The importance of monitoring wet age‐related macular degeneration patients during coronavirus disease 2019 pandemic: A retrospective study of assessment of functional and structural outcomes

Abstract

AbstractPurposeIntravitreal anti‐Vascular Endothelial Growth Factor (anti‐VEGF) injections are the gold standard treatment for wet Age‐related Macular Degeneration (wet AMD). Coronavirus disease 2019 (COVID‐19), and the resulting confinement, led to the cancellation of many programmed intravitreal anti‐VEGF injection visits. We compared the functional and structural visual outcomes of patients that did not respect their intravitreal anti‐VEGF injection intervals during the period of confinement due to COVID‐19 (group 1) and those who respected them (group 2).MethodsWet AMD patients of Swiss Visio Montchoisi and RétinElysée were included. Best Corrected Visual Acuity (BCVA) and Optical Coherence Tomography (OCT) changes between the first post‐ and last pre‐confinement visit were assessed, with favorable and unfavorable being the possible outcomes for each change.ResultsGroup 1 (n = 89, 109 eyes) had 13.41% greater rate of unfavorable BCVA outcome and 38.27% greater rate of unfavorable OCT outcome than Group 2 (n = 96, 122 eyes) (p = 0.04, p < 0.0001, respectively). The multivariate analysis showed that the more the patients deviated from their programmed injections and the higher the BCVA pre‐confinement, the higher the rate of unfavorable BCVA outcome (p = 0.03, p = 0.02, respectively). The OCT changes were not a predictive factor for an unfavorable BCVA outcome. The rates of pigment epithelial detachment (PED) and intraretinal fluid (IRF) increase in the first post‐confinement visit were higher in group 1 than in group 2 (p = 0.0004, p = 0.0374, respectively), with a relative increase of unfavorable OCT outcome of 200% and 66.67%, respectively.ConclusionsCOVID‐19 pandemic led many patients to refrain from their routine intravitreal anti‐VEGF injection visits, allowing us to analyze the role of designated intervals in the treatment of patients with wet AMD. During a next confinement due to COVID‐19, or circumstances similar to it, ophthalmologists should ensure the continuity of injections for their patients.Bibliography Fung THM et al. Addressing COVID‐19 fear to improve clinic attendance for patients with wet age‐related macular degeneration. Acta Ophthalmol 99: e285 (2021). Colantuono D et al. AMD management during the COVID‐19 pandemic. Acta Ophthalmol 98, e925–e925 (2020).