Background: Intravitreal injections (IVI) of anti-vascular endothelial growth factor (anti-VEGF) agents have become the most prevalent intraocular procedure as they represent the major therapeutic modality for prevalent retinal conditions such as age-related macular degeneration (AMD) and diabetic retinopathy. Effective therapy requires adherence to a schedule of iterative IVI as well as routine clinic appointments. The ongoing Coronavirus disease 2019 (COVID-19) pandemic has resulted in the reduction of attendance at scheduled clinics visits and IVI. In this study we attempted to analyze the effect of COVID-19 on compliance with anti-VEGF therapy.Methods: A total of 636 eyes received injections during a four-week period of the COVID-19 outbreak in the Retina Clinic. The number of clinic visits for IVI during one month from March 15 to April 14 of 2020 was compared to the similar time period in each of the last four years.Results: The study demonstrates a decrease in clinic visits for IVI when compared with the same four-week interval in the four previous years. Based on the trend of the previous four years, 10.2% of the year’s total was expected for this time period. Using this model, the 636 reported number of injections for the March-April, 2020 period was ~ 5%. This represents a decrease of ~50% of the expected IVI for this time period.Conclusion: The COVID-19 outbreak in Israel severely impacted compliance with anti-VEGF treatments.
Objectives The aim of the study was to describe time intervals between pessary maintenance visits in racially diverse women receiving care in a U.S. epicenter of the COVID-19 pandemic. We secondarily aimed to determine whether time interval between pessary changes is associated with adverse outcomes and to identify factors associated with adverse pessary outcomes. Methods We performed a retrospective study of women undergoing pessary care after the COVID-19 pandemic began. Time between the most recent visit before the pandemic and first visit after the pandemic began was recorded. Pessary care data were collected from the latter visit, including vaginal bleeding, vaginal discharge, and erosion. Patient-reported symptoms and demographics were also recorded. The relationship between time interval between pessary visits and adverse outcomes as well as between adverse outcomes and demographic data was assessed. Results We identified 104 women undergoing pessary care, of which 35.6% were Hispanic and 32.7% were Black and 26.2% ± 10.5% lived in poverty. The median time to in-person visit was 4.5 months (interquartile range, 3.7–5.3 months). Seven women (8.7%) had vaginal bleeding, 15 (14.6%) had vaginal discharge, and 7 (6.8%) had erosions. There was no significant association between time interval between pessary visits and adverse outcomes or between adverse outcomes and patient characteristics (all P > 0.05). Conclusions Longer duration of time between pessary maintenance visits is not associated with increased adverse outcomes in this group of racially diverse women. Extended intervals between pessary visits can be considered to minimize risk and maintain patient safety during challenging circumstances, such as the COVID-19 pandemic.
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