Outcomes of anti-VEGF therapy for retinal diseases altered by COVID-19 lockdown
Investigators found that patients with neovascular age-related macular degeneration in all countries included in the study lost vision as a result of the lockdown and reduced number of treatments during the COVID-19 pandemic.
Javier Zarranz-Ventura, MD, PhD, FEBO, from the Institut Clínic of Ophthalmology, Hospital Clínic and the August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain, and colleagues from the Fight Retinal Blindness Registry, found that patients with neovascular age-related macular degeneration (AMD) in all countries included in the study lost vision as a result of the lockdown and reduced number of treatments during the COVID-19 pandemic.
This group conducted an international database study1 that included 5,782 eyes of 4,708 patients who were being treated with anti-vascular endothelial growth factor injections before, during, and after the pandemic lockdown. Patients from 8 countries were included and in addition to neovascular AMD, those with diabetic macular edema (DME) and retinal vein occlusion (RVO) were included in the analysis.
The investigators reported that 4,649 eyes with neovascular AMD had decreased vision in all countries.
“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 and 4–7 to 2–4 and 2–4 postlockdown,” they said.
Regarding the other diseases, the changes in the mean visual acuity in the 654 eyes with DME and the 479 eyes with RVO, respectively, ranged from −2.8 to +1.7 letters and −1.6 to +0.1 letters. The median numbers of injections/visits also decreased from 2.5–5 and 4–6 to 1–3 and 2–4 and from 3–5.5 and 4–5 to 1–3.5 and 2–3.5, respectively.
At the 6-month time point after the lockdown, the dropout rates were 20% for neovascular AMD, 27% for DME, and 28% for RVO.
The authors commented, “This international study provides estimates of the impact of the COVID-19 pandemic lockdown on intravitreal therapy and suggests that prioritizing eyes with neovascular AMD seems appropriate.”
