June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Intended versus actual intervals between intravitreal anti-VEGF injections and assessment of treatment delays
Author Affiliations & Notes
  • NICOLE Anisha SOMANI
    Ophthalmology, Baylor College of Medicine, Houston, Texas, United States
  • Daniel Olson
    Ophthalmology, Baylor College of Medicine, Houston, Texas, United States
  • Jeel Jainesh Metha
    Ophthalmology, Baylor College of Medicine, Houston, Texas, United States
  • Dylan McBee
    Ophthalmology, Baylor College of Medicine, Houston, Texas, United States
  • Austin Huang
    Ophthalmology, Baylor College of Medicine, Houston, Texas, United States
  • Anshul Bhatnagar
    Ophthalmology, Baylor College of Medicine, Houston, Texas, United States
  • Christina Weng
    Ophthalmology, Baylor College of Medicine, Houston, Texas, United States
  • Footnotes
    Commercial Relationships   NICOLE SOMANI None; Daniel Olson None; Jeel Metha None; Dylan McBee None; Austin Huang Corza, Code C (Consultant/Contractor); Anshul Bhatnagar None; Christina Weng Alcon, Alimera Sciences, Abbvie/Allergan, Regeneron, REGENXBIO, DORC, Novartis, Genentech, Opthea, Code C (Consultant/Contractor)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2712. doi:
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      NICOLE Anisha SOMANI, Daniel Olson, Jeel Jainesh Metha, Dylan McBee, Austin Huang, Anshul Bhatnagar, Christina Weng; Intended versus actual intervals between intravitreal anti-VEGF injections and assessment of treatment delays. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2712.

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

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Abstract

Purpose : To compare the intended versus actual follow-up interval in county hospital and private clinic patients receiving anti-vascular endothelial growth factor (VEGF) injections for diabetic macular edema (DME), retinal vein occlusion (RVO), or wet age-related macular degeneration (AMD).

Methods : Retrospective chart review of Ben Taub General Hospital and Baylor College of Medicine patients treated 1/1/2017-3/1/2022 with anti-VEGF intravitreal injections for AMD, DME, or RVO. Statistical analysis was performed using Python and Excel. For each injection, the “delta” was defined as the time between actual and intended follow-up interval. Analyses were performed on a per-injection, per-patient, and per-eye basis. P<0.05 represented statistical significance.

Results : 1,881 injections (172 patients) were included in the analysis. Amongst county hospital patients (n=106), mean age was 61.1 years and most were Hispanic (63.5%). Amongst private clinic patients (n=66), mean age was 75.8 years and most were Caucasian (64.6%). Overall, the mean delta per injection was 8.4 days; the mean delta per patient was 8.3 days. A significant proportion of injections had a clinically significant delta >7 days (24.5%, 95% CI, 0.226-0.264); more of these were observed in the county versus private cohort (30.5% <county>vs. 18.1% <private>, p<0.0001). Amongst injections with a delta >7 days, the mean delta was 33.62 days. No clinically significant delta >7 days was observed for AMD patients; there was a clinically significant delta >7 days in DME and RVO patients, but no difference based on practice setting (DME: 9.92 days <county> vs. 12.50 days <private>; p = 0.283, RVO: 21.42 days <county> vs. 9.04 days <private>; p = 0.509). Visual acuity improved by an average of -0.0338 logMAR for eyes with delays >7 days versus -0.0027 logMAR for eyes with delays ≤7 days (p=0.554).

Conclusions : Nearly one-quarter of anti-VEGF injections were received at least one week later than intended; amongst injections delayed by >7 days, the average delay exceeded one month. The proportion of delayed injections and the extent of delay were greater in the county hospital versus private clinic setting. Greater delays were associated with injections for DME and RVO versus AMD. Eyes with longer delays trended towards lower visual gains. Efforts to improve schedule adherence are warranted in order to optimize visual outcomes for patients.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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