Delaying anti-VEGF therapy during the COVID-19 pandemic: long-term impact on visual outcomes in patients with neovascular age-related macular degeneration

BMC Ophthalmology

Research

Andrea Aretti¹  Francesco Pozzo Giuffrida¹  Paolo Milella¹  Claudia Mainetti²  Simone Ganci²  Chiara Mapelli²  Laura Dell’Arti²  Marco Nassisi³  Francesco Viola³ 

[1] Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122, Milan, Italy;Ophthalmological Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy;Ophthalmological Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy;Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122, Milan, Italy;

关键词: Anti-VEGF;    Neovascular age-related macular degeneration;    Intravitreal injections;    COVID-19;   

DOI  :  10.1186/s12886-023-02864-x

 received in 2021-11-21, accepted in 2023-03-17,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectivesTo evaluate the outcomes of delayed intravitreal injections (IVIs) caused by the outbreak of coronavirus disease 2019 (COVID-19), in patients with neovascular age-related macular degeneration (nAMD).MethodsnAMD patients with scheduled IVIs between March 1st and April 30th, 2020 were stratified through a risk-based selection into a non-adherent group (NA-group) if they skipped at least one IVI and an adherent group (A-group) if they followed their treatment schedule. During the pandemic visit (v0), if a significant worsening of the disease was detected, a rescue therapy of three-monthly IVIs was performed. Multimodal imaging and best-corrected visual acuity (BCVA) findings were evaluated after 6 months (v6), compared between groups and with the visit prior the lockdown (v−1).ResultsTwo hundred fifteen patients (132 females, mean age: 81.89 ± 5.98 years) delayed their scheduled IVI while 83 (53 females, mean age: 77.92 ± 6.06 years) adhered to their protocol. For both groups, BCVA at v0 was significantly worse than v−1 (mean 4.15 ± 7.24 ETDRS letters reduction for the NA-group and 3 ± 7.96 for the A-group) but remained stable at v6. The two groups did not significantly differ in BCVA trends after 6 months and neither for development of atrophy nor fibrosis.ConclusionsA risk-based selection strategy and a rescue therapy may limit the long-term outcomes of an interruption of the treatment protocol in patients with nAMD.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 3