A Prospective Review of Patients Receiving Intravitreal Anti-VEGF: How are we doing during the SARS-Cov-2 Pandemic?

Abstract

Objective: During the SARS-CoV-2 pandemic, service provision of Anti- Vascular Endothelial Growth Factor (anti-VEGF) therapy is continued to prevent severe visual loss. As the majority of the patients requiring intravitreal anti- VEGF are elderly and vulnerable, we aim to assess the safety and efficacy of the delivery of anti-VEGF therapy. Method: A prospective data collection of 337 patients who attended the nurse led injection clinics in the UK during the lockdown period from 30 March 2020 to 1 June 2020. A follow up of all of the attended patients was conducted to assess for diagnosis of SARS-CoV-2. Results: 182 (54%) were female and 155 (46%) male. Majority (95%) were Caucasian and 5% were Asian ethnicity. The indication for anti-VEGF injection include wet age related macular degeneration (wet AMD) (70.9%), Diabetic Macular Oedema (DMO) (17.2%), and Retinal Vein Occlusion (RVO) (11.9%). Mean age was 78.84±9.76 for wet AMD, 67.63±3.26 for RVO and 59.28±14.54 for DMO. More wet AMD patients reported subjective deterioration of vision compared to RVO and DMO (40.2% vs. 37.5% vs. 22.4%) [P=0.04]. Chronic Obstructive Pulmonary Disease (COPD) is more common in the wet AMD group as compared to other groups (P=0.03). Five patients from the study group were tested for SARS-CoV-2, none were positive. Conclusion: Delivery of anti-VEGF therapy is safe with the current precautionary measures despite caring for a vulnerable group of patients. Majority of the wet AMD patients are continuing to attend intravitreal injection appointments.