Author: Georgios N. Tsiropoulos (Switzerland)
Co-authors: Rodolphe Vallée, Coraline Calci, Daniela Gallo Castro, Aude Ambresin
Purpose
The purpose of this study is to present the patients’ subjective view concerning the monitoring of their wet Age-related Macular Degeneration (wet AMD) during Coronavirus disease 2019 (COVID-19) pandemic, as well as the impact that the techniques of telemedicine could have on it. Two questionnaires were completed by each patient for the fulfillment of this purpose.
Setting/Venue
Swiss Visio Montchoisi (Lausanne, Switzerland) and RétinElysée Ophthalmology Center (Lausanne, Switzerland).
Methods
Patients diagnosed with neovascular AMD (nAMD) of any type (I, II, or III), that had intravitreal anti-Vascular Endothelial Growth Factor (anti-VEGF) injections both before and after the period of confinement due to the COVID-19 pandemic, regardless if the programmed injection interval was respected or not, were included in the study, after signing an informed consent form. Two questionnaires were given to each patient. Our research team explained to each patient how to complete the questionnaires. The patients completed the questionnaires without any time restrictions either in the clinic or in their homes, alone or with the help of their families. The first questionnaire aimed to evaluate the patients’ subjective opinion concerning their adherence to their programmed intravitreal anti-VEGF injections during the period of confinement and to assess their opinion on the future use of telemedicine. The second questionnaire was a visual function questionnaire adapted from National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ25) and focused on the patients’ opinion regarding the change of their visual function during or after the confinement, compared to their visual function before the confinement. The statistical significance level was set to 0.05.
Results
130 of 185 patients (70.2%) responded to the questionnaires. 8.4% responded that they did not respect their assigned injection interval during the confinement (group 1), while the other 91.5% responded that they respected it (group 2). The majority of group 1 (37.5%) responded they did not attend their programmed injection visit to avoid using public transportation. The majority of group 2 (78.7%) considered the continuation of their treatment more important than the risk of contracting COVID-19. Before the lockdown, patients of group 2 were more worried about their vision than patients of group 1 (P=0.0579) and had more need for help from others (P=0.0225). During the lockdown, patients’ NEI-VFQ25 visual function was similar between the two groups. In the event of a future lockdown, 36.3% of group 1 and 8.7% of group 2 would prefer remote monitoring of their wet AMD using telemedicine (P = 0.0204), 54.5% of group 1 and 86.9% of group 2 would prefer to visit the clinic, while 9.0% of group 1 and 4.3% of group 2 would completely avoid the visit. 70% of group 1 and 33.6% of group 2 would rather use the telemedicine application in their home than visiting a telemedicine center (P=0.0367).
Conlusions
COVID-19 pandemic and the resulting confinement was a unique circumstance, in which a large proportion of wet AMD patients did not receive their scheduled treatment, despite the availability of our clinic to provide continuous intravitreal anti-VEGF injections. Our results suggest that during a next confinement due to COVID-19, or circumstances similar to it, the majority of the patients would still prefer to visit the clinic. The patients that missed their intravitreal anti-VEGF injection would prefer remote monitoring of their AMD using telemedicine at a much higher rate than the patients that followed their scheduled injections during the confinement due to COVID-19.
Financial Disclosure
None
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