COVID-related injection reductions in wet AMD correlated with worse visual outcomes
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NEW ORLEANS — Most patients with wet age-related macular degeneration were able to quickly resume treatment after initial COVID-19 lockdowns, but those who missed more injections had worse visual outcomes, according to a study.
In a presentation at Retina Subspecialty Day at the American Academy of Ophthalmology meeting, Mark Gillies, MD, PhD, presented data from the “Fight Retinal Blindness!” study that looked at the real-world implications of COVID-19 disruptions to ophthalmic services and how they differed by retinal disease and country.
Researchers looked at patients’ last injection visit before lockdown and analyzed 6 months before and 6 months after lockdown to find visual acuity change, number of injections and visits, as well as dropout rates. Data were included for eight countries: Austria, France, Ireland, Italy, the Netherlands, New Zealand, Spain and Switzerland.
Gillies and colleagues found that there was a reduction in injections across all countries after the initial lockdown, with larger reductions in Ireland, Italy, New Zealand and Spain. They also identified mild-moderate vision loss in Ireland, Italy and Spain for wet AMD in the 6 months after lockdown.
Additionally, they observed a long treatment interval for the first injection after the initial lockdown, indicating at least one missed injection. Among patients with wet AMD, 20% failed to complete 6 months of follow-up and 11% had no visits at all post-lockdown.
Despite identifying higher dropout rates and more missed injections among patients with diabetic macular edema and retinal vein occlusion, vision loss was generally stable or mild across all countries, Gillies said.
“This gives us some evidence to suggest that we should prioritize eyes with neovascular macular degeneration in circumstances such as this,” he said.
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Gillies M. International impact of the COVID-19 pandemic lockdown on intravitreal therapy outcomes. Presented at: American Academy of Ophthalmology meeting; Nov. 12-15, 2021; New Orleans.
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