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DOI: 10.1055/a-1830-0505
The Impact of the COVID-19 Pandemic on the Quality of Care of Treatment-Naïve Patients with Neovascular Age-Related Macular Degeneration Receiving Intravitreal Aflibercept
Article in several languages: deutsch | EnglishAbstract
Objective The aim of this study was to compare the quality of care received by treatment-naïve patients with neovascular age-related macular degeneration (nAMD) who received intravitreal aflibercept therapy before the coronavirus disease 2019 (COVID-19) pandemic with patients who received the same therapy during the pandemic.
Methods Data, including best corrected visual acuity (BCVA) as the logarithm of the minimum angle of resolution (logMAR) and anatomical outcomes at diagnosis and at each follow-up, was collected on 297 treatment-naïve patients who received intravitreal aflibercept. Therapy-naïve patients who started therapy at least 24 months prior to the first pandemic-related lockdown and were thus treated exclusively prior to the pandemic (n = 123) were compared with patients who started therapy within 12 months prior to the first lockdown and were thus treated during the pandemic (n = 174). Both groups were followed over a two-year period.
Results In patients treated before the COVID-19 pandemic, VA remained stable (0.58 ± 0.41 logMAR) compared to baseline (0.54 ± 0.34 logMAR; p = 0.228) until the end of the observation period. In patients treated during the COVID-19 pandemic, BCVA dropped below the baseline (0.56 ± 0.35 logMAR) within 24-month of follow-up (0.79 ± 0.43 logMAR; p = 0.010). Compared to the patients treated prior to the COVID-19 pandemic, the latter group showed a significantly worse VA at the 6-month (p = 0.041), 12-month (p = 0.040), 18-month (p = 0.024), 21-month (p = 0.035), and 24-month (p = 0.004) follow-up. Additionally, the group treated during the COVID-19 pandemic received significantly fewer aflibercept injections (3,94 ± 1,9 vs. 3,30 ± 1,6; p = 0,007) and fewer follow-up examinations (2,71 ± 1,2 vs. 2,16 ± 0,9; p < 0,001) in the second year compared to the group that was treated before the COVID-19 pandemic.
Conclusion We confirmed significantly worse VA outcomes in the group of nAMD patients treated during the COVID-19 pandemic. Impeded access to care could be attributed to the restrictions imposed owing to the COVID-19 pandemic.
Publication History
Received: 10 February 2022
Accepted: 12 April 2022
Accepted Manuscript online:
20 April 2022
Article published online:
04 August 2022
© 2022. Thieme. All rights reserved.
Georg Thieme Verlag KG
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References/Literatur
- 1 Wu Y, Ho W, Huang Y. et al. SARS-CoV-2 is an appropriate name for the new coronavirus. Lancet 2020; 395: 949-950 DOI: 10.1016/S0140-6736(20)30557-2.
- 2 Sohrabi C, Alsafi Z, OʼNeill N. et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg 2020; 76: 71-76 DOI: 10.1016/j.ijsu.2020.02.034.
- 3 Greco F, Altieri VM, Esperto F. et al. Impact of COVID-19 Pandemic on Health-Related Quality of Life in Uro-oncologic Patients: What Should We Wait For?. Clin Genitourin Cancer 2021; 19: e63-e68 DOI: 10.1016/j.clgc.2020.07.008.
- 4 Rodríguez-Leor O, Cid-Álvarez B, Ojeda S. et al. Impact of the COVID-19 pandemic on interventional cardiology activity in Spain. REC: interventional cardiology (English Edition) 2020. DOI: 10.24875/recice.m20000123
- 5 Tapper EB, Asrani SK. The COVID-19 pandemic will have a long-lasting impact on the quality of cirrhosis care. J Hepatol 2020; 73: 441-445 DOI: 10.1016/j.jhep.2020.04.005.
- 6 Del Vecchio Blanco G, Calabrese E, Biancone L. et al. The impact of COVID-19 pandemic in the colorectal cancer prevention. Int J Colorectal Dis 2020; 35: 1951-1954 DOI: 10.1007/s00384-020-03635-6.
- 7 dellʼOmo R, Filippelli M, Semeraro F. et al. Effects of the first month of lockdown for COVID-19 in Italy: A preliminary analysis on the eyecare system from six centers. Eur J Ophthalmol 2021; 31: 2252-2258 DOI: 10.1177/1120672120953074.
- 8 Yang KB, Feng H, Zhang H. Effects of the COVID-19 Pandemic on Anti-vascular Endothelial Growth Factor Treatment in China. Front Med (Lausanne) 2020; 7: 576275 DOI: 10.3389/fmed.2020.576275.
- 9 Stattin M, Haas AM, Ahmed D. et al. Evaluation of a calculation model to estimate the impact of the COVID-19 pandemic lockdown on visual acuity in neovascular AMD. Eur J Ophthalmol 2021; DOI: 10.1177/11206721211052389.
- 10 Schmidt-Erfurth U, Kaiser PK, Korobelnik JF. et al. Intravitreal Aflibercept Injection for Neovascular Age-related Macular Degeneration: Ninety-Six–Week Results of the VIEW Studies. Ophthalmology 2014; 121: 193-201 DOI: 10.1016/j.ophtha.2013.08.011.
- 11 Comparison of Age-related Macular Degeneration Treatments Trials (CATT) Research Group. Maguire MG, Martin DF, Ying GS. et al. Five-Year Outcomes with Anti-Vascular Endothelial Growth Factor Treatment of Neovascular Age-Related Macular Degeneration: The Comparison of Age-Related Macular Degeneration Treatments Trials. Ophthalmology 2016; 123: 1751-1761 DOI: 10.1016/j.ophtha.2016.03.045.
- 12 Evans RN, Reeves BC, Maguire MG. et al. Associations of Variation in Retinal Thickness With Visual Acuity and Anatomic Outcomes in Eyes With Neovascular Age-Related Macular Degeneration Lesions Treated With Anti-Vascular Endothelial Growth Factor Agents. JAMA Ophthalmol 2020; 138: 1043-1051 DOI: 10.1001/jamaophthalmol.2020.3001.
- 13 Stattin M, Ahmed D, Graf A. et al. The Effect of Treatment Discontinuation During the COVID-19 Pandemic on Visual Acuity in Exudative Neovascular Age-Related Macular Degeneration: 1-Year Results. Ophthalmol Ther 2021; 10: 935-945 DOI: 10.1007/s40123-021-00381-y.
- 14 Yeter DY, Dursun D, Bozali E. et al. Effects of the COVID-19 pandemic on neovascular age-related macular degeneration and response to delayed Anti-VEGF treatment. J Fr Ophtalmol 2021; 44: 299-306 DOI: 10.1016/j.jfo.2021.02.001.
- 15 Soares RR, Mellen P, Garrigan H. et al. Outcomes of Eyes Lost to Follow-up with Neovascular Age-Related Macular Degeneration Receiving Intravitreal Anti-Vascular Endothelial Growth Factor. Ophthalmol Retina 2020; 4: 134-140 DOI: 10.1016/j.oret.2019.07.010.
- 16 Matsunaga DR, Salabati M, Obeid A. et al. Outcomes of Eyes With Diabetic Macular Edema That Are Lost to Follow-up After Anti-Vascular Endothelial Growth Factor Therapy. Am J Ophthalmol 2022; 233: 1-7 DOI: 10.1016/j.ajo.2021.06.028.
- 17 Salabati M, Mahmoudzadeh R, Wong JC. et al. Outcomes of eyes with retinal vein occlusion that are lost to follow-up after antivascular endothelial growth factor therapy. Br J Ophthalmol 2021; DOI: 10.1136/bjophthalmol-2021-319180.
- 18 Lazzerini M, Barbi E, Apicella A. et al. Delayed access or provision of care in Italy resulting from fear of COVID-19. Lancet Child Adolesc Health 2020; 4: e10-e11 DOI: 10.1016/S2352-4642(20)30108-5.
- 19 Pinggera D, Kerschbaumer J, Grassner L. et al. Effect of the COVID-19 Pandemic on Patient Presentation and Perception to a Neurosurgical Outpatient Clinic. World Neurosurg 2021; 149: e274-e280 DOI: 10.1016/j.wneu.2021.02.037.
- 20 Wong LE, Hawkins JE, Langness S. et al. Where Are All the Patients? Addressing Covid-19 Fear to Encourage Sick Patients to Seek Emergency Care. NEJM Catal 2020; DOI: 10.1056/CAT.20.0193.
- 21 World Health Organization (WHO). Model List of Essential Medicines. 21st List 2019. Im Internet (Stand: 14.12.2021): https://apps.who.int/iris/bitstream/handle/10665/325771/WHO-MVP-EMP-IAU-2019.06-eng.pdf
- 22 Comparison of Age-related Macular Degeneration Treatments Trials (CATT) Research Group. Martin DF, Maguire MG, Fine SL. et al. Ranibizumab and bevacizumab for treatment of neovascular age-related macular degeneration: two-year results. Ophthalmology 2012; 119: 1388-1398 DOI: 10.1016/j.ophtha.2012.03.053.
- 23 Holz FG, Tadayoni R, Beatty S. et al. Multi-country real-life experience of anti-vascular endothelial growth factor therapy for wet age-related macular degeneration. Br J Ophthalmol 2015; 99: 220-226 DOI: 10.1136/bjophthalmol-2014-305327.
- 24 Mantel I. Optimizing the Anti-VEGF Treatment Strategy for Neovascular Age-Related Macular Degeneration: From Clinical Trials to Real-Life Requirements. Transl Vis Sci Technol 2015; 4: 6 DOI: 10.1167/tvst.4.3.6.
- 25 Wolf A, Kampik A. Efficacy of treatment with ranibizumab in patients with wet age-related macular degeneration in routine clinical care: data from the COMPASS health services research. Graefes Arch Clin Exp Ophthalmol 2014; 252: 647-655 DOI: 10.1007/s00417-013-2562-6.
- 26 Kim JH, Chang YS, Kim JW. Natural Course Of Patients Discontinuing Treatment For Age-Related Macular Degeneration And Factors Associated With Visual Prognosis. Retina 2017; 37: 2254-2261 DOI: 10.1097/IAE.0000000000001494.