost to Follow-up with Proliferative Diabetic Retinopathy That Received Panretinal Photocoagulation versus Intravitreal Anti–Vascular Endothelial Growth Factor</title><author>Obeid, Anthony ; Su, Daniel ; Patel, Samir N. ; Uhr, Joshua H. ; Borkar, Durga ; Gao, Xinxiao ; Fineman, Mitchell S. ; Regillo, Carl D. ; Maguire, Joseph I. ; Garg, Sunir J. ; Hsu, Jason</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3237-dec23994c597945501475f4930315d3d924810b2b6cdf932c013adc16440ab3e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Angiogenesis Inhibitors - therapeutic use</topic><topic>Bevacizumab - therapeutic use</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetic Retinopathy - drug therapy</topic><topic>Diabetic Retinopathy - physiopathology</topic><topic>Diabetic Retinopathy - surgery</topic><topic>Diabetic Retinopathy - therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Intravitreal Injections</topic><topic>Laser Coagulation</topic><topic>Lost to Follow-Up</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Ranibizumab - therapeutic use</topic><topic>Receptors, Vascular Endothelial Growth Factor - therapeutic use</topic><topic>Recombinant Fusion Proteins - therapeutic use</topic><topic>Retinal Neovascularization - drug therapy</topic><topic>Retinal Neovascularization - physiopathology</topic><topic>Retinal Neovascularization - surgery</topic><topic>Retinal Neovascularization - therapy</topic><topic>Retrospective Studies</topic><topic>Tomography, Optical Coherence</topic><topic>Treatment Outcome</topic><topic>Vascular Endothelial Growth Factor A - antagonists & inhibitors</topic><topic>Visual Acuity - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Obeid, Anthony</creatorcontrib><creatorcontrib>Su, Daniel</creatorcontrib><creatorcontrib>Patel, Samir N.</creatorcontrib><creatorcontrib>Uhr, Joshua H.</creatorcontrib><creatorcontrib>Borkar, Durga</creatorcontrib><creatorcontrib>Gao, Xinxiao</creatorcontrib><creatorcontrib>Fineman, Mitchell S.</creatorcontrib><creatorcontrib>Regillo, Carl D.</creatorcontrib><creatorcontrib>Maguire, Joseph I.</creatorcontrib><creatorcontrib>Garg, Sunir J.</creatorcontrib><creatorcontrib>Hsu, Jason</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Ophthalmology (Rochester, Minn.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Obeid, Anthony</au><au>Su, Daniel</au><au>Patel, Samir N.</au><au>Uhr, Joshua H.</au><au>Borkar, Durga</au><au>Gao, Xinxiao</au><au>Fineman, Mitchell S.</au><au>Regillo, Carl D.</au><au>Maguire, Joseph I.</au><au>Garg, Sunir J.</au><au>Hsu, Jason</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of Eyes Lost to Follow-up with Proliferative Diabetic Retinopathy That Received Panretinal Photocoagulation versus Intravitreal Anti–Vascular Endothelial Growth Factor</atitle><jtitle>Ophthalmology (Rochester, Minn.)</jtitle><addtitle>Ophthalmology</addtitle><date>2019-03</date><risdate>2019</risdate><volume>126</volume><issue>3</issue><spage>407</spage><epage>413</epage><pages>407-413</pages><issn>0161-6420</issn><eissn>1549-4713</eissn><abstract>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).
Retrospective cohort study.
Fifty-nine patients who were LTFU immediately after treatment for more than 6 months between September 2013 and September 2016.
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.
Visual acuity and anatomic outcomes.
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).
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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30077614</pmid><doi>10.1016/j.ophtha.2018.07.027</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-3050-9129</orcidid><orcidid>https://orcid.org/0000-0002-3203-1544</orcidid><orcidid>https://orcid.org/0000-0002-2761-4219</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Ophthalmology (Rochester, Minn.), 2019-03, Vol.126 (3), p.407-413 |
| issn | 0161-6420 1549-4713 |
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| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Adult Aged Angiogenesis Inhibitors - therapeutic use Bevacizumab - therapeutic use Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 2 - complications Diabetic Retinopathy - drug therapy Diabetic Retinopathy - physiopathology Diabetic Retinopathy - surgery Diabetic Retinopathy - therapy Female Humans Intravitreal Injections Laser Coagulation Lost to Follow-Up Male Middle Aged Ranibizumab - therapeutic use Receptors, Vascular Endothelial Growth Factor - therapeutic use Recombinant Fusion Proteins - therapeutic use Retinal Neovascularization - drug therapy Retinal Neovascularization - physiopathology Retinal Neovascularization - surgery Retinal Neovascularization - therapy Retrospective Studies Tomography, Optical Coherence Treatment Outcome Vascular Endothelial Growth Factor A - antagonists & inhibitors Visual Acuity - physiology |
| title | Outcomes of Eyes Lost to Follow-up with Proliferative Diabetic Retinopathy That Received Panretinal Photocoagulation versus Intravitreal Anti–Vascular Endothelial Growth Factor |
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