PURPOSE To 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). DESIGN Retrospective cohort study. PARTICIPANTS Fifty-nine patients who were LTFU immediately after treatment for more than 6 months between September 2013 and September 2016. METHODS Patients 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. MAIN OUTCOMES MEASURES Visual acuity and anatomic outcomes. RESULTS Seventy-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; P = 0.001) as well as with the final visit (0.92±0.94 logMAR; P = 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; P = 0.03). However, no significant difference was observed at the final visit (0.46±0.47 logMAR; P = 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; P = 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; P = 0.02). CONCLUSIONS Eyes 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.

中文翻译：

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与玻璃体内抗血管内皮生长因子相比，接受全视网膜光凝治疗的增生性糖尿病性视网膜病变的随访结果不佳。

目的比较玻璃体腔注射抗血管内皮生长因子（IVI）治疗后六个月以上失去随访的增生性糖尿病视网膜病变（PDR）眼睛的解剖和功能结局药物或全视网膜光凝（PRP）。设计回顾性队列研究。参与者2013年9月至2016年9月之间接受治疗超过6个月的59例接受LTFU治疗的患者。方法接受玻璃体内抗VEGF治疗或PRP的眼患者，在接受治疗后6个月以上进行下次随访被确定。在进行LTFU之前的访视，回访，回访后6个月访视，回访后12个月访视时的视敏度（VA）和解剖学结果，并收集了最终的访视，并比较了两个治疗组。主要结局指标视敏度和解剖结局。结果本研究纳入59例患者的76眼，其中30例接受抗VEGF的IVI，46例接受PRP。在抗VEGF组中，将LTFU之前的访视（最小分辨角[logMAR]的对数的0.43±0.38对数）与回诊（0.97±0.80 logMAR； P = 0.001）进行比较，平均VA显着恶化。最后一次访视（0.92±0.94 logMAR; P = 0.01）。在PRP组中，当将LTFU之前的访视（0.42±0.34 logMAR）与回访（0.62±0.64 logMAR; P = 0.03）进行比较时，平均VA显着恶化。但是，在最后一次访视时未观察到显着差异（0.46±0.47 logMAR； P = 0.38）。在最后一次就诊时，与PRP组相比，IVI组中有视网膜脱离的眼睛数量要多得多（分别为10对1； P = 0.005）。在最后一次就诊时，与PRP组相比，IVI组中虹膜新血管形成的发生率显着更高（分别为4 vs. 0； P = 0.02）。结论仅接受玻璃体内抗VEGF的PDR眼睛与接受PRP的眼睛相比，在LTFU后表现出更差的解剖学和功能结局。考虑到成为LTFU的潜在后遗症，必须仔细考虑PDR的治疗选择。在最后一次就诊时，与PRP组相比，IVI组中虹膜新血管形成的发生率显着更高（分别为4 vs. 0； P = 0.02）。结论仅接受玻璃体内抗VEGF的PDR眼睛与接受PRP的眼睛相比，在LTFU后表现出更差的解剖学和功能结局。考虑到成为LTFU的潜在后遗症，必须仔细考虑PDR的治疗选择。在最后一次访视时，与PRP组相比，IVI组中虹膜新血管形成的发生率显着更高（分别为4 vs. 0； P = 0.02）。结论仅接受玻璃体内抗VEGF的PDR眼睛与接受PRP的眼睛相比，在LTFU后表现出更差的解剖学和功能结局。考虑到成为LTFU的潜在后遗症，必须仔细考虑PDR的治疗选择。