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1.
Retina ; 42(4): 616-627, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1575997

ABSTRACT

PURPOSE: To evaluate the impact of the COVID-19 pandemic lockdowns on the outcomes of eyes treated for neovascular age-related macular degeneration, diabetic macular edema, and retinal vein occlusion in eight countries. METHODS: A multicenter international database study of 5,782 eyes (4,708 patients) receiving intravitreal antivascular endothelial growth factor injections before, during, and after national lockdowns. The baseline visit was defined as the last visit within 3 months before lockdown, and prelockdown and postlockdown periods were defined as 6 months before and after the lockdown date. RESULTS: Eyes with neovascular age-related macular degeneration (n = 4,649) lost vision in all countries in proportion to the reduced number of injections. The mean visual acuity change postlockdown ranged from -0.4 to -3.8 logarithm of the minimum angle of resolution letters, and the median number of injections/visits decreased from 4-5/4-7 to 2-4/2-4 postlockdown. The diabetic macular edema (n = 654) and retinal vein occlusion (n = 479) eyes' mean visual acuity change ranged from -2.8 to +1.7 letters and -1.6 to +0.1 letters, and the median number of injections/visits decreased from 2.5-5/4-6 to 1-3/2-4 and from 3-5.5/4-5 to 1-3.5/2-3.5, respectively. The 6-month dropout rates postlockdown were 20% for neovascular age-related macular degeneration, 27% for diabetic macular edema, and 28% for retinal vein occlusion. CONCLUSION: This international study provides estimates of the impact of COVID-19 pandemic lockdown on intravitreal therapy and suggests that prioritizing neovascular age-related macular degeneration eyes seems appropriate.


Subject(s)
COVID-19 , Diabetic Retinopathy , Macular Edema , Angiogenesis Inhibitors/therapeutic use , Blindness/drug therapy , COVID-19/epidemiology , Communicable Disease Control , Diabetic Retinopathy/complications , Diabetic Retinopathy/drug therapy , Diabetic Retinopathy/epidemiology , Humans , Intravitreal Injections , Macular Edema/drug therapy , Macular Edema/epidemiology , Pandemics , Ranibizumab/therapeutic use , Registries , Retrospective Studies , Treatment Outcome , Vascular Endothelial Growth Factor A
2.
ssrn; 2021.
Preprint in English | PREPRINT-SSRN | ID: ppzbmed-10.2139.ssrn.3889730

ABSTRACT

As COVID-19 threatens the food security of vulnerable populations across the globe, there is an increasing need to identify places that are affected most in order to target aid. We propose a two-step approach to predict changes in food insecurity risk caused by income shocks at a locality level only using existing household-level data and external information about income shocks. Using national household survey data between 2010 and 2018, we find that a 10% decrease in income leads to a 3.5% increase in food insecurity. We use the 2019 national Labor Force Survey to predict changes in food insecurity risk caused by the income shocks during the pandemic for 702 districts in Vietnam. We find that the small, predicted change in food insecurity at the national level masks substantial variation at the district level, and changes in food insecurity risk are higher among young children. Food relief policies, therefore, should prioritize a small number of districts predicted to be severely affected.


Subject(s)
COVID-19
3.
Eye (Lond) ; 35(10): 2793-2801, 2021 10.
Article in English | MEDLINE | ID: covidwho-947532

ABSTRACT

BACKGROUND/OBJECTIVE: Some clinicians may be forced to temporarily extend treatment intervals in neovascular age-related macular degeneration (nAMD) eyes with frequent retreatments to reduce the number of visits during the COVID-19 pandemic. To provide an indication of what these outcomes may be, we studied eyes with active lesions with unplanned treatment interval extensions before the pandemic occurred. METHODS: We compared eyes with active disease despite ≤6 weekly injections whose next injection was extended to ≥7 weeks and those whose intervals were not extended. We identified 1559 (16%) of 9602 eyes from the Fight Retinal Blindness! (FRB!) registry (2013 and 2018) that fit this criteria. Eyes were further stratified into four groups by the mean interval over the following 6 months: (1) ≤6 weeks (81%), (2) 7-9 weeks (9%), (3) 10-12 weeks (5%) and (4) >12 weeks (5%). RESULTS: There was a significant loss in VA in eyes extended to >12 weeks compared to the non-extended group (adjusted VA change, mean (95% CI): ≤6 weeks, 0.4 (-1.5 to 2.2), versus >12 weeks, -4.7 (-7.4 to -2.1), letters, p = 0.03 and a threefold increase in relative risk of losing ≥15 letters (absolute risk (14% versus 4%, p < 0.01)). CONCLUSION: Mean VA remained stable for 6 months in eyes requiring frequent treatment despite retreatment interval extension up to 10-12 weeks. There was a significant short-term risk to vision when retreatment interval was extended beyond 12 weeks, hence extensions to this level should be considered cautiously. These data may be useful for physicians who are considering reducing visits to mitigate the risk of COVID-19.


Subject(s)
COVID-19 , Wet Macular Degeneration , Angiogenesis Inhibitors/therapeutic use , Follow-Up Studies , Humans , Intravitreal Injections , Pandemics , Ranibizumab/therapeutic use , Retreatment , SARS-CoV-2 , Treatment Outcome , Vascular Endothelial Growth Factor A/therapeutic use , Visual Acuity , Wet Macular Degeneration/drug therapy
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