Does Visit Adherence Affect Visual Acuity in Patients with Neovascular AMD?

Previous studies have established a correlation between visit adherence and health outcomes. A new study evaluated the relationship between visit adherence and visual acuity in patients with neovascular age-related macular degeneration (AMD). The researchers concluded that visit adherence plays a significant role in visual acuity in this patient population.

Data from the Comparison of Age-Related Macular Degeneration Treatment Trial randomized clinical trial were evaluated. The study included patients with AMD from 44 clinical centers in the United States who were recruited between February 2008 and December 2009. Patients were required to attend one visit every four weeks, totaling 26 visits, for monthly versus pro re nata treatments of bevacizumab versus ranibizumab. Visit adherence was determined by the total number of missed visits, average number of days between each visit, longest duration in days between visits, and visit consistency. Average and maximum days were stratified into three groups: on time (28 to 35 days), late (36 to 60 days), and very late (>60 days).

Final analysis included 1,178 patients (mean age, 79.1 years; 61.7% were female); mean missed visits was 2.4. During the study, the majority of patients (n=1,091; 92.6%) had complete visit consistency. When assessing average days, 1,060 patients (90.0%) were classified as on time, 108 (9.2%) were late, and 10 (0.8%) were very late. For maximum days between visits, the rates were 197 patients (16.7%), 773 patients (65.6%), and 208 patients (17.7%), respectively. When adjusting for covariates, the late and very late groups in the average and maximum days categories, compared with the on-time groups, saw fewer visual acuity letter scores in both average and maximum days.

“The magnitude of the association of visit adherence with visual acuity outcomes in this clinical scenario suggests that substantial effort should be expended to strive for visit adherence or therapeutic strategies that reduce the visit burden without compromising visual acuity outcomes,” summarized the researchers.