Abstract
Purpose :
Diabetic macular oedema (DMO) is the comments cause of vision loss in patients with diabetes. As per the Royal College of ophthalmologist of the UK guidelines during the 2020 COVID-19 pandemic, in an effort to reduce injection and clinic visit frequency, and to minimize the risk of exposure of patients and healthcare staff many patients attending the eye unit had their appointments and treatment postponed. Patients diabetic retinopathy were offered clinic review and treatment during this time but many of these patients chose not to attend their appointments because they were at high risk from the virus.
To evaluate the impact of delays in anti_VEGF treatment during the pandemic at a single university hospital clinic. Specifically, to identify the gap in treatment, and to examine the impact of this on visual acuity and anatomical outcomes.
Methods :
Retrospective data collection from the electronic medical record system (medisoft ophthalmology), and OCT scans of patients with DMO. Patients were included if they have active diagnosis of DMO with Anti-VEGF treatment in the 12 weeks prior to national lockdown and restriction of services. Exclusion criteria included patients with no follow up visits.
Results :
Average gap in treatment is16.5 (range) weeks and Average reduction of the best corrected visual acuity from last recorded before treatment gap to visual acuity when patient was reviewed, or treatment restarted was -0.15. (P > 0.05). One patient showed progression of his diabetic retinopathy to proliferative stage.
Conclusions :
Information was gathered for 328 patients (125 F, 203 M), who were treated with Anti-VEGF between 01/01/2020 & 01/09/2020
Preliminary data analysis of 134 eyes of 105 consecutive patients showed average gap in treatment of 13.2 (10-31) weeks. The average reduction of the best corrected visual acuity from last recorded before treatment gap to visual acuity when patient was reviewed, or treatment restarted was -0.05 LogMar. (P > 0.05) with mean VA 0.4 (range 0-1.6 LogMar) pre break and mean VA post treatment of 0.45 LogMar (range 0.06-1.6). 27/134 lost 5 letters or more of vision, 6 eyes lost 15 letters, 63 were within +/-5 letters of baseline vision.
One patient showed progression of his diabetic retinopathy to proliferative stage, and two patients showed improvement in their DMO after their treatment gap, and their Anti-VEGF treatment was stopped.
This is a 2021 ARVO Annual Meeting abstract.