Effects of the COVID-19 Pandemic on Anti-vascular Endothelial Growth Factor Treatment in China

Yang, Kaibo; Feng, Hao; Zhang, Han

doi:10.3389/fmed.2020.576275

Cited by 35 publications

(47 citation statements)

References 8 publications

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“…During the lockdown, the national healthcare system focused on the prevention and management of COVID-19-related disease and emergency services only. In the majority of ophthalmology clinics in Greece, regular clinic visits, elective surgeries, scheduled intravitreal injections, and non-urgent eye conditions were deferred, as it also occurred in most countries worldwide [4][5][6][7][8]. In addition, many patients have themselves postponed their visits to ophthalmology clinics in order to avoid being exposed.…”

Section: Introductionmentioning

confidence: 99%

Effect of COVID-19-Associated Lockdown on Patients With Diabetic Retinopathy

Chatziralli¹,

Dimitriou²,

Kazantzis³

et al. 2021

Cureus

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To evaluate the effect of the coronavirus disease 2019 (COVID-19)-related lockdown in the management of patients with diabetic retinopathy (DR), including diabetic macular edema (DME), in a tertiary reference center in Greece. MethodsIn this retrospective study, we first compared the number of patients who were diagnosed with DR or DME in our clinic during the period of the lockdown and during the same period of the previous year. In addition, we included consecutive patients with DR or DME, who were followed up and treated regularly in our clinic and their appointments deferred due to lockdown, so as to compare the visual acuity, fundoscopy, and optical coherence tomography (OCT) findings prior to and post lockdown. ResultsDuring the lockdown period, there was a statistically significant decrease in patients with DR and DME as compared to the same period in the previous year. Regarding patients with previously diagnosed DME, there was a statistically significant worsening in their visual acuity and central retinal thickness after lockdown as compared to the last visit before lockdown (p<0.001 for both comparisons). Concerning patients diagnosed with DR and without DME before lockdown, 30% of patients with severe non-proliferative diabetic retinopathy (NDPR) and 8.3% of patients with quiescent proliferative DR (PDR) progressed to active PDR while four out of 107 patients (3.7%) developed DME during the lockdown. Multivariate regression analysis revealed that only the time interval between the last visit before lockdown and the first visit after the lockdown was associated with the best-corrected visual acuity (BCVA) change (p=0.017). ConclusionsThe COVID-19-related lockdown was related to the postponement in patient care, which resulted in significantly worse visual acuity outcomes in patients with DR.

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Section: Introductionmentioning

confidence: 99%

Effect of COVID-19-Associated Lockdown on Patients With Diabetic Retinopathy

Chatziralli¹,

Dimitriou²,

Kazantzis³

et al. 2021

Cureus

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“… 9 The results of the study evaluating the impact of the COVID-19 pandemic on anti-VEGF treatment in ophthalmology patients also demonstrated that longer treatment interruption was associated with worsened visual acuity. 18 Again, these findings emphasize the importance of normative, adequate course of anti-VEGF therapy in patients with CRVO-ME.…”

Section: Discussionmentioning

confidence: 82%

“…Anatomic and functional outcomes suggest that patients with anti-VEGF treatment interruptions are at risk for severe adverse visual sequelae. 18 In the CRUISE trial, 15.4% of patients in the group that received sham injections lost ≥15 letters (3 lines) from their baseline BCVA letter score at month 6, which is considered similar to the natural loss of visual acuity over a 6-month period. 5 A recent meta-analysis conducted for 24 studies determined that the pooled mean decrease was 10 letters in visual acuity from baseline to 6 months and 3 letters from baseline to ≥12 months for eyes with non-ischemic CRVO.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of Eyes Lost to Follow-Up in Patients with Central Retinal Vein Occlusion Who are Receiving Anti-Vascular Endothelial Growth Factor Treatment

Yang¹,

Liu²,

Feng³

et al. 2021

TCRM

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Background: To evaluate the anatomic and functional outcomes in eyes of patients with macular edema (ME) caused by central retinal vein occlusion (CRVO) who were lost to follow-up (LTFU) for more than 6 months following treatment with anti-vascular endothelial growth factor (VEGF) therapy and to determine the predictive factors of visual prognosis in these patients. Methods: This study was conducted as a retrospective, case series investigation. Patients whose eyes were receiving intravitreal anti-VEGF treatment for CRVO-ME, with the next follow-up visit occurring more than 6 months following treatment were identified. Baseline disease characteristics (at the last visit before being LTFU), cause and duration of treatment interruption, and the resulting disease progression, complications, and outcomes were assessed. Baseline characteristics predictive of visual outcome were also analyzed. Results: This study included a total of 17 eyes of 17 patients. The mean duration of being LTFU was 7.8 ± 2.1 months. On the return visit after being LTFU, 7 of 17 eyes (41.2%) developed neovascular complications. Despite treatment, 12 eyes (70.1%) lost ≥3 best-corrected visual acuity (BCVA) lines, with 2 eyes (11.8%) developing a final BCVA of hand motion or more severe. At the final visit, the mean logarithm of minimal angle of resolution (logMAR) BCVA deteriorated significantly compared to before being LTFU (P < 0.001). The increasing duration of being LTFU is associated with a deterioration of visual acuity prognosis. Conclusion:In CRVO-ME patients who are receiving anti-VEGF therapy, unintentional treatment interruptions can cause visually disastrous consequences, including irreversible blindness. Patients who were LTFU for a long period should be strongly warned about their poor visual prognosis.

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“… 37 In addition, a Chinese study showed that interruption of anti-VEGF treatments exposes patients at significative risk for severe adverse visual sequelae. 38 A USA team recently demonstrated that patients who missed a visit for intravitreal injection lost more vision than patients who completed the scheduled visits (no visit −5.024 ±1.88, canceled visit: −1.633 ±0.65, completed visits 0.373 ±0.50; p = 0.0028) so that a delay in care of even only 5.34 weeks resulted in vision loss (Italian lockdown lasted 9.857 weeks). 39 The population of diabetic subjects treated in Italy with intravitreal injection was estimated, starting from the fact that about 30% of the total intravitreal injections are administered to diabetic patients by an average of eight injections per year.…”

Section: Methodsmentioning

confidence: 99%

Economic Impact of COVID-19 Lockdown on Italian NHS: Focus on Diabetes Mellitus

Torre¹,

Colombo²,

Matteo³

et al. 2021

CEOR

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Background In Italy, the adoption of a total lockdown has generated almost total suspension of outpatient visits except for emergencies. Even after lockdown, the pandemic fear created additional barriers to access the health services. The aim of our study is to evaluate the economic impact of the lockdown for COVID-19 on public health in Italy, focusing on its effects on diabetic population. Materials and Methods We analyzed the impact of the lockdown on excess mortality and morbidity in the Italian diabetic population during 2020. The analysis was divided into several steps: a quantification of specialist visit reduction, the calculation of excess mortality in the diabetic population, the economic evaluation of the slowdown in the use of innovative diabetic therapies. Furthermore, the impact of the lockdown on the reduction of procedures and follow-up visits in diabetic population was evaluated. The overall impact of the pandemic and lockdown effects on costs and quality of life was then calculated. Results During 2020, a drop of 28% in patient access has been observed. Diabetic patients recorded a twice higher mortality value compared to general population (20.4% vs 10.2%). The analysis of market data revealed a slowdown in consumption of new antidiabetic therapies (−14%, 27% vs 41%). We estimated an expense of €26.6 million for NHS and a loss of 257 utilities in diabetic population due to the missed benefits related to slowdown in innovative antidiabetic drugs use and non-optimal follow-up and control of diabetes complications. In simulation scenarios, we also estimated an overall expenditure ranging from €38.7 to 94.0 million and a loss of 294–836 utilities. Conclusion Diabetic population paid a high tribute to pandemic and lockdown, both in terms of number of deaths and burden of diabetic complications, together with an overall deterioration of quality of life.

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Effects of the COVID-19 Pandemic on Anti-vascular Endothelial Growth Factor Treatment in China

Cited by 35 publications

References 8 publications

Effect of COVID-19-Associated Lockdown on Patients With Diabetic Retinopathy

Effect of COVID-19-Associated Lockdown on Patients With Diabetic Retinopathy

Outcomes of Eyes Lost to Follow-Up in Patients with Central Retinal Vein Occlusion Who are Receiving Anti-Vascular Endothelial Growth Factor Treatment

Economic Impact of COVID-19 Lockdown on Italian NHS: Focus on Diabetes Mellitus

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