COVID-19 pandemic lockdown international impact on nAMD, DME and RVO intravitreal therapy outcomes: Fight Retinal Blindness International registry

Abstract

Purpose : To evaluate the impact of COVID-19 pandemic lockdown on the clinical outcomes of an international cohort of neovascular AMD (nAMD), diabetic macular edema (DME) and retinal vein occlusion (RVO) treated eyes in eight countries: Australia, France, Ireland, Italy, Netherlands, New Zealand, Spain and Switzerland.

Methods : Multicenter international nAMD, DME and RVO database observational study. Data was internationally collected using a validated web-based tool (Fight Retinal Blindness! Project). Baseline visit was defined as the closest visit prior (up to 3 months) to the initial lockdown date, which differed by country. Pre- and post-lockdown periods were defined as 6 months prior and post-baseline visit. Data collected included: demographics, visual acuity (VA) in logarithm of the minimum angle of resolution (logMAR) ETDRS letters at baseline and pre- and post-baseline visits, number of injections and visits.

Results : 5271 eyes of 4288 patients were included. In nAMD eyes (n=4240), mean VA change post-lockdown ranged from -0.3 to -3.3 letters, and the median number of injections/visits decreased from a pre-lockdown range of 4-5/4-7 to a range of 2-4/2-4 post-lockdown, respectively. In DME eyes (n=605), mean VA change ranged from -4 to +2.3 letters, and the median number of injections/visits decreased from a pre-lockdown range of 2-5/4-6.5 to 1-3/2-3. In RVO eyes (n=426), mean VA change ranged from -2.4 to +3 letters, and the median number of injections/visits decreased from a range of 3-7/4-7.5 to 1-6/2.5-6 post-lockdown. The dropout rates for the 6 months post-lockdown period were 34% for nAMD (n=1458), 43% for DME (n=264) and 44% for RVO (n=188). Study drugs included ranibizumab (33.5%,), aflibercept (50.9%) and bevacizumab (15.5%).

Conclusions : This study provides accurate estimates of the impact of COVID-19 pandemic lockdown on the visual outcomes of an international cohort of eyes treated with intravitreal therapy. The data reported in this study may serve clinicians to prepare strategies to mitigate vision loss in future scenarios of the COVID-19 pandemic evolution.

This is a 2021 ARVO Annual Meeting abstract.

 

Mean visual acuity for patients (Cohort 1) in the 6 months prior to the baseline (lockdown) visit, at baseline, and 6 months after the baseline visit stratified by country.