Characteristics of Patients Who Drop Out From Ranibizumab Therapy

Purpose: Anti-vascular endothelial growth factor therapy is a first-line treatment for age-related macular degeneration, but frequent visits and injections can be a burden for patients. This study aimed to estimate the dropout rate and tolerability of ranibizumab therapy in a clinical setting. Design: A retrospective case-control study. Methods: We investigated 250 eyes with choroidal neovascular membranes who underwent anti-vascular endothelial growth factor therapy in a single practice from July 1, 2008, to June 30, 2010. Clinical characteristics of patients who dropped out of treatment (n = 85) were recorded and compared with patients who continued with follow-up (n = 165). Results: The dropout rate from follow-up was 34.5%. The dropout rate was not significantly different between age groups, but there was a trend increasing dropout with increasing age. Dropout rate did not differ between sexes. Dropout rate was significantly higher (50.0%) in those living farther than 100 km from the clinic, compared with those who lived within 100 km (28.0%; odds ratio, 2.48). Patients with no other systemic diseases were also seen to drop out at a significantly higher rate (48.7%; P < 0.04). Financial status did not appear to affect dropout rate. Conclusions: Dropout of ranibizumab therapy was higher among patients who lived far from the clinic, those referred with a diagnosis of age-related macular degeneration, and patients with other health problems. The dropout rate from this clinic was 34.5%. These findings have implications in the planning of interventions to improve the follow-up of patients with blinding eye disease.