Anthony Obeid

Loss to Follow-Up in Patients with Proliferative Diabetic Retinopathy after Panretinal Photocoagulation or Intravitreal Anti-VEGF Injections

PURPOSEnLoss to follow-up (LTFU) may contribute to vision loss in patients with active proliferative diabetic retinopathy (PDR). The aim of this study is to determine and compare the rates of LTFU in patients with PDR receiving panretinal photocoagulation (PRP) or intravitreal injections (IVIs) with anti-vascular endothelial growth factor (VEGF) over approximately 4 years. Moreover, this study evaluates various risk factors for LTFU.nnnDESIGNnRetrospective cohort study.nnnPARTICIPANTSnA total of 2302 patients with PDR receiving IVIs with anti-VEGF or PRP between January 1, 2012, and April 20,xa02016.nnnMETHODSnIntervals between each procedure and the subsequent follow-up visit were measured. Loss to follow-up was defined as at least 1 interval exceeding 12 months duration.nnnMAIN OUTCOME MEASURESnThe LTFU rates and associated risk factors.nnnRESULTSnA total of 1718 patients (74.6%) followed up postprocedure and 584 patients (25.4%) were LTFU over approximately 4 years. Of the patients receiving PRP, 28.0% were LTFU compared with 22.1% of patients receiving IVI with anti-VEGF (Pxa0= 0.001). The LTFU rates decreased as age increased, with rates of 28.1% for patients aged ≤55 years, 27.0% for patients aged 56 to 65 years, and 20.9% for patients aged >65 years (Pxa0=xa00.002). Loss to follow-up also differed by race, with rates of 19.4% for whites, 30.2% for African Americans, 19.7% for Asians, 38.0% for Hispanics, Native Americans, and Pacific Islanders, and 34.9% for patients of unreported race (P < 0.001). The LTFU rates also increased as regional average adjusted gross incomes (AGIs) decreased, with rates of 33.9% for patients with regional average AGI of ≤

Outcomes of Eyes Lost to Follow-up with Proliferative Diabetic Retinopathy That Received Panretinal Photocoagulation versus Intravitreal Anti–Vascular Endothelial Growth Factor

40u2009000, 24.0% for patients with regional average AGI from

Loss to Follow-up Among Patients With Neovascular Age-Related Macular Degeneration Who Received Intravitreal Anti–Vascular Endothelial Growth Factor Injections

41u2009000 to

Cryptococcal choroiditis in advanced AIDS with clinicopathologic correlation

80u2009000, and 19.7% for patients with regional average AGI >

Endophthalmitis Rates after Bilateral Same-Day Intravitreal Anti–Vascular Endothelial Growth Factor Injections

80u2009000 (Pxa0<xa00.001). Procedure type, age, race, and regional average AGI were all significant (P < 0.05) independent risk factors of LTFU in the multivariate regression.nnnCONCLUSIONSnA large proportion of patients with PDR were LTFU after receiving PRP or an anti-VEGF injection over approximately 4 years. Key risk factors included age, race, and regional average AGI.

BILATERAL ENTEROCOCCUS FAECALIS ENDOPHTHALMITIS WITH MULTIPLE RECURRENCES

PURPOSEnTo 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).nnnDESIGNnRetrospective cohort study.nnnPARTICIPANTSnFifty-nine patients who were LTFU immediately after treatment for more than 6 months between September 2013 and Septemberxa02016.nnnMETHODSnPatients 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.nnnMAIN OUTCOMES MEASURESnVisual acuity and anatomic outcomes.nnnRESULTSnSeventy-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; Pxa0= 0.001) as well as with the final visit (0.92±0.94 logMAR; Pxa0= 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; Pxa0= 0.03). However, no significant difference was observed at the final visit (0.46±0.47 logMAR; Pxa0= 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; Pxa0= 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; Pxa0= 0.02).nnnCONCLUSIONSnEyes 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.

TOPICAL DORZOLAMIDE–TIMOLOL WITH INTRAVITREOUS ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR FOR RETINAL VEIN OCCLUSION: A PILOT STUDY

Importance Loss to follow-up (LTFU) after anti–vascular endothelial growth factor (anti-VEGF) injections increases the risk of vision loss among patients with neovascular age-related macular degeneration (nAMD). Objective To report rates of LTFU among patients with nAMD after anti-VEGF injections and to identify risk factors associated with LTFU in this population. Design, Setting, and Participants This retrospective cohort study of data from 9007 patients who received anti-VEGF injections for treatment of nAMD was performed at an urban, private retina practice with multiple locations from April 1, 2012, to January 12, 2016. Main Outcomes and Measures Rates of LTFU after anti-VEGF injections. Loss to follow-up was defined as receipt of 1 or more injections with no subsequent follow-up visit within 12 months. Results Among the 9007 patients (mean [SD] age, 81.2 [8.8] years; 5917 [65.7%] female; 7905 [87.8%] white), 2003 (22.2%) were LTFU. Odds of LTFU were greater among patients 81 to 85 years of age (odds ratio [OR], 1.58; 95% CI, 1.38-1.82; Pu2009<u2009.001), 86 to 90 years of age (OR, 2.29; 95% CI, 2.00-2.62; Pu2009<u2009.001), and more than 90 years of age (OR, 3.31; 95% CI, 2.83-3.86; Pu2009<u2009.001) compared with patients 80 years of age and younger. Odds of LTFU among African American patients (OR, 1.47; 95% CI, 1.00-2.16; Pu2009=u2009.05), Asian patients (OR, 2.63; 95% CI, 1.71-4.03; Pu2009<u2009.001), patients of other race (OR, 3.07; 95% CI, 1.38-6.82; Pu2009=u2009.006), and patients of unreported race (OR, 2.29; 95% CI, 1.96-2.68; Pu2009<u2009.001) were greater than odds of LTFU among white patients. Odds of LTFU were greater among patients with regional adjusted gross income of

LONG-TERM VISUAL OUTCOMES AND CLINICAL FEATURES AFTER ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR INJECTION–RELATED ENDOPHTHALMITIS

50 000 or less (OR, 1.52; 95% CI, 1.30-1.79; Pu2009<u2009.001),

OCULAR HYPERTENSION AFTER INTRAVITREAL INJECTION OF 2-MG TRIAMCINOLONE

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ENDOPHTHALMITIS AFTER PARS PLANA VITRECTOMY: Efficacy of Intraoperative Subconjunctival Antibiotics

75 000 (OR, 1.35; 95% CI, 1.17-1.56; Pu2009<u2009.001), and