Author: Juan Marín Nieto (Spain)
Co-authors: María Victoria Segura Fernández-Noguera, Juan Yanguas Lucena
The rapid spread of coronavirus infections at the beginning of 2020 forced a lockdown in most countries during the months of March, April and May. This lockdown carried consequences in most of the medical fields. In Ophthalmology, a decrease in the number of patients attending intravitreal injections was noted. Despite the warning of worsening in case of not attending these appointments as well as a series of measures to guarantee hygiene, many patients prefer not to leave their home. We present here the frequency of assistance to intravitreal injection of anti-VEGF during these months, indicating how they varied throughout the lockdown and dividing the sample depending on the type of pathology as well as type of treatment: Ranibizumab (Lucentis ®) or Aflibercept (Eylea ®).
Tertiary level hospital. Department of Retina.
Attendance at intravitreal injections of antiVEGF was recorded during a total of 9 weeks in the period from the 15th of March 2020 (beginning of lockdown) to 10th of May 2020 (when lockdown measures started to allow displacements as well as going to medical centers). The sample was divided according to the pathology for which the treatment was indicated, as well as between those who received Aflibercept (Eylea ® ) and those who received Ranivizumab (Lucentis ® ).
Of the total of 535 injections indicated in this period, only 330 (62%) were applied. This percentage changed during the period, having a minimum in the second week (40% of attendance) and a maximum in the eighth week (92%) coinciding with fewer confinement measures. Regarding the total number of injections indicated each week, it stands out that there was a decrease in last weeks, probably due to less attendance at the consultation during the first weeks of lockdown. Depending on pathological condition, the percentage of assistance was 63% (177) of the total number of injections in patients with AMD, 58% (102) in the case of CME secondary to DR, 72% (48) CME secondary to retinal thrombosis, 94% (33) in the case of myopic patients as well as 80% (32) in the case of other pathological conditions. Depending on the type of injection, the indication of Aflibercept (Eylea ® ) was greater (319 [59%]) than that of Ranibizumab (Lucentis ® ) (216 [41%]), due to hospital policy. The percentage of assistance depending on the type of medication were as follows: 63% (201 injections) in the case of Aflibercept and 72% of Ranivizumab (156 injections applied).
Despite the measures taken to guarantee therapeutic compliance, many patients did not assist with their intravitreal injection appointment. As can be seen from the data, the minimum attendance occurred after the first week, probably due to the uncertainty of the moment as well as the possible belief that the confinement were not going to extend beyond one or two weeks. From that moment there is an increase in attendance. It is still pending to determine the impact on vision acuity derived from this missed attendance.
Non of the authors have financial relations with any company.