Song Weilin, Kanyo Emese, Bastian Riley, Singh Rishi P, Rachitskaya Aleksandra V
Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA.
Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
J Vitreoretin Dis. 2022 Dec 16;7(1):20-26. doi: 10.1177/24741264221136637. eCollection 2023 Jan-Feb.
To assess the short-term and long-term effects of a delay in care on visual acuity (VA) in patients requiring intravitreal injections. This retrospective cohort study comprised patients with neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), or retinal vein occlusion (RVO) receiving intravitreal injections. The visual and anatomic outcomes at the next completed visit and at the 1-year follow-up were studied. Of 1172 patients, 38% had a delay in care (mean 5.7 weeks). Compared with baseline, these patients lost VA (Early Treatment Diabetic Retinopathy Study letters) (mean -2.13 ± 0.49 SE) in the short-term ( = .0003) and had a thicker central subfield. Patients with no delay in care had a net VA gain (0.97 ± 0.39) ( = .0067). There was no difference in VA between 1 year and the baseline in either group. Long term, patients with nAMD in both groups had VA loss (no delay in care: -1.76 ± 0.60; delayed care: -2.44 ± 0.78) ( = .0005 and = .0114, respectively). Patients with DME and no delay in care maintained gains in vision (4.68 ± 1.86) but those with delayed care did not (1.72 ± 2.24) ( = .0202 and = .3756, respectively). In both groups, patients with RVO had no significant difference in vision from baseline. In patients requiring intravitreal injections, a delay in care of 5.7 weeks affected vision outcomes in the short term but not the long term.
评估延迟治疗对需要玻璃体内注射的患者视力（VA）的短期和长期影响。这项回顾性队列研究纳入了接受玻璃体内注射的新生血管性年龄相关性黄斑变性（nAMD）、糖尿病性黄斑水肿（DME）或视网膜静脉阻塞（RVO）患者。研究了下次完整随访时以及1年随访时的视力和解剖学结果。在1172例患者中，38%存在治疗延迟（平均5.7周）。与基线相比，这些患者在短期内视力下降（早期糖尿病性视网膜病变研究字母评分）（平均-2.13±0.49标准误）（P = 0.0003），且中心子野更厚。未延迟治疗的患者视力净增加（0.97±0.39）（P = 0.0067）。两组在1年时与基线时的视力均无差异。长期来看，两组中nAMD患者均有视力下降（未延迟治疗组：-1.76±0.60；延迟治疗组：-2.44±0.78）（P分别为0.0005和0.0114）。未延迟治疗的DME患者视力保持增加（4.68±1.86），但延迟治疗的患者则没有（1.72±2.24）（P分别为0.0202和0.3756）。在两组中，RVO患者的视力与基线相比无显著差异。在需要玻璃体内注射的患者中，5.7周的治疗延迟在短期内影响视力结果，但在长期内不影响。
