Effects of Loss-to-Follow-Up on Functional and Anatomic Outcomes in Patients with Neovascular Age-Related Macular Degeneration

Purpose: To study the effect of loss-to-follow-up (LTFU) in patients receiving anti-vascular endothelial growth factor (VEGF) injections for neovascular age-related macular degeneration (nAMD). Patients and Methods: Retrospective, multi-center, cohort study of patients that received intravitreal bevacuzimab, ranibizumab, or aflibercept between January 2020 and March 2020 who were lost to follow-up. Results: A total of 7114 eyes of 5727 patients met the study inclusion criteria. At the first return visit after LTFU, logMAR VA was 0.85 (Snellen 20/142) in the LTFU group compared to 0.67 (Snellen 20/94, p<0.001) in the control group. On the final study visit, VA in the LTFU group remained decreased at 0.86 (Snellen 20/145, p<0.001). For the LTFU group, mean CFT increased when comparing the visit before LTFU (280 µm) to the return visit (295 µm, p<0.001), but there was no difference at the final study visit (277 µm, p=0.42). Despite CFT returning back to GSD values by the final study visit for those LTFU, VA did not recover. Conclusions: Patients with nAMD being treated with anti-VEGF who were lost to follow-up during the COVID-19 pandemic experienced irrecoverable loss in VA during the duration of the study, despite resumption of anti-VEGF therapy.