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Purpose   This study determined the clinical impact and causes of loss to follow-up (LTFU) from the patients' perspective in individuals with proliferative diabetic retinopathy (PDR) who received panretinal photocoagulation (PRP) and/or intravitreal injections (IVIs) of antivascular endothelial growth factor (VEGF).Methods   This prospective cohort study included 467 patients with PDR who received PRP and/or IVIs of anti-VEGF between May 2013 and June 2018. LTFU was defined as missing any follow-up visit for any interval exceeding 6 months, provided that patients eventually resumed care. Main outcome measures include rates and causes of LTFU.Results   A total of 391 patients (83.7%) were followed up, and 76 patients (16.3%) were LTFU over the study period. Rates of LTFU decreased with age ( P =0.005). Questionnaire analysis conducted for patients' LTFU showed a significant positive correlation between best corrected visual activity (BCVA) loss and patient's lack of trust and satisfaction with treatment (rs = 0.458,  P =0.005). Questionnaire analysis conducted for patients' LTFU showed a significant positive correlation between best corrected visual activity (BCVA) loss and patient's lack of trust and satisfaction with treatment (rs = 0.458,  P =0.005). Questionnaire analysis conducted for patients' LTFU showed a significant positive correlation between best corrected visual activity (BCVA) loss and patient's lack of trust and satisfaction with treatment (rs = 0.458,  P =0.005). Questionnaire analysis conducted for patients' LTFU showed a significant positive correlation between best corrected visual activity (BCVA) loss and patient's lack of trust and satisfaction with treatment (rs = 0.458,Conclusions   LTFU threatens vision in PDR patients receiving PRP and/or IVIs of anti-VEGF. Possibly, patient-specific LTFU causes should be addressed before treatment in order to minimize the risk of LTFU. The clinical trial is registered with  NCT04018326  (trial registration: ClinicalTrials.gov Identifier:  NCT04018326 , 10th of July 2019 “Retrospectively registered”).

Causes and Clinical Impact of Loss to Follow-Up in Patients with Proliferative Diabetic Retinopathy