Abstract
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.
Key words COVID-19 - pandemic - age-related macular degeneration - quality of care
