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COVID-19 封锁期间视网膜疾病延迟抗血管内皮生长因子治疗的影响。

The impact of delayed anti-vascular endothelial growth factor treatment for retinal diseases during the COVID-19 lockdown.

机构信息

University of Health Sciences Kartal Dr. Lütfi Kırdar Training and Research Hospital, Eye Department, Istanbul, Turkey.

University of Health Sciences Kartal Dr. Lütfi Kırdar Training and Research Hospital, Eye Department, Istanbul, Turkey.

出版信息

Photodiagnosis Photodyn Ther. 2021 Sep;35:102449. doi: 10.1016/j.pdpdt.2021.102449. Epub 2021 Jul 24.

Abstract

PURPOSE

To assess the clinical status of treatment-naive patients who had to delay 3-dose loading anti-VEGF (anti-vascular endothelial growth factor) injections during the COVID-19 lockdown, and to evaluate the effect of the delayed visual acuity treatment on spectral domain optical coherence tomography (SD-OCT) parameters.

METHOD

A total of 55 eyes of 46 patients who were received in the study period participated in this retrospective study, including 28 patients (37 eyes) with diabetic macular edema (DME), 11 patients (11 eyes) with retinal vein occlusion (RVO), and 7 patients (7 eyes) with wet age-related macular degeneration (wet-AMD). The patients were diagnosed with DME, RVO, or wet-AMD in February 2020 and had planned 3-dose loading injections in March, April, and May 2020, but could not be injected due to the COVID-19 pandemic.

RESULTS

From the patients' initial examination in February 2020, the mean best corrected visual acuity (BCVA) was 0.72 ± 59 logMAR. After the patients' lockdown visit in July 2020, the mean BCVA was 0.76 ± 64 logMAR. BCVA was stable in 11 eyes, decreased in 12 eyes, and increased in 14 eyes for patients with DME. BCVA was stable in 6, decreased in 3, and increased in 2 eyes for patients with RVO, and it was stable in 4 eyes and decreased in 3 eyes for patients with wet-AMD.

CONCLUSION

We concluded that 6-month delay in treatment of DME patients with non-proliferative DRP had no adverse effect on the visual acuity. However, the loading dose in wet-AMD and RVO patients should be applied as soon as possible.

摘要

目的

评估在 COVID-19 封锁期间不得不延迟 3 剂负荷剂量抗血管内皮生长因子(anti-vascular endothelial growth factor,抗 VEGF)注射的未经治疗的初治患者的临床状况,并评估延迟视力治疗对谱域光相干断层扫描(spectral domain optical coherence tomography,SD-OCT)参数的影响。

方法

共有 46 名患者的 55 只眼参与了这项回顾性研究,其中包括 28 名患者(37 只眼)患有糖尿病性黄斑水肿(diabetic macular edema,DME),11 名患者(11 只眼)患有视网膜静脉阻塞(retinal vein occlusion,RVO),以及 7 名患者(7 只眼)患有湿性年龄相关性黄斑变性(wet age-related macular degeneration,wet-AMD)。这些患者在 2020 年 2 月被诊断患有 DME、RVO 或 wet-AMD,并计划在 2020 年 3 月、4 月和 5 月接受 3 剂负荷剂量注射,但由于 COVID-19 大流行而无法注射。

结果

从患者在 2020 年 2 月的初始检查开始,平均最佳矫正视力(best corrected visual acuity,BCVA)为 0.72±59 logMAR。在 2020 年 7 月的封锁后就诊时,平均 BCVA 为 0.76±64 logMAR。DME 患者中有 11 只眼的 BCVA 稳定,12 只眼下降,14 只眼上升。RVO 患者中有 6 只眼的 BCVA 稳定,3 只眼下降,2 只眼上升,而 wet-AMD 患者中有 4 只眼的 BCVA 稳定,3 只眼下降。

结论

我们得出结论,对于患有非增生性糖尿病性视网膜病变的 DME 患者,延迟 6 个月治疗对视力没有不利影响。然而,湿性 AMD 和 RVO 患者的负荷剂量应尽快应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9837/8305215/5fa3930f672a/gr1_lrg.jpg

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