This is interesting and important. The bottom line: If you are getting treated for wet AMD and stop going to follow-ups, you are proven not to do as well as if you follow the schedule set by the treating doctor. It sounds obvious, but like everything else, we need data/science to prove it.
Researchers evaluated the long-term visual outcomes of patients with neovascular age-related macular degeneration (AMD) who were lost to follow-up (LTFU) during treatment compared with those with continuous follow-up (CFU).
A retrospective study was conducted on patients diagnosed with neovascular AMD who received anti-VEGF therapy from 2010 to 2022. The patients were classified into a long-term LTFU group (LTFU for more than 6 months), a short-term LTFU group (LTFU for 2 months to less than 6 months), and the CFU group. Researchers conducted a comparative analysis of baseline characteristics, factors related to visual prognosis, and differences in the occurrence of severe vision loss.
A total of 169 patients were classified into 43 in the long-term LTFU group, 57 in the short-term LTFU group, and 69 in the CFU group. The mean follow-up duration was 57.12 ± 31.68 months. No significant difference was found in baseline visual acuity (logMAR) among the long-term LTFU, short-term LTFU, and CFU groups (0.76 ± 0.54, 0.68 ± 0.51, and 0.72 ± 0.54, respectively; p=0.734). The final visual acuity was significantly lower in the long-term LTFU group (1.12 ± 0.79) compared with the short-term LTFU group (0.65 ± 0.62) and the CFU group (0.65 ± 0.56)(p<0.001), and the change in visual acuity was significantly greater in the long-term LTFU group (0.36 ± 0.69) compared with the short-term LTFU group (-0.03 ± 0.64) and the CFU group (-0.07 ± 0.58)(p=0.001). Long-term LTFU was significantly associated with changes in visual acuity from the baseline to the final visit (p=0.002) and severe vision loss (p=0.002).
Researchers wrote that, in patients with neovascular AMD, those in the LTFU group for more than six months during treatment had worse long-term visual outcomes than those with regular follow-up or shorter LTFU durations.
SOURCE: Nam KT, Yun C. Long-term visual outcomes of patients with neovascular age-related macular degeneration treated with anti-VEGF therapy lost to follow-up. Graefes Arch Clin Exp Ophthalmol. 2025 Mar 20. doi: 10.1007/s00417-025-06798-6. Epub ahead of print. PMID: 40111518.
Jeffry D. Gerson, O.D., F.A.A.O.