目的:评估治疗模式变化的影响,在COVID-19大流行期间和之后,先前治疗过的新生血管性年龄相关性黄斑变性(nAMD)患者的最佳矫正视力(BCVA)。
方法:多中心,回顾性,2019-2021年连续nAMD患者的观察性研究。收集的数据包括人口统计,BCVA,玻璃体内注射抗血管内皮生长因子(抗VEGF)和临床就诊的日期。
结果:共纳入1652例nAMD患者的1652只眼,其中850只眼在2019年进行了评估(COVID-19之前),2020年评估了630只眼(COVID-19),2021年评估了974只眼(COVID-19后)。在COVID-19期间,平均抗VEGF注射次数显著低于相应的COVID-19前和COVID-19后时期(分别为5.55和6.13和6.60,p<0.01)。与前几年和后几年相比,COVID-19期间观察到每名患者/月的注射比例持续较低,在3月至4月期间显着下降,2020年的比率为0.4,2019年为0.65,2021年为0.62(p<0.01)。基线BCVA(0.825,p<0.001),注射次数(-0.007,p<0.001),性别(-0.027,p=0.037)和年龄(0.004,p<0.001)是最终BCVA的显著预测因子.
结论:在COVID-19期间,与前一年相比,患者接受的玻璃体内注射抗VEGF治疗明显减少,并在下一年获得补偿.治疗模式的这些变化对BCVA结果没有显著影响。年龄,性别,基线BCVA和注射次数是最终视觉结果的预测因子。
OBJECTIVE: To evaluate the impact of the changes in treatment patterns before, during and after the COVID-19 pandemic on best-corrected visual acuity (BCVA) in previously treated neovascular age-related macular degeneration (nAMD) patients.
METHODS: A multi-centre, retrospective, observational study of consecutive nAMD patients during 2019-2021. Data collected included demographics, BCVA, dates of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections and clinic visits.
RESULTS: A total of 1652 eyes of 1652 nAMD patients were included, out of which 850 eyes were assessed in 2019 (pre-COVID-19), 630 eyes were assessed in 2020 (COVID-19) and 974 eyes were assessed in 2021 (post-COVID-19). During the COVID-19 period, the mean number of anti-VEGF injections was significantly lower than the corresponding pre-COVID-19 and post-COVID-19 periods (5.55 compared to 6.13 and 6.60, respectively p < 0.01). A constant lower ratio of injections per patient/month was observed during COVID-19 compared to previous and following years, with a notable decline during March-April, reaching a ratio of 0.4 in 2020 versus 0.65 in 2019 and 0.62 in 2021 (p < 0.01). Baseline BCVA (0.825, p < 0.001), number of injections (-0.007, p < 0.001), gender (-0.027, p = 0.037) and age (0.004, p < 0.001) were shown to be significant predictors of final BCVA.
CONCLUSIONS: During the COVID-19 period, patients were treated with significantly less intravitreal anti-VEGF injection compared to the previous year with compensation in the following year. These changes in treatment patterns did not have a significant impact on BCVA outcomes. Age, gender, baseline BCVA and number of injections are predictors of final visual outcomes.