Stattin Martin, Ahmed Daniel, Graf Alexandra, Haas Anna-Maria, Kickinger Stefan, Jacob Michael, Krepler Katharina, Ansari-Shahrezaei Siamak
Karl Landsteiner Institute for Retinal Research and Imaging, Vienna, Austria.
Medical Retina Unit, Clinic Landstraße, Department of Ophthalmology, Vienna Healthcare Group, Juchgasse 25, 1030, Vienna, Austria.
Ophthalmol Ther. 2021 Dec;10(4):935-945. doi: 10.1007/s40123-021-00381-y. Epub 2021 Aug 9.
To evaluate the effect of a 9-week treatment deferral due to healthcare restrictions caused by Austria's first governmental lockdown associated with the coronavirus disease 2019 (COVID-19) pandemic on visual acuity (VA) in eyes compromised by exudative neovascular age-related macular degeneration (nAMD) after 1 year.
Retrospective data collection of 98 eyes (98 patients) with a treatment discontinuation at a tertiary eye care center (Clinic Landstraße, Vienna Healthcare Group, Austria) between March 16 and May 4, 2020. Prior to the lockdown, patients received multiple intravitreal injections (IVI) of anti-vascular endothelial growth factor with a personalized treatment interval for 3 years on average and at least three IVI after the lockdown.
When the treatment interval doubled to 117.6 ± 31.4 days in spring 2020, patients lost 2.2 ± 4.6 ETDRS letters (p = 0.002) on average before reinitiating therapy. In total, 4.1 ± 8.1 letters (p < 0.0001) were lost despite continuous individual re-treatment over the course of the next year. In a univariate analysis, the extended interval time remained statistically significant (p < 0.0001), indicating a larger VA reduction within intervals with increasing interval time in days.
The short-term treatment interruption had a persistent negative impact on the VA course of eyes under therapy after 1 year. Continuous therapy independent of the underlying treatment regimen remains of utmost importance in exudative nAMD. Our data should create awareness to regulators regarding future decisions despite the global pandemic.
评估因2019年冠状病毒病（COVID-19）大流行导致奥地利首次政府封锁而造成的医疗保健限制，使9周治疗延迟对1年后因渗出性新生血管性年龄相关性黄斑变性（nAMD）而受损眼睛的视力（VA）产生的影响。
回顾性收集2020年3月16日至5月4日期间在奥地利维也纳医疗集团兰德施塔特诊所这一三级眼科护理中心中断治疗的98只眼睛（98名患者）的数据。在封锁之前，患者平均接受了3年的个性化治疗间隔的多次玻璃体内注射抗血管内皮生长因子，封锁之后至少接受了3次玻璃体内注射。
2020年春季治疗间隔翻倍至117.6±31.4天，患者在重新开始治疗前平均视力下降2.2±4.6个早期糖尿病性视网膜病变研究（ETDRS）字母（p = 0.002）。尽管在接下来的一年中持续进行个体化再治疗，但总共仍有4.1±8.1个字母的视力下降（p < 0.0001）。在单因素分析中，延长的间隔时间在统计学上仍然显著（p < 0.0001），表明随着间隔天数的增加，间隔期间视力下降幅度更大。
短期治疗中断对1年后接受治疗的眼睛的视力进程产生了持续的负面影响。在渗出性nAMD中，无论基础治疗方案如何，持续治疗仍然至关重要。尽管全球大流行，我们的数据应使监管机构对未来决策有所警觉。
