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October 04, 2022
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IRIS Registry: 11% of patients with wet AMD lost to follow-up

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CHICAGO — Factors such as age, race/ethnicity and insurance type increased risk for loss to follow-up in patients with neovascular age-related macular degeneration, according to a study at the American Academy of Ophthalmology meeting.

Rahul N. Khurana, MD, and colleagues sought to determine how many patients on anti-VEGF therapy are lost to follow-up in the United States.

OSN1022AAO_Khurana_Graphic_01_WEB

“In order to answer this question, we turned to the largest registry in clinical medicine, the IRIS Registry from the American Academy of Ophthalmology,” he said in a poster presentation. “We looked at patients diagnosed with neovascular AMD between 2013 and 2015 and subsequently treated with anti-VEGF therapy over the next 4 years.”

Loss to follow-up was defined as a visit more than 12 months from the last intravitreal injection, and baseline demographic and clinical conditions were used to determine risk factors for loss to follow-up; 191,694 patients were included in the analysis.

Overall, 11% of patients were lost to follow-up.

Starting at age 76 years, patients with increased age were more likely to be lost to follow-up compared with patients younger than age 70 years (P < .001). Women were less likely to be lost to follow-up than men (P < .001). In addition, Black (P = .006) and Hispanic (P < .001) patients were more likely to be lost to follow-up than white patients.

Patients with unilateral involvement were at higher risk for loss to follow-up than patients with bilateral involvement (P < .001).

While patients with Medicaid were at higher risk for loss to follow-up compared with patients with private insurance (P < .001), patients with Medicare were at lower risk for loss to follow-up (P < .001).

“Improving adherence would be key to optimizing long-term outcomes,” Khurana said. “We really need to devise new strategies to have better compliance and adherence if we want to maximize our benefits for our patients.”