Delayed anti-VEGF injections during the COVID-19 pandemic and changes in visual acuity in patients with three common retinal diseases: A systematic review and meta-analysis.
Surv Ophthalmol
; 67(6): 1593-1602, 2022.
Article
in English
| MEDLINE | ID: covidwho-1984091
ABSTRACT
The COVID-19 pandemic disrupted the regular injections of anti-vascular endothelial growth factor (anti-VEGF) in patients with various retinal diseases globally. It is unclear to what extent delayed anti-VEGF injections have worsened patients' visual acuity. We performed a meta-analysis to assess the impact of delayed anti-VEGF injections on the best-corrected visual acuity (BCVA) in patients with neovascular age-related macular degeneration (nAMD), retinal vein occlusion (RVO), and diabetic macular edema (DME). We searched four computer databases (EMBASE, MEDLINE, Web of Science, Scopus) from inception to January 5, 2022. Data were pooled using the random-effects model. Results were reported by less than 4 months and 4 months or longer for the time period between the first injection during the pandemic and the last pre-pandemic injection. All BCVA measures were converted to the logarithm of the minimum angle of resolution (logMAR) for analyses. Among patients who received injections 4 months or longer apart, the mean difference in BCVA was 0.10 logMAR (or 5 ETDRS letters) (95% confidence interval [CI] 0.06â¼0.14) for nAMD patients, 0.01 logMAR (orâ¼ 1 ETDRS letter) (95% CI -0.25â¼0.27) for RVO patients, and 0.03 logMAR (or â¼1 ETDRS letters) (95% CI -0.06â¼0.11) for DME patients. These results suggest that patients with nAMD needing scheduled anti-VEGF injections may require priority treatment over those with RVO and DME in the event of disturbed anti-VEGF injections from COVID-19 lockdowns or similar scenarios.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Retinal Diseases
/
Retinal Vein Occlusion
/
Macular Edema
/
Diabetic Retinopathy
/
COVID-19
Type of study:
Randomized controlled trials
/
Reviews
/
Systematic review/Meta Analysis
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
Surv Ophthalmol
Year:
2022
Document Type:
Article
Affiliation country:
J.survophthal.2022.08.002
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