Institut Clínic of Ophthalmology (ICOF), Hospital Clínic, Barcelona, Spain.
August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
Retina. 2022 Apr 1;42(4):616-627. doi: 10.1097/IAE.0000000000003368.
To evaluate the impact of the COVID-19 pandemic lockdowns on the outcomes of eyes treated for neovascular age-related macular degeneration, diabetic macular edema, and retinal vein occlusion in eight countries.
A multicenter international database study of 5,782 eyes (4,708 patients) receiving intravitreal antivascular endothelial growth factor injections before, during, and after national lockdowns. The baseline visit was defined as the last visit within 3 months before lockdown, and prelockdown and postlockdown periods were defined as 6 months before and after the lockdown date.
Eyes with neovascular age-related macular degeneration (n = 4,649) lost vision in all countries in proportion to the reduced number of injections. The mean visual acuity change postlockdown ranged from -0.4 to -3.8 logarithm of the minimum angle of resolution letters, and the median number of injections/visits decreased from 4-5/4-7 to 2-4/2-4 postlockdown. The diabetic macular edema (n = 654) and retinal vein occlusion (n = 479) eyes' mean visual acuity change ranged from -2.8 to +1.7 letters and -1.6 to +0.1 letters, and the median number of injections/visits decreased from 2.5-5/4-6 to 1-3/2-4 and from 3-5.5/4-5 to 1-3.5/2-3.5, respectively. The 6-month dropout rates postlockdown were 20% for neovascular age-related macular degeneration, 27% for diabetic macular edema, and 28% for retinal vein occlusion.
This international study provides estimates of the impact of COVID-19 pandemic lockdown on intravitreal therapy and suggests that prioritizing neovascular age-related macular degeneration eyes seems appropriate.
评估 COVID-19 大流行封锁对 8 个国家接受抗血管内皮生长因子治疗的新生血管性年龄相关性黄斑变性、糖尿病性黄斑水肿和视网膜静脉阻塞的眼部结局的影响。
这是一项多中心国际数据库研究,纳入了 5782 只眼(4708 例患者),这些眼在国家封锁前后接受了玻璃体内抗血管内皮生长因子注射治疗。基线访视点定义为封锁前 3 个月内的最后一次访视点,封锁前和封锁后时期分别定义为封锁日期前 6 个月和后 6 个月。
所有国家的新生血管性年龄相关性黄斑变性眼(n=4649)视力均下降,与注射次数减少成比例。封锁后平均视力变化范围为-0.4 至-3.8 最小角分辨率对数字母,封锁后每只眼/访视点的中位数注射次数从 4-5/4-7 减少至 2-4/2-4。糖尿病性黄斑水肿眼(n=654)和视网膜静脉阻塞眼(n=479)的平均视力变化范围为-2.8 至+1.7 字母和-1.6 至+0.1 字母,每只眼/访视点的中位数注射次数从 2.5-5/4-6 减少至 1-3/2-4 和从 3-5.5/4-5 减少至 1-3.5/2-3.5。封锁后 6 个月的脱落率分别为新生血管性年龄相关性黄斑变性眼 20%、糖尿病性黄斑水肿眼 27%和视网膜静脉阻塞眼 28%。
这项国际研究提供了 COVID-19 大流行封锁对玻璃体内治疗影响的估计,并表明优先考虑新生血管性年龄相关性黄斑变性眼似乎是合适的。