A new study in JAMA Ophthalmology corroborates Woody Allen’s old quote that 80% success in life is just showing up. Whether or not your patients turn up for their appointments can play a significant role in their ultimate visual outcome, the research shows. The authors advocate for substantial effort to reduce any burden associated with seeing an eye care professional to avoid vision loss.
A research team evaluated the records of 1,178 AMD patients who were originally examined for a clinical trial. These patients were scheduled to return to their doctor once every four weeks. The group’s mean number of missed visits was 2.4. The researchers classified the patients as on time (visits every 28 to 35 days), late (every 36 to 60 days) and very late (more than 60 days between visits).
Overall, patients were relatively adherent to their follow-up schedule, with 92.6% achieving complete visit constancy. The investigators compared data between the patients’ baselines and last doctor visits and found those with a less-than-stellar record experienced worse visual outcomes. After controlling for covariates, the late and very late groups saw fewer letters than patients in the on-time group.
The researchers found that after only six months, each missed visit was associated with an average visual acuity letter score decline of 0.7. Compared with patients who were on time, those who averaged between 36 to 60 days and more than 60 days between visits lost 6.1 and 12.5 letters, respectively.
|Ramakrishnan M, Yu Y, VanderBeek B. Association of visit adherence and visual acuity in patients with neovascular age-related macular degeneration. JAMA Ophthalmol. February 6, 2020. [Epub ahead of print].|