Ophthalmology Department, Hadassah Medical Center, Faculty of Medicine, Hebrew University, Kiryat Hadassah, POB 12000, 91120, Jerusalem, Israel.
Graefes Arch Clin Exp Ophthalmol. 2022 Jul;260(7):2201-2208. doi: 10.1007/s00417-021-05549-7. Epub 2022 Jan 7.
Determine the anatomical consequences of delaying intravitreal injection (IVI) therapy with anti-vascular endothelial growth factor (anti-VEGF) in patients using treat-and-extend (T&E) protocol.
Retrospective medical record review of consecutive patients receiving intravitreal anti-VEGF therapy using T&E protocol prior to and during the COVID-19 pandemic.
The study included 923 eyes of 691patients; 58.8% (543 eyes), 25% (231 eyes), and 16.2% (149 eyes) had nvAMD, DME, and RVO, respectively. Mean (± SD) patient age was 74.5 ± 11.7 years. Overall, 56.3% of cases had a delay in therapy of ≥ 7 days; specifically, 56.2%, 61.5%, and 49.0% of nvAMD, DME, and RVO cases, respectively, had a delay. The median delay in days, among cases ≥ 7 days late was 21 (IQR 7 to 42) days, with 21(IQR 7 to 45), 22.5(IQR 8 to 42), and 14(IQR 7 to 33.5) days of delay among patients with nvAMD, DME, and RVO, respectively. Delaying therapy by ≥ 7 days resulted in increased CST in 47.5%, 58.5%, and 58.9% of nvAMD, DME, and RVO cases, respectively, with a significant correlation between the length of treatment delay and the increase in CST (Spearman's rho: 0.196; p < 0.001).
Delayed IVI treatment in eyes treated with T&E protocol was associated with increased macular thickness with potential consequences with respect to visual outcome.
确定在使用治疗后随访（T&E）方案的患者中，延迟玻璃体腔内注射（IVI）抗血管内皮生长因子（anti-VEGF）治疗的解剖学后果。
回顾性分析 COVID-19 大流行前和期间接受 T&E 方案的连续患者的玻璃体腔内抗 VEGF 治疗的病历。
该研究纳入了 923 只眼的 691 例患者；分别有 58.8%（543 只眼）、25%（231 只眼）和 16.2%（149 只眼）患有 nvAMD、DME 和 RVO。患者平均（±SD）年龄为 74.5±11.7 岁。总体而言，56.3%的病例治疗延迟≥7 天；具体而言，分别有 56.2%、61.5%和 49.0%的 nvAMD、DME 和 RVO 病例出现延迟。延迟≥7 天的病例中，中位延迟天数为 21 天（IQR 7 至 42）天，nvAMD、DME 和 RVO 患者的延迟天数分别为 21（IQR 7 至 45）天、22.5（IQR 8 至 42）天和 14（IQR 7 至 33.5）天。延迟治疗≥7 天导致 47.5%、58.5%和 58.9%的 nvAMD、DME 和 RVO 病例 CST 增加，治疗延迟时间与 CST 增加之间存在显著相关性（Spearman's rho：0.196；p<0.001）。
在使用 T&E 方案治疗的眼中，延迟 IVI 治疗与黄斑厚度增加相关，这可能对视功能产生潜在影响。
