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COVID-19 大流行第一波对德国大都市地区玻璃体腔内注射治疗情况的影响。

Impact of the COVID-19 pandemic's first wave on the care and treatment situation of intravitreal injections in a German metropolitan region.

机构信息

Department of Ophthalmology, Asklepios Hospital Barmbek, Hamburg, Germany.

Department of Ophthalmology, Asklepios Hospital Nord-Heidberg, Hamburg, Germany.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2022 Jun;260(6):1877-1886. doi: 10.1007/s00417-021-05521-5. Epub 2022 Jan 10.

Abstract

PURPOSE

This study aims to evaluate the impact of the first coronavirus 2019 (COVID-19) wave in 2020 on patients scheduled for intravitreal injections (IVI) in a German metropolitan region.

METHODS

We performed a multicentre prospective survey and retrospective analysis of the records of patients treated with intravitreal injections during the 20-week period from March to July 2020 in all four hospital eye departments in the city of Hamburg using a questionnaire (on treatment adherence, SarsCoV2-related personal, familial and social data) and treatment data.

RESULTS

A total of 1038 patients (2472 IVI, 1231 eyes) and 818 questionnaires were evaluated. Longer duration of therapy, lower visual acuity (VA) of the treated and higher VA of the fellow untreated eye was were associated with a higher probability of visit cancellation. Every additional year of life posed a 2.6% lower risk of noncompliance. A COVID-19 infection in the family environment displayed a 5.5-fold chance of visit cancellation. Patients treated for neovascular age-related macular degeneration (nAMD) had a 36% reduced risk of visit cancellation compared to patients with diabetic macular oedema (DME).

CONCLUSION

A long preceding treatment period, low VA of the treated eye, high VA of the untreated eye, COVID-19 in the family and DME were identified as risk factors for IVI visit cancellations during the COVID-19 pandemic. Compliance to treatment might be improved in the future by taking these risk factors into account when scheduling patients for IVI during the exceptional circumstances of a pandemic.

摘要

目的

本研究旨在评估 2020 年首次 2019 年冠状病毒(COVID-19)疫情对德国大都市地区接受玻璃体腔内注射(IVI)治疗的患者的影响。

方法

我们使用问卷(关于治疗依从性、与 SARS-CoV2 相关的个人、家庭和社会数据)和治疗数据,对汉堡市 4 家医院眼科 2020 年 3 月至 7 月的 20 周内接受玻璃体腔内注射治疗的患者的记录进行了多中心前瞻性调查和回顾性分析。

结果

共评估了 1038 名患者(2472 次 IVI,1231 只眼)和 818 份问卷。治疗时间延长、治疗眼的视力(VA)较低和未治疗眼的 VA 较高与就诊取消的概率较高相关。每增加 1 岁,不遵医嘱的风险降低 2.6%。家庭环境中发生 COVID-19 感染,就诊取消的几率增加 5.5 倍。与糖尿病性黄斑水肿(DME)患者相比,接受新生血管性年龄相关性黄斑变性(nAMD)治疗的患者就诊取消的风险降低 36%。

结论

在 COVID-19 大流行期间,治疗前的治疗时间长、治疗眼的 VA 较低、未治疗眼的 VA 较高、家庭中存在 COVID-19 感染和 DME 被确定为 IVI 就诊取消的危险因素。在大流行期间为患者安排 IVI 治疗时,考虑这些危险因素可能会提高治疗的依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e93/9061672/82b91ab56789/417_2021_5521_Fig1_HTML.jpg

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