Martin Stattin1,2, Daniel Ahmed1,2, Alexandra Graf3, Anna-Maria Haas1,2, Stefan Kickinger1,2, Michael Jacob1, Katharina Krepler1,2, Siamak Ansari-Shahrezaei4,5,6,7. 1. Karl Landsteiner Institute for Retinal Research and Imaging, Vienna, Austria. 2. Medical Retina Unit, Clinic Landstraße, Department of Ophthalmology, Vienna Healthcare Group, Juchgasse 25, 1030, Vienna, Austria. 3. Center for Medical Statistic, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria. 4. Karl Landsteiner Institute for Retinal Research and Imaging, Vienna, Austria. siamak.ansarishahrezaei@gesundheitsverbund.at. 5. Medical Retina Unit, Clinic Landstraße, Department of Ophthalmology, Vienna Healthcare Group, Juchgasse 25, 1030, Vienna, Austria. siamak.ansarishahrezaei@gesundheitsverbund.at. 6. Medical School, Sigmund Freud University Vienna, Campus Prater Freudplatz 3, 1020, Vienna, Austria. siamak.ansarishahrezaei@gesundheitsverbund.at. 7. Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 1, 8036, Graz, Austria. siamak.ansarishahrezaei@gesundheitsverbund.at.
Abstract
INTRODUCTION: To evaluate the effect of a 9-week treatment deferral due to healthcare restrictions caused by Austria's first governmental lockdown associated with the coronavirus disease 2019 (COVID-19) pandemic on visual acuity (VA) in eyes compromised by exudative neovascular age-related macular degeneration (nAMD) after 1 year. METHODS: Retrospective data collection of 98 eyes (98 patients) with a treatment discontinuation at a tertiary eye care center (Clinic Landstraße, Vienna Healthcare Group, Austria) between March 16 and May 4, 2020. Prior to the lockdown, patients received multiple intravitreal injections (IVI) of anti-vascular endothelial growth factor with a personalized treatment interval for 3 years on average and at least three IVI after the lockdown. RESULTS: When the treatment interval doubled to 117.6 ± 31.4 days in spring 2020, patients lost 2.2 ± 4.6 ETDRS letters (p = 0.002) on average before reinitiating therapy. In total, 4.1 ± 8.1 letters (p < 0.0001) were lost despite continuous individual re-treatment over the course of the next year. In a univariate analysis, the extended interval time remained statistically significant (p < 0.0001), indicating a larger VA reduction within intervals with increasing interval time in days. CONCLUSION: The short-term treatment interruption had a persistent negative impact on the VA course of eyes under therapy after 1 year. Continuous therapy independent of the underlying treatment regimen remains of utmost importance in exudative nAMD. Our data should create awareness to regulators regarding future decisions despite the global pandemic.
INTRODUCTION: To evaluate the effect of a 9-week treatment deferral due to healthcare restrictions caused by Austria's first governmental lockdown associated with the coronavirus disease 2019 (COVID-19) pandemic on visual acuity (VA) in eyes compromised by exudative neovascular age-related macular degeneration (nAMD) after 1 year. METHODS: Retrospective data collection of 98 eyes (98 patients) with a treatment discontinuation at a tertiary eye care center (Clinic Landstraße, Vienna Healthcare Group, Austria) between March 16 and May 4, 2020. Prior to the lockdown, patients received multiple intravitreal injections (IVI) of anti-vascular endothelial growth factor with a personalized treatment interval for 3 years on average and at least three IVI after the lockdown. RESULTS: When the treatment interval doubled to 117.6 ± 31.4 days in spring 2020, patients lost 2.2 ± 4.6 ETDRS letters (p = 0.002) on average before reinitiating therapy. In total, 4.1 ± 8.1 letters (p < 0.0001) were lost despite continuous individual re-treatment over the course of the next year. In a univariate analysis, the extended interval time remained statistically significant (p < 0.0001), indicating a larger VA reduction within intervals with increasing interval time in days. CONCLUSION: The short-term treatment interruption had a persistent negative impact on the VA course of eyes under therapy after 1 year. Continuous therapy independent of the underlying treatment regimen remains of utmost importance in exudative nAMD. Our data should create awareness to regulators regarding future decisions despite the global pandemic.
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