The effect of a brief, unplanned treatment delay on neovascular age-related macular degeneration patients: a retrospective cohort study

Zehden, Jason; Ghosh, Arko; Soundararajan, Srinath; Tsujimoto, Tamy; Jiang, Huijun; Lin, Feng‐Chang; Blahnik, T.; Fleischman, David; Zhang, Alice Yang

doi:10.1038/s41598-023-29819-y

Cited by 2 publications

(1 citation statement)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Zehden et al chose to compare historic data from a separate matched cohort of patients to patients with care delay and noted a decline in visual acuity and an increase in central macular thickness at the visit upon care resumption, but these factors stabilized by the third visit at least 4 months after care resumption 20 . Zehden et al’s methodology helps to bypass the issues discussed above and is more consistent with our findings in that long-term outcomes appear to show a stabilization in visual acuity.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes in neovascular age-related macular degeneration: a cohort study of patients with care delay due to the COVID-19 pandemic

Janetos,

Zandi,

Younessi

et al. 2023

Sci Rep

View full text Add to dashboard Cite

The COVID-19 pandemic has led to both intentional and unintentional care delay among age-related neovascular macular degeneration (nvAMD) patients. Prior studies have demonstrated that patients who discontinue nvAMD treatment for prolonged intervals are at high risk for vision loss, but less is known regarding shorter-term delay, such as during the height of the pandemic. Previous studies have looked at COVID-19 related delay in care and have shown a loss of visual acuity (VA) among these patients, but studies are limited by short follow-up or insufficient comparisons. This was an observational cohort study of nvAMD patients from March 1, 2019, through July 1, 2021, who experienced care delay. VA was modeled using a linear longitudinal mixed-effects model comparing historic data pre-lockdown to data post-lockdown. Covariates included baseline anatomic variables, demographic variables, and time intervals (treatment interval, delay interval). Secondary anatomic and treatment outcomes were modeled using a multilevel binary logistic regression model. 163 eyes among 116 patients were included. Initial longitudinal mixed-effects models found that although overall VA decreased at a yearly rate, when comparing pre-lockdown and post-lockdown time periods, VA slopes were not statistically different. Single-covariate longitudinal models showed that age, sex, and delay interval significantly affected VA slope. The multivariate longitudinal model found that a longer delay interval significantly decreased rate of VA loss. Multilevel binary logistic regression models showed a significant increase in odds of anti-VEGF treatment, presence of subretinal fluid, and macular hemorrhages in the post-lockdown period. Overall, when compared to historic data, rate of VA loss among our cohort did not vary significantly in pre-versus post-lockdown time periods, although treatment and anatomic variables did worsen post-lockdown suggesting that patients may be appropriately delayed but this comes at the risk of increased need for treatment.

show abstract

Section: Discussionmentioning

confidence: 99%