4.4 Article

TREATMENT DEFERRAL DURING COVID-19 LOCKDOWN Functional and Anatomical Impact on Patients With Neovascular Age-Related Macular Degeneration

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/IAE.0000000000003369

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SARS-CoV-2; COVID-19; lockdown; retina; intravitreal injections; anti-VEGF; neovascular age-related macular degeneration

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This study investigated the impact of deferring intravitreal injection treatment during the COVID-19 lockdown on patients with neovascular age-related macular degeneration. Patients who continued treatment according to schedule showed stable visual acuity and central subfield thickness, while those who deferred treatment experienced irreversible deterioration in visual function. Treatment continuation is recommended for patients with neovascular age-related macular degeneration during a lockdown.
Purpose: To investigate the visual and anatomical impact of intravitreal injection treatment deferral because of the COVID-19 lockdown on patients affected by neovascular age-related macular degeneration. Methods: We retrospectively reviewed 314 patients (394 eyes) who were scheduled to receive the impact of intravitreal injections during the Swiss lockdown. We compared patients who continued to receive scheduled impact of intravitreal treatment without clinical consultation (Group Continue C; n = 215) and patients for whom the impact of intravitreal treatment was completely deferred (Group Stop, S; n = 179). Functional and anatomical parameters were collected at four time points before and after the lockdown. Results: In Group C, the visual acuity at baseline and after the lockdown did not differ significantly. In Group S, the visual acuity deteriorated significantly compared with baseline and then improved slightly after the resumption of treatment, but it did not recover to baseline values. The mean central subfield thickness remained stable in Group C, whereas it increased in Group S and then returned to prelockdown values after the resumption of treatment. Conclusion: An injection-only approach was effective in managing patients with neovascular age-related macular degeneration during the pandemic lockdown, whereas patients who deferred their scheduled treatment showed partially irreversible deterioration of visual function. We recommend treatment continuation in patients with neovascular age-related macular degeneration during a lockdown.

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