Treatment patterns and visual acuity change of AMD patients, before, during and after the COVID-19 pandemic lockdowns: A large cohort

IF 3 3区医学 Q1 OPHTHALMOLOGY Acta Ophthalmologica Pub Date : 2023-09-12 DOI:10.1111/aos.15756

Dana Barequet, Reut Shor, Ori Segal, Eran Greenbaum, Omer Trivizki, Anat Loewenstein, Gilad Rabina

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Abstract

Purpose

To evaluate the impact of the changes in treatment patterns before, during and after the COVID-19 pandemic on best-corrected visual acuity (BCVA) in previously treated neovascular age-related macular degeneration (nAMD) patients.

Methods

A multi-centre, retrospective, observational study of consecutive nAMD patients during 2019–2021. Data collected included demographics, BCVA, dates of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections and clinic visits.

Results

A total of 1652 eyes of 1652 nAMD patients were included, out of which 850 eyes were assessed in 2019 (pre-COVID-19), 630 eyes were assessed in 2020 (COVID-19) and 974 eyes were assessed in 2021 (post-COVID-19). During the COVID-19 period, the mean number of anti-VEGF injections was significantly lower than the corresponding pre-COVID-19 and post-COVID-19 periods (5.55 compared to 6.13 and 6.60, respectively p < 0.01). A constant lower ratio of injections per patient/month was observed during COVID-19 compared to previous and following years, with a notable decline during March–April, reaching a ratio of 0.4 in 2020 versus 0.65 in 2019 and 0.62 in 2021 (p < 0.01). Baseline BCVA (0.825, p < 0.001), number of injections (−0.007, p < 0.001), gender (−0.027, p = 0.037) and age (0.004, p < 0.001) were shown to be significant predictors of final BCVA.

Conclusion

During the COVID-19 period, patients were treated with significantly less intravitreal anti-VEGF injection compared to the previous year with compensation in the following year. These changes in treatment patterns did not have a significant impact on BCVA outcomes. Age, gender, baseline BCVA and number of injections are predictors of final visual outcomes.

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在 COVID-19 大流行封锁之前、期间和之后，AMD 患者的治疗模式和视力变化：大型队列

目的评估 COVID-19 大流行之前、期间和之后治疗模式的变化对既往接受过治疗的新生血管性年龄相关性黄斑变性（nAMD）患者最佳矫正视力（BCVA）的影响。方法对2019-2021年间连续接受治疗的nAMD患者进行多中心、回顾性、观察性研究。收集的数据包括人口统计学、BCVA、玻璃体内抗血管内皮生长因子（anti-VEGF）注射日期和门诊访问。结果共纳入 1652 名 nAMD 患者的 1652 只眼睛，其中 850 只眼睛在 2019 年（COVID-19 前）接受评估，630 只眼睛在 2020 年（COVID-19）接受评估，974 只眼睛在 2021 年（COVID-19 后）接受评估。在 COVID-19 期间，抗血管内皮生长因子注射的平均次数明显低于相应的 COVID-19 前和 COVID-19 后期间（分别为 5.55 次和 6.13 次和 6.60 次）。与之前和之后几年相比，COVID-19 期间观察到每名患者/月注射比例持续降低，3 月至 4 月期间明显下降，2020 年达到 0.4，而 2019 年和 2021 年分别为 0.65 和 0.62（p <0.01）。基线 BCVA（0.825，p <0.001）、注射次数（-0.007，p <0.001）、性别（-0.027，p = 0.037）和年龄（0.004，p <0.001）被证明是最终 BCVA 的重要预测因素。结论在 COVID-19 期间，与前一年相比，患者接受玻璃体内抗 VEGF 注射治疗的次数明显减少，并在第二年得到补偿。这些治疗模式的变化并未对BCVA结果产生显著影响。年龄、性别、基线 BCVA 和注射次数是最终视力结果的预测因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Ophthalmologica 医学-眼科学

CiteScore

7.60

自引率

5.90%

发文量

433

审稿时长

6 months

期刊介绍： Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.