June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Real impact and reasons for anti-VEGF treatment delay during Covid-19 pandemic lockdown in neovascular age-related macular degeneration: A national study
Author Affiliations & Notes
  • Javier Zarranz-Ventura
    Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
    Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Catalunya, Spain
  • Roberto Gallego Pinazo
    Clínica Oftalvist, Valencia, Valencia, Spain
  • Ruben Martin-Pinardel
    Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Catalunya, Spain
  • Laia Gomez
    Novartis Pharmaceuticals, Spain
  • Jose juan Escobar
    Hospital Dos de Maig, Barcelona, Catalunya, Spain
  • Footnotes
    Commercial Relationships   Javier Zarranz-Ventura Novartis Pharmaceuticals, Allergan, Bayer, Alcon, Alimera Sciences, Bausch and Lomb, Brill Pharma, DORC, Preceyes, Roche, Topcon, and Zeiss, Code C (Consultant/Contractor), Bayer, Allergan, Code R (Recipient); Roberto Gallego Pinazo Allergan, Bloss, Heidelberg Engineering, Horus Pharma, Novartis, Roche, Code C (Consultant/Contractor), Novartis, Roche, Syneos Health, Thrombogenics, Code R (Recipient); Ruben Martin-Pinardel None; Laia Gomez Novartis, Code E (Employment); Jose juan Escobar Novartis, Allergan, Bayer, Roche, Code C (Consultant/Contractor), Novartis, Allergan, Roche, Kodiak Sciences Inc., SamChunDang Pharm. Co. Ltd. , IVERIC BIO, INC., Boehringer Ingelheim, Code R (Recipient)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 341 – F0172. doi:
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      Javier Zarranz-Ventura, Roberto Gallego Pinazo, Ruben Martin-Pinardel, Laia Gomez, Jose juan Escobar; Real impact and reasons for anti-VEGF treatment delay during Covid-19 pandemic lockdown in neovascular age-related macular degeneration: A national study. Invest. Ophthalmol. Vis. Sci. 2022;63(7):341 – F0172.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess the visual impact and reasons for treatment delay during the COVID-19 pandemic lockdown in neovascular age-related macular degeneration (nAMD) patients in ongoing anti-VEGF therapy.

Methods : Retrospective, national, multicentre, observational study in nAMD patients treated with anti-VEGF therapy and registered in the Fight Retinal Blindness (FRB) Spain platform prior to lockdown. Study cohort was divided in timely treated patients (TTP) and delayed treatment patients (DTP). Mean change in best corrected visual acuity (BCVA, in ETDRS letters) from the last follow-up visit (FUV) before lockdown (BLD) (baseline [BL] visit) to the first FUV after lockdown (ALD) was assessed. A specific questionnaire was distributed to the participant centers to investigate further the reasons for treatment delay in all individual cases.

Results : A total of 245 eyes fulfilled the eligibility criteria, from which 39.6% were TTP (n=97) and 60.4% were DTP (n=148). TTP presented greater baseline and final BCVA compared to DTP (64.1 vs 58.7 letters, p=0.023, and 63.6 vs 57.1, p=0.004). BCVA loss was significantly greater for DTP vs TTP (-2.0 vs -0.6 letters, p=0.016). For DTP cohort, the primary reason for visit delay was patient decision (48.2%) followed by limited hospital clinic capacity (42.7%). When patients decided not to attend scheduled visits, the main reason was fear to Covid-19 infection (49.4%).

Conclusions : This study provides relevant data about the impact on visual outcomes of Covid-19 pandemic lockdown on nAMD patients and specifically provides new additional information regarding the main reasons for treatment and visits delay from both patients and healthcare service delivery perspectives.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

Figure 1: Mean BCVA change before and after lockdown for timely treated patients (TTP) and delayed treatment patients (DTP) cohorts. (CI: confidence interval, SD: standard deviation; Q: quartile; Min: minimum, Max: maximum)

Figure 1: Mean BCVA change before and after lockdown for timely treated patients (TTP) and delayed treatment patients (DTP) cohorts. (CI: confidence interval, SD: standard deviation; Q: quartile; Min: minimum, Max: maximum)

 

Figure 2. Reasons for visit delay. A: Hospital capacity vs patient decision, B: Reasons for visit cancelation/delay.

Figure 2. Reasons for visit delay. A: Hospital capacity vs patient decision, B: Reasons for visit cancelation/delay.

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